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 con-
traception, 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 contracep-
tion, medication related to contraception, and for other 
purposes. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Access to Birth Control 
Act’’. 
SEC. 2. FINDINGS. 
Congress finds as follows: 
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(1) Family planning is basic health care. Access 
to contraception helps prevent unintended pregnancy 
and control the timing and spacing of planned 
births. 
(2) As a result of the enactment of the Patient 
Protection and Affordable Care Act (Public Law 
111–148), nearly 62,800,000 women now have cov-
erage of the full range of Food and Drug Adminis-
tration-approved contraceptive methods without cost 
sharing. 
(3) The Patient Protection and Affordable Care 
Act saved women $1,400,000,000 on birth control 
pills alone in 2013. 
(4) Nearly 2⁄3 of women of reproductive age are 
currently using a contraceptive method. 
(5) Although the Centers for Disease Control 
and Prevention included family planning in its pub-
lished list of the Ten Great Public Health Achieve-
ments in the 20th Century, the United States still 
has one of the highest rates of unintended preg-
nancies among industrialized nations. 
(6) Each year, 2,800,000 pregnancies, nearly 
half of all pregnancies, in the United States are un-
intended, and nearly half of unintended pregnancies 
end in abortion. 
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(7) Access to contraceptives at no cost has been 
found to contribute to significantly lower rates of 
unintended pregnancy and abortion. 
(8) Women who do not use contraception, 
women who have gaps in contraception, and women 
who use contraception inconsistently or incorrectly 
account for 95 percent of unintended pregnancies in 
the United States. 
(9) Prescription contraceptives are used for a 
range of medical purposes in addition to birth con-
trol, such as regulation of cycles and endometriosis. 
(10) The Food and Drug Administration has 
approved emergency contraception as safe and effec-
tive in preventing unintended pregnancy and has ap-
proved over-the-counter access to some forms of 
emergency contraception for all individuals, regard-
less of age. If taken soon after unprotected sex or 
primary contraceptive failure, emergency contracep-
tion can significantly reduce a woman’s chance of 
unintended pregnancy. 
(11) Legal contraception is a protected funda-
mental right in the United States and should not be 
impeded by one individual’s personal beliefs. 
(12) Reports of pharmacists refusing to fill pre-
scriptions for contraceptives or provide emergency 
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contraception over-the-counter, including emergency 
contraceptives, have surfaced in States across the 
Nation, including Alabama, Arizona, California, the 
District of Columbia, Georgia, Illinois, Louisiana, 
Massachusetts, Michigan, Minnesota, Missouri, Mon-
tana, New Hampshire, New Mexico, New York, 
North Carolina, Ohio, Oklahoma, Oregon, Rhode Is-
land, Tennessee, Texas, Washington, West Virginia, 
and Wisconsin. 
SEC. 3. DUTIES OF PHARMACIES TO ENSURE PROVISION OF 
FDA-APPROVED CONTRACEPTION AND MEDI-
CATION RELATED TO CONTRACEPTION. 
Part B of title II of the Public Health Service Act 
(42 U.S.C. 238 et seq.) is amended by adding at the end 
the following: 
‘‘SEC. 249. DUTIES OF PHARMACIES TO ENSURE PROVISION 
OF FDA-APPROVED CONTRACEPTION AND 
MEDICATION RELATED TO CONTRACEPTION. 
‘‘(a) IN GENERAL.—Subject to subsection (c), a 
pharmacy that receives Food and Drug Administration- 
approved drugs or devices in interstate commerce shall 
maintain compliance with the following: 
‘‘(1) If a customer requests a contraceptive or 
a medication related to a contraceptive that is in 
stock, the pharmacy shall ensure that the contracep-
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tive or the medication related to a contraceptive is 
provided to the customer without delay. 
‘‘(2) If a customer requests a contraceptive or 
a medication related to a contraceptive that is not 
in stock and the pharmacy in the normal course of 
business stocks contraception or the medication re-
lated to contraception, the pharmacy shall imme-
diately inform the customer that the contraceptive or 
the medication related to a contraceptive is not in 
stock and without delay offer the customer the fol-
lowing options: 
‘‘(A) If the customer prefers to obtain the 
contraceptive or the medication related to a 
contraceptive through a referral or transfer, the 
pharmacy shall— 
‘‘(i) locate a pharmacy of the cus-
tomer’s choice or the closest pharmacy 
confirmed to have the contraceptive or the 
medication related to a contraceptive in 
stock; and 
‘‘(ii) refer the customer or transfer 
the prescription to that pharmacy. 
‘‘(B) If the customer prefers for the phar-
macy to order the contraceptive or the medica-
tion related to a contraceptive, the pharmacy 
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shall obtain the contraceptive or the medication 
related to a contraceptive under the pharmacy’s 
standard procedure for expedited ordering of 
medication and notify the customer when the 
contraceptive or the medication related to a 
contraceptive arrives. 
