I 

116TH CONGRESS 

1ST SESSION H. R. 2182 

To establish certain duties for pharmacies to ensure provision of Food and 

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

IN THE HOUSE OF REPRESENTATIVES 

APRIL 9, 2019 

Mrs. CAROLYN B. MALONEY of New York (for herself, Ms. NORTON, Ms. 

SPEIER, Mr. GRIJALVA, Ms. MOORE, Mr. CONNOLLY, Mr. DEFAZIO, and 

Ms. BONAMICI) introduced the following bill; which was referred to the 

Committee on Energy and Commerce 

A BILL 

To establish certain duties for pharmacies to ensure provision 

of Food and Drug Administration-approved contraception, 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: 


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

2 to contraception helps prevent unintended pregnancy 

3 and control the timing and spacing of planned 

4 births. 

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

6 Protection and Affordable Care Act (Public Law 

7 111–148), nearly 62,800,000 women now have cov8 erage of the full range of Food and Drug Adminis9 tration-approved contraceptive methods without cost 

10 sharing. 

11 (3) The Patient Protection and Affordable Care 

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

13 pills alone in 2013. 

(4) Nearly 2 14 ⁄3 of women of reproductive age are 

15 currently using a contraceptive method. 

16 (5) Although the Centers for Disease Control 

17 and Prevention included family planning in its pub18 lished list of the Ten Great Public Health Achieve19 ments in the 20th Century, the United States still 

20 has one of the highest rates of unintended preg21 nancies among industrialized nations. 

22 (6) Each year, 2,800,000 pregnancies, nearly 

23 half of all pregnancies, in the United States are un24 intended, and nearly half of unintended pregnancies 

25 end in abortion. 


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1 (7) Access to contraceptives at no cost has been 

2 found to contribute to significantly lower rates of 

3 unintended pregnancy and abortion. 

4 (8) Women who do not use contraception, 

5 women who have gaps in contraception, and women 

6 who use contraception inconsistently or incorrectly 

7 account for 95 percent of unintended pregnancies in 

8 the United States. 

9 (9) Prescription contraceptives are used for a 

10 range of medical purposes in addition to birth con11 trol, such as regulation of cycles and endometriosis. 

12 (10) The Food and Drug Administration has 

13 approved emergency contraception as safe and effec14 tive in preventing unintended pregnancy and has ap15 proved over-the-counter access to some forms of 

16 emergency contraception for all individuals, regard17 less of age. If taken soon after unprotected sex or 

18 primary contraceptive failure, emergency contracep19 tion can significantly reduce a woman’s chance of 

20 unintended pregnancy. 

21 (11) Legal contraception is a protected funda22 mental right in the United States and should not be 

23 impeded by one individual’s personal beliefs. 

24 (12) Reports of pharmacists refusing to fill pre25 scriptions for contraceptives or provide emergency 


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1 contraception over-the-counter, including emergency 

2 contraceptives, have surfaced in States across the 

3 Nation, including Alabama, Arizona, California, the 

4 District of Columbia, Georgia, Illinois, Louisiana, 

5 Massachusetts, Michigan, Minnesota, Missouri, Mon6 tana, New Hampshire, New Mexico, New York, 

7 North Carolina, Ohio, Oklahoma, Oregon, Rhode Is8 land, Tennessee, Texas, Washington, West Virginia, 

9 and Wisconsin. 

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

11 FDA-APPROVED CONTRACEPTION AND MEDI12 CATION RELATED TO CONTRACEPTION. 

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

14 (42 U.S.C. 238 et seq.) is amended by adding at the end 

15 the following: 

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

17 OF FDA-APPROVED CONTRACEPTION AND 

18 MEDICATION RELATED TO CONTRACEPTION. 

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

20 pharmacy that receives Food and Drug Administration21 approved drugs or devices in interstate commerce shall 

22 maintain compliance with the following: 

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

24 a medication related to a contraceptive that is in 

25 stock, the pharmacy shall ensure that the contracepVerDate Sep 11 2014 21:20 Apr 17, 2019 Jkt 089200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H2182.IH H2182

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1 tive or the medication related to a contraceptive is 

2 provided to the customer without delay. 

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

4 a medication related to a contraceptive that is not 

5 in stock and the pharmacy in the normal course of 

6 business stocks contraception or the medication re7 lated to contraception, the pharmacy shall imme8 diately inform the customer that the contraceptive or 

9 the medication related to a contraceptive is not in 

10 stock and without delay offer the customer the fol11 lowing options: 

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

13 contraceptive or the medication related to a 

14 contraceptive through a referral or transfer, the 

15 pharmacy shall— 

16 ‘‘(i) locate a pharmacy of the cus17 tomer’s choice or the closest pharmacy 

18 confirmed to have the contraceptive or the 

19 medication related to a contraceptive in 

20 stock; and 

21 ‘‘(ii) refer the customer or transfer 

22 the prescription to that pharmacy. 

