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Buehler and Steiner Hayward Want Additional Access to Birth Control

The House Health Committee is considering legislation that would allow pharmacists to dispense additional types of contraception without a doctor’s note, as well as a bill that will require the Oregon Health Plan to set up billing codes to allow hospitals to be paid for inserting IUDs after mothers have given birth.
March 21, 2017

The Legislature’s two physicians are backing legislation that would further increase access to birth control, pushing Oregon further to the forefront of women’s reproductive healthcare.

House Bill 3135 would assure that women on the Oregon Health Plan can receive an intrauterine device at the hospital after childbirth, while House Bill 2527 would expand the types of birth control that pharmacists may prescribe to include the vaginal ring and hormonal injections.

In 2015, Oregon paved the way for a national movement to lower barriers to birth control access by allowing pharmacists to dispense birth control pills from behind the counter, without a physician’s prescription.

A woman seeking birth control must simply fill out a screening form that a pharmacist can use to determine whether to dispense. Since the drugs are still behind the counter, they are included in insurer’s prescription drug benefit plan, unlike over-the-counter medications. The policy allows a woman to avoid making an extra, routine trip to her physician, while making it less likely that she’ll lapse in coverage and have an unplanned pregnancy.

“We were the first state in the country to provide over-the-counter hormonal birth control,” said Rep. Knute Buehler, R-Bend, the chief House sponsor of the bills and an orthopedic surgeon. “That legislation has been a model for Legislatures in other states.”

Buehler and co-sponsor Sen. Elizabeth Steiner Hayward, D-Beaverton, said backers of the 2015 legislation had hoped to include these non-invasive forms of birth control in the original legislation, but amended them out to be sure pharmacists could handle just giving out the pill.

“It’s not a huge expansion,” Steiner Hayward said. “Women really appreciate the access to this.”

Steiner Hayward said she’d already seen the new policy put into effect at her local Fred Meyer supermarket, where the in-store pharmacy was enthusiastically advertising the new prescription-free birth control sales.

HB 2527 is “a natural extension of the legislation you enacted in 2015,” said Bill Cross, the lobbyist for the Oregon State Pharmacy Association, which is backing the additional expansion. Pharmacists are also capable of administering vaccinations and dispensing prescription-grade smoking cessation kits without a doctor’s prescription in Oregon.

The Board of Pharmacy will be charged with overseeing the rules for the expanded program and the pharmacist training, which will likely include an online certification module.

Dr. Maria Rodriguez, an obstetrician-gynecologist at Oregon Health & Science University, said that requiring the Oregon Health Plan to pay for IUD placement while the new mother is still in  the hospital will save women an additional visit to a clinic and save the CCOs money in unplanned pregnancies.

“Nearly half of all pregnancies in Oregon are still unplanned,” Rodriguez said, adding that survey reports show that even when mothers who leave the hospital say they’ll return at a later date to get an IUD, only 40 percent actually do.

Oregon Health Authority lobbyist Jeston Black said the agency already authorizes payment for IUD placement for members who are not in a CCO that’s above and beyond the billing package which hospitals receive for childbirth. But some CCOs still haven’t set up a billing process to make this possible. HB 3135 requires that.

“The cost savings would vastly outweigh the cost,” argued Steiner Hayward, who said that IUDs cost between $600 to $800 but last anywhere from three to seven years.

Health Share of Oregon CEO Janet L. Meyer also wrote testimony in support of the IUD legislation: “Ensuring OHP payment for immediate postpartum placement of [long-acting reversible contraceptives] will facilitate our efforts to get the right care to the right people at the right time.”

HB 3135 does not include immigrant women giving birth to Oregon babies who do not have legal permission to live in the United States. A separate piece of legislation, House Bill 3391, would expand post-partum care to the immigrant mothers, but federal statute prohibits the use of federal Medicaid funding to provide post-birth sterilization or contraception for this group of women.

Chris can be reached at [email protected]