I 

118TH CONGRESS 

2D SESSION H. R. 9104 

To amend the Public Health Service Act to establish certain duties for 

pharmacies to ensure provision of Food and Drug Administration-approved contraception and medication related to contraception, and for 

other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

JULY 23, 2024 

Ms. KELLY of Illinois (for herself, Ms. DELBENE, Mr. FOSTER, Ms. BUSH, 

Mr. SARBANES, Mr. VEASEY, Ms. NORTON, Ms. BROWNLEY, Ms. STEVENS, Ms. SCANLON, Mr. SHERMAN, Ms. GARCIA of Texas, Mr. CARTWRIGHT, Mr. GREEN of Texas, Mrs. WATSON COLEMAN, Mr. ALLRED, 

Ms. STANSBURY, Ms. SEWELL, Ms. WASSERMAN SCHULTZ, Mr. TAKANO, 

Ms. WILSON of Florida, Mr. KILMER, Ms. CASTOR of Florida, Mr. KILDEE, Mr. POCAN, Ms. BARRAGA ́N, Mr. THANEDAR, Ms. CROCKETT, Mr. 

VARGAS, Ms. SALINAS, Ms. MCCOLLUM, Mr. TONKO, Mrs. CHERFILUSMCCORMICK, Ms. CLARKE of New York, Mr. LARSON of Connecticut, Ms. 

KAMLAGER-DOVE, Ms. LEE of California, Ms. STRICKLAND, Ms. WILLIAMS of Georgia, Mr. MFUME, Mr. BERA, Ms. MATSUI, Ms. LOIS

FRANKEL of Florida, Mr. DESAULNIER, Mr. LEVIN, Ms. PORTER, Ms. 

BLUNT ROCHESTER, Mr. TRONE, Ms. MCCLELLAN, Ms. ADAMS, Mr. 

ESPAILLAT, Mr. IVEY, Mr. NICKEL, Mr. STANTON, Mr. PHILLIPS, Mr. 

GARAMENDI, Ms. OCASIO-CORTEZ, Mr. GOTTHEIMER, Ms. DEGETTE, 

Mr. SWALWELL, Mr. SCHIFF, Mr. FROST, Mr. MOULTON, Mr. COHEN, 

Ms. CHU, Mr. CONNOLLY, Mrs. RAMIREZ, Ms. TLAIB, Mrs. TRAHAN, Mr. 

JOHNSON of Georgia, Mr. DELUZIO, Mr. GOLDMAN of New York, Mr. 

GOMEZ, Mrs. FOUSHEE, Mr. LIEU, Mr. ROBERT GARCIA of California, 

Mr. NEGUSE, Mr. MULLIN, Mr. EVANS, Mr. CASE, Ms. TITUS, Ms. 

SHERRILL, Ms. DELAURO, Ms. KUSTER, Ms. CARAVEO, Mr. KENNEDY, 

Ms. SCHOLTEN, Mr. KIM of New Jersey, Ms. OMAR, and Mrs. HAYES) 

introduced the following bill; which was referred to the Committee on Energy and Commerce 


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A BILL 

To amend the Public Health Service Act to establish certain 

duties for pharmacies to ensure provision of Food and 

Drug Administration-approved contraception and medication related to contraception, and for other purposes. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Access to Birth Control 

5 Act’’. 

6 SEC. 2. FINDINGS. 

7 Congress finds as follows: 

8 (1) Family planning is basic health care. Access 

9 to contraception helps people determine if and when 

10 to become pregnant. Contraception is also a corner11 stone of reproductive autonomy and can help people 

12 fulfill their educational, professional, and social aspi13 rations. 

14 (2) As a result of the enactment of the Patient 

15 Protection and Affordable Care Act (Public Law 

16 111–148), approximately 151,600,000 individuals in 

17 the United States were enrolled in private health in18 surance plans in the United States in 2020, includ19 ing 58,000,000 women between the ages of 19 and 

20 64 who had coverage of contraceptive methods ap21 proved, cleared, or authorized by the Food and Drug 


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1 Administration without cost-sharing under such 

2 plans. 

3 (3) The Patient Protection and Affordable Care 

4 Act saved women $1,400,000,000 on birth control 

5 pills alone in 2013. 