23 ‘‘(B) If the customer prefers for the phar24 macy to order the contraceptive or the medica25 tion related to a contraceptive, the pharmacy 


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1 shall obtain the contraceptive or the medication 

2 related to a contraceptive under the pharmacy’s 

3 standard procedure for expedited ordering of 

4 medication and notify the customer when the 

5 contraceptive or the medication related to a 

6 contraceptive arrives. 

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

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

9 which customers are intimidated, threatened, or 

10 harassed in the delivery of services relating to 

11 a request for contraception or a medication re12 lated to contraception; 

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

14 obstruct the delivery of services relating to a re15 quest for contraception or a medication related 

16 to contraception; 

17 ‘‘(C) its employees do not intentionally 

18 misrepresent or deceive customers about the 

19 availability of contraception or a medication re20 lated to contraception or its mechanism of ac21 tion; 

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

23 confidentiality with respect to a request for a 

24 contraception or a medication related to contraVerDate Sep 11 2014 21:20 Apr 17, 2019 Jkt 089200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\H2182.IH H2182

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1 ception or threaten to breach such confiden2 tiality; or 

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

4 a valid, lawful prescription for a contraception 

5 or a medication related to contraception upon 

6 customer request. 

7 ‘‘(b) CONTRACEPTIVES OR MEDICATION RELATED TO

8 A CONTRACEPTIVE NOT ORDINARILY STOCKED.—Noth9 ing in subsection (a)(2) shall be construed to require any 

10 pharmacy to comply with such subsection if the pharmacy 

11 does not ordinarily stock contraceptives or medication re12 lated to a contraceptive in the normal course of business. 

13 ‘‘(c) REFUSALS PURSUANT TO STANDARD PHAR14 MACY PRACTICE.—This section does not prohibit a phar15 macy from refusing to provide a contraceptive or a medi16 cation related to a contraceptive to a customer in accord17 ance with any of the following: 

18 ‘‘(1) If it is unlawful to dispense the contracep19 tive or the medication related to a contraceptive to 

20 the customer without a valid, lawful prescription and 

21 no such prescription is presented. 

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

23 contraceptive or the medication related to a contra24 ceptive. 


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

2 provide the contraceptive or the medication related 

3 to a contraceptive on the basis of a professional clin4 ical judgment. 

5 ‘‘(d) RELATION TO OTHER LAWS.— 

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

7 this section shall be construed to invalidate or limit 

8 rights, remedies, procedures, or legal standards 

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

10 ‘‘(2) CERTAIN CLAIMS.—The Religious Free11 dom Restoration Act of 1993 (42 U.S.C. 2000bb et 

12 seq.) shall not provide a claim concerning, or a de13 fense to a claim under, a covered title, or provide a 

14 basis for challenging the application or enforcement 

15 of a covered title. 

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

17 any provision of State law or any professional obligation 

18 made applicable by a State board or other entity respon19 sible for licensing or discipline of pharmacies or phar20 macists, to the extent that such State law or professional 

21 obligation provides protections for customers that are 

22 greater than the protections provided by this section. 

23 ‘‘(f) ENFORCEMENT.— 

24 ‘‘(1) CIVIL PENALTY.—A pharmacy that vio25 lates a requirement of subsection (a) is liable to the 


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1 United States for a civil penalty in an amount not 

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

3 $100,000 for all violations adjudicated in a single 

4 proceeding. 

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

6 aggrieved as a result of a violation of a requirement 

7 of subsection (a) may, in any court of competent ju8 risdiction, commence a civil action against the phar9 macy involved to obtain appropriate relief, including 

10 actual and punitive damages, injunctive relief, and a 

11 reasonable attorney’s fee and cost. 

12 ‘‘(3) LIMITATIONS.—A civil action under para13 graph (1) or (2) may not be commenced against a 

14 pharmacy after the expiration of the 5-year period 

15 beginning on the date on which the pharmacy alleg16 edly engaged in the violation involved. 

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

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

19 means any drug or device approved by the Food and 

20 Drug Administration to prevent pregnancy. 

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

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

23 a pharmacy. 

24 ‘‘(3) The term ‘medication related to contracep25 tion’ or ‘medication related to a contraceptive’ 


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1 means any drug or device approved by the Food and 

2 Drug Administration that a medical professional de3 termines necessary to use before or in conjunction 

4 with contraception or a contraceptive. 

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

6 that— 

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

8 the business of selling prescription drugs at re9 tail; and 

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

11 ‘‘(5) The term ‘product’ means a Food and 

12 Drug Administration-approved drug or device. 

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

14 means the use of professional knowledge and skills 

15 to form a clinical judgment, in accordance with pre16 vailing medical standards. 

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

18 a pharmacy providing, providing a referral for, or 

19 ordering contraception or a medication related to 

20 contraception, or transferring the prescription for 

21 contraception or a medication related to contracep22 tion, means within the usual and customary time23 frame at the pharmacy for providing, providing a re24 ferral for, or ordering other products, or transferring 

25 the prescription for other products, respectively. 


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1 ‘‘(h) EFFECTIVE DATE.—This section shall take ef2 fect on the 31st day after the date of the enactment of 

3 this section, without regard to whether the Secretary has 

4 issued any guidance or final rule regarding this section.’’. 

Æ 


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