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-ap-
proved 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. STE-
VENS, Ms. SCANLON, Mr. SHERMAN, Ms. GARCIA of Texas, Mr. CART-
WRIGHT, 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. KIL-
DEE, Mr. POCAN, Ms. BARRAGA´N, Mr. THANEDAR, Ms. CROCKETT, Mr. 
VARGAS, Ms. SALINAS, Ms. MCCOLLUM, Mr. TONKO, Mrs. CHERFILUS- 
MCCORMICK, Ms. CLARKE of New York, Mr. LARSON of Connecticut, Ms. 
KAMLAGER-DOVE, Ms. LEE of California, Ms. STRICKLAND, Ms. WIL-
LIAMS 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 En-
ergy and Commerce 
VerDate Sep 11 2014 
07:23 Aug 20, 2024
Jkt 049200
PO 00000
Frm 00001
Fmt 6652
Sfmt 6652
E:\BILLS\H9104.IH
H9104
kjohnson on