‘‘(3) The pharmacy shall ensure that— 
‘‘(A) it does not operate an environment in 
which customers are intimidated, threatened, or 
harassed in the delivery of services relating to 
a request for contraception or a medication re-
lated to contraception; 
‘‘(B) its employees do not interfere with or 
obstruct the delivery of services relating to a re-
quest for contraception or a medication related 
to contraception; 
‘‘(C) its employees do not intentionally 
misrepresent or deceive customers about the 
availability of contraception or a medication re-
lated to contraception or its mechanism of ac-
tion; 
‘‘(D) its employees do not breach medical 
confidentiality with respect to a request for a 
contraception or a medication related to contra-
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ception or threaten to breach such confiden-
tiality; or 
‘‘(E) its employees do not refuse to return 
a valid, lawful prescription for a contraception 
or a medication related to contraception upon 
customer request. 
‘‘(b) CONTRACEPTIVES OR MEDICATION RELATED TO 
A CONTRACEPTIVE NOT ORDINARILY STOCKED.—Noth-
ing in subsection (a)(2) shall be construed to require any 
pharmacy to comply with such subsection if the pharmacy 
does not ordinarily stock contraceptives or medication re-
lated to a contraceptive in the normal course of business. 
‘‘(c) REFUSALS PURSUANT
TO STANDARD PHAR-
MACY PRACTICE.—This section does not prohibit a phar-
macy from refusing to provide a contraceptive or a medi-
cation related to a contraceptive to a customer in accord-
ance with any of the following: 
‘‘(1) If it is unlawful to dispense the contracep-
tive or the medication related to a contraceptive to 
the customer without a valid, lawful prescription and 
no such prescription is presented. 
‘‘(2) If the customer is unable to pay for the 
contraceptive or the medication related to a contra-
ceptive. 
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‘‘(3) If the employee of the pharmacy refuses to 
provide the contraceptive or the medication related 
to a contraceptive on the basis of a professional clin-
ical judgment. 
‘‘(d) RELATION TO OTHER LAWS.— 
‘‘(1) RULE
OF
CONSTRUCTION.—Nothing in 
this section shall be construed to invalidate or limit 
rights, remedies, procedures, or legal standards 
under title VII of the Civil Rights Act of 1964. 
‘‘(2) CERTAIN
CLAIMS.—The Religious Free-
dom Restoration Act of 1993 (42 U.S.C. 2000bb et 
seq.) shall not provide a claim concerning, or a de-
fense to a claim under, a covered title, or provide a 
basis for challenging the application or enforcement 
of a covered title. 
‘‘(e) PREEMPTION.—This section does not preempt 
any provision of State law or any professional obligation 
made applicable by a State board or other entity respon-
sible for licensing or discipline of pharmacies or phar-
macists, to the extent that such State law or professional 
obligation provides protections for customers that are 
greater than the protections provided by this section. 
‘‘(f) ENFORCEMENT.— 
‘‘(1) CIVIL PENALTY.—A pharmacy that vio-
lates a requirement of subsection (a) is liable to the 
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United States for a civil penalty in an amount not 
exceeding $1,000 per day of violation, not to exceed 
$100,000 for all violations adjudicated in a single 
proceeding. 
‘‘(2) PRIVATE CAUSE OF ACTION.—Any person 
aggrieved as a result of a violation of a requirement 
of subsection (a) may, in any court of competent ju-
risdiction, commence a civil action against the phar-
macy involved to obtain appropriate relief, including 
actual and punitive damages, injunctive relief, and a 
reasonable attorney’s fee and cost. 
‘‘(3) LIMITATIONS.—A civil action under para-
graph (1) or (2) may not be commenced against a 
pharmacy after the expiration of the 5-year period 
beginning on the date on which the pharmacy alleg-
edly engaged in the violation involved. 
‘‘(g) DEFINITIONS.—In this section: 
‘‘(1) The term ‘contraception’ or ‘contraceptive’ 
means any drug or device approved by the Food and 
Drug Administration to prevent pregnancy. 
‘‘(2) The term ‘employee’ means a person hired, 
by contract or any other form of an agreement, by 
a pharmacy. 
‘‘(3) The term ‘medication related to contracep-
tion’ or ‘medication related to a contraceptive’ 
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means any drug or device approved by the Food and 
Drug Administration that a medical professional de-
termines necessary to use before or in conjunction 
with contraception or a contraceptive. 
‘‘(4) The term ‘pharmacy’ means an entity 
that— 
‘‘(A) is authorized by a State to engage in 
the business of selling prescription drugs at re-
tail; and 
‘‘(B) employs one or more employees. 
‘‘(5) The term ‘product’ means a Food and 
Drug Administration-approved drug or device. 
‘‘(6) The term ‘professional clinical judgment’ 
means the use of professional knowledge and skills 
to form a clinical judgment, in accordance with pre-
vailing medical standards. 
‘‘(7) The term ‘without delay’, with respect to 
a pharmacy providing, providing a referral for, or 
ordering contraception or a medication related to 
contraception, or transferring the prescription for 
contraception or a medication related to contracep-
tion, means within the usual and customary time-
frame at the pharmacy for providing, providing a re-
ferral for, or ordering other products, or transferring 
the prescription for other products, respectively. 
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‘‘(h) EFFECTIVE DATE.—This section shall take ef-
fect on the 31st day after the date of the enactment of 
this section, without regard to whether the Secretary has 
issued any guidance or final rule regarding this section.’’. 
Æ 
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