6 (4) According to the Centers for Disease Control and Prevention, nearly 2 7 ⁄3 of women between the 

8 ages of 15 and 49 are currently using a contracep9 tive method, and among sexually active women who 

10 were not seeking pregnancy, nearly 9 in 10 have 

11 used contraception. 

12 (5) Although the Centers for Disease Control 

13 and Prevention included family planning in its pub14 lished list of the Ten Great Public Health Achieve15 ments in the 20th Century, people in the United 

16 States face a myriad of barriers in accessing birth 

17 control, including cost, geography, immigration sta18 tus, language access, discrimination, and stigma. 

19 These contraceptive barriers are rooted in systemic 

20 inequities, structural racism, and other forms of op21 pression in our health care system and society. 

22 (6) In 2019, approximately 2,293,000 preg23 nancies, nearly 42 percent of all pregnancies, in the 

24 United States were unintended. 


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1 (7) Systemic racism and discrimination, as well 

2 as lack of access to comprehensive sex education, ex3 acerbates severe health inequities and creates addi4 tional barriers to accessing contraception; for exam5 ple, due to high uninsured rates and barriers, His6 panic women with low-incomes experience a signifi7 cantly higher rate of unintended pregnancy (58 per8 cent) compared to their White counterparts (33 per9 cent). In a 2023 study exploring challenges access10 ing contraceptive care among people who identified 

11 as Asian American, Native Hawaiian, or Pacific Is12 lander, Black or African American, Indigenous, or 

13 Latina/Latinx, 45 percent of respondents reported 

14 experiencing at least one challenge accessing contra15 ception in the past year. 

16 (8) In addition to preventing pregnancy, contra17 ceptives are used for a range of medical purposes, 

18 such as treating abnormal uterine bleeding, irregular 

19 menstrual cycles, and endometriosis, as well as for 

20 people managing other chronic conditions, which are 

21 generally higher in communities of color due to sys22 temic discrimination. 

23 (9) The Food and Drug Administration has ap24 proved, cleared, or authorized multiple emergency 

25 contraceptive methods as safe and effective in preVerDate Sep 11 2014 07:23 Aug 20, 2024 Jkt 049200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H9104.IH H9104

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1 venting unintended pregnancy and has approved 

2 over-the-counter access to some forms of emergency 

3 contraception for all individuals, regardless of age. If 

4 taken soon after unprotected sex or primary contra5 ceptive failure, emergency contraception can signifi6 cantly reduce a person’s chance of unintended preg7 nancy. Additionally, in 2023, the Food and Drug 

8 Administration approved the first over-the-counter 

9 daily birth control pill which will give people of all 

10 ages greater access to birth control options without 

11 a prescription. 

12 (10) Contraception is a protected fundamental 

13 right in the United States and access to contracep14 tion should not be impeded by one individual’s per15 sonal beliefs. Providers, including pharmacists, play 

16 a key role in providing contraceptive services and 

17 important information about prescription and over18 the-counter birth control options to people across the 

19 country. It is critical that contraceptive care is pro20 vided to people of all ages in a supportive way that 

21 is culturally appropriate and delivered without stig22 ma, bias, or delay. 

23 (11) Reports of pharmacists refusing to fill pre24 scriptions for contraceptives, including emergency 

25 contraceptives, or provide emergency contraception 


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1 over-the-counter have surfaced in States across the 

2 Nation, including Alabama, Arizona, California, the 

3 District of Columbia, Georgia, Illinois, Louisiana, 

4 Massachusetts, Michigan, Minnesota, Missouri, Mon5 tana, New Hampshire, New Mexico, New York, 

6 North Carolina, Ohio, Oklahoma, Oregon, Rhode Is7 land, Tennessee, Texas, Washington, West Virginia, 

8 and Wisconsin. 

9 (12) Since the Supreme Court decision in 

10 Dobbs v. Jackson Women’s Health Organization 

11 (142 S. Ct. 2228 (2022)), there have been increased 

12 reports of people being denied birth control at phar13 macies. 

14 (13) In 2022, the Department of Health and 

15 Human Services issued guidance clarifying that re16 fusing to dispense birth control can be sex discrimi17 nation under section 1557 of the Patient Protection 

18 and Affordable Care Act (42 U.S.C. 18116). 

19 SEC. 3. DUTIES OF PHARMACIES TO ENSURE PROVISION OF 

20 CONTRACEPTION AND MEDICATION RE21 LATED TO CONTRACEPTION. 

22 Part B of title II of the Public Health Service Act 

23 (42 U.S.C. 238 et seq.) is amended by adding at the end 

24 the following: 


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1 ‘‘SEC. 249. DUTIES OF PHARMACIES TO ENSURE PROVISION 

2 OF CONTRACEPTION AND MEDICATION RE3 LATED TO CONTRACEPTION. 

4 ‘‘(a) IN GENERAL.—Subject to subsection (c), a 

5 pharmacy that receives drugs or devices approved, cleared, 

6 or authorized by the Food and Drug Administration in 

7 interstate commerce shall maintain compliance with the 

8 following: 

9 ‘‘(1) If a customer requests a contraceptive or 

10 a medication related to a contraceptive that is in 

11 stock, the pharmacy shall ensure that the contracep12 tive or the medication related to a contraceptive is 

13 provided to the customer without delay. 

14 ‘‘(2) If a customer requests a contraceptive or 

15 a medication related to a contraceptive that is not 

16 in stock and the pharmacy in the normal course of 

17 business stocks contraception or the medication re18 lated to contraception, the pharmacy shall imme19 diately inform the customer that the contraceptive or 

20 the medication related to a contraceptive is not in 

21 stock and without delay offer the customer the fol22 lowing options: 

23 ‘‘(A) If the customer prefers to obtain the 

24 contraceptive or the medication related to a 

25 contraceptive through a referral or transfer, the 

26 pharmacy shall— 


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1 ‘‘(i) locate a pharmacy of the cus2 tomer’s choice or the closest pharmacy 

3 confirmed to have the contraceptive or the 

4 medication related to a contraceptive in 

5 stock; and 

6 ‘‘(ii) refer the customer or transfer 

7 the prescription to that pharmacy. 

8 ‘‘(B) If the customer prefers for the phar9 macy to order the contraceptive or the medica10 tion related to a contraceptive, the pharmacy 

11 shall obtain the contraceptive or the medication 

12 related to a contraceptive under the pharmacy’s 

13 standard procedure for expedited ordering of 

14 medication and notify the customer when the 

15 contraceptive or the medication related to a 

16 contraceptive arrives. 

17 ‘‘(3) The pharmacy shall ensure that— 

18 ‘‘(A) it does not operate an environment in 

19 which customers are intimidated, threatened, or 

20 harassed in the delivery of services relating to 

21 a request for contraception or a medication re22 lated to contraception; 

23 ‘‘(B) its employees do not interfere with or 

24 obstruct the delivery of services relating to a reVerDate Sep 11 2014 07:23 Aug 20, 2024 Jkt 049200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\H9104.IH H9104

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1 quest for contraception or a medication related 

2 to contraception; 

3 ‘‘(C) its employees do not intentionally 

4 misrepresent or deceive customers about the 

5 availability of contraception or a medication re6 lated to contraception or its mechanism of ac7 tion; 

8 ‘‘(D) its employees do not breach medical 

9 confidentiality with respect to a request for con10 traception or a medication related to contracep11 tion or threaten to breach such confidentiality; 

12 or 

13 ‘‘(E) its employees do not refuse to return 

14 a valid, lawful prescription for contraception or 

15 a medication related to contraception upon cus16 tomer request. 

17 ‘‘(b) CONTRACEPTIVES OR MEDICATION RELATED TO

18 A CONTRACEPTIVE NOT ORDINARILY STOCKED.—Noth19 ing in subsection (a)(2) shall be construed to require any 

20 pharmacy to comply with such subsection if the pharmacy 

21 does not ordinarily stock contraceptives or medication re22 lated to a contraceptive in the normal course of business. 

23 ‘‘(c) REFUSALS PURSUANT TO STANDARD PHAR24 MACY PRACTICE.—This section does not prohibit a phar25 macy from refusing to provide a contraceptive or a mediVerDate Sep 11 2014 07:23 Aug 20, 2024 Jkt 049200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\H9104.IH H9104

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1 cation related to a contraceptive to a customer in accord2 ance with any of the following: 

3 ‘‘(1) If it is unlawful to dispense the contracep4 tive or the medication related to a contraceptive to 

5 the customer without a valid, lawful prescription and 

6 no such prescription is presented. 

7 ‘‘(2) If the customer is unable to pay for the 

8 contraceptive or the medication related to a contra9 ceptive. 

10 ‘‘(3) If the employee of the pharmacy refuses to 

11 provide the contraceptive or the medication related 

12 to a contraceptive on the basis of a professional clin13 ical judgment. 

14 ‘‘(d) RELATION TO OTHER LAWS.— 

15 ‘‘(1) RULE OF CONSTRUCTION.—Nothing in 

16 this section shall be construed to invalidate or limit 

17 rights, remedies, procedures, or legal standards 

18 under title VII of the Civil Rights Act of 1964. 

19 ‘‘(2) CERTAIN CLAIMS.—The Religious Free20 dom Restoration Act of 1993 shall not provide a 

21 claim concerning, or a defense to a claim under, a 

22 covered title, or provide a basis for challenging the 

23 application or enforcement of a covered title. 

24 ‘‘(e) PREEMPTION.—This section does not preempt 

25 any provision of State law or any professional obligation 


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1 made applicable by a State board or other entity respon2 sible for licensing or discipline of pharmacies or phar3 macists, to the extent that such State law or professional 

4 obligation provides protections for customers that are 

5 greater than the protections provided by this section. 

6 ‘‘(f) ENFORCEMENT.— 

7 ‘‘(1) CIVIL PENALTY.—A pharmacy that vio8 lates a requirement of subsection (a) is liable to the 

9 United States for a civil penalty in an amount not 

10 exceeding $1,000 per day of violation, not to exceed 

11 $100,000 for all violations adjudicated in a single 

12 proceeding. 

13 ‘‘(2) PRIVATE CAUSE OF ACTION.—Any person 

14 aggrieved as a result of a violation of a requirement 

15 of subsection (a) may, in any court of competent ju16 risdiction, commence a civil action against the phar17 macy involved to obtain appropriate relief, including 

18 actual and punitive damages, injunctive relief, and a 

19 reasonable attorney’s fee and cost. 

20 ‘‘(3) LIMITATIONS.—A civil action under para21 graph (1) or (2) may not be commenced against a 

22 pharmacy after the expiration of the 5-year period 

23 beginning on the date on which the pharmacy alleg24 edly engaged in the violation involved. 

25 ‘‘(g) DEFINITIONS.—In this section: 


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1 ‘‘(1) The term ‘contraception’ or ‘contraceptive’ 

2 means any drug or device approved, cleared, or au3 thorized by the Food and Drug Administration to 

4 prevent pregnancy. 

5 ‘‘(2) The term ‘employee’ means a person hired, 

6 by contract or any other form of an agreement, by 

7 a pharmacy. 

8 ‘‘(3) The term ‘medication related to contracep9 tion’ or ‘medication related to a contraceptive’ 

10 means any drug or device approved, cleared, or au11 thorized by the Food and Drug Administration that 

12 a medical professional determines necessary to use 

13 before or in conjunction with contraception or a con14 traceptive. 

15 ‘‘(4) The term ‘pharmacy’ means an entity 

16 that— 

17 ‘‘(A) is authorized by a State to engage in 

18 the business of selling prescription drugs at re19 tail; and 

20 ‘‘(B) employs one or more employees. 

21 ‘‘(5) The term ‘product’ means a drug or device 

22 approved, cleared, or authorized by the Food and 

23 Drug Administration. 

24 ‘‘(6) The term ‘professional clinical judgment’ 

25 means the use of professional knowledge and skills 


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1 to form a clinical judgment, in accordance with pre2 vailing medical standards. 

3 ‘‘(7) The term ‘without delay’, with respect to 

4 a pharmacy providing, providing a referral for, or 

5 ordering contraception or a medication related to 

6 contraception, or transferring the prescription for 

7 contraception or a medication related to contracep8 tion, means within the usual and customary time9 frame at the pharmacy for providing, providing a re10 ferral for, or ordering other products, or transferring 

11 the prescription for other products, respectively. 

12 ‘‘(h) EFFECTIVE DATE.—This section shall take ef13 fect 31 days after the date of enactment of this section, 

14 without regard to whether the Secretary has issued any 

15 guidance or final rule regarding this section.’’. 

Æ 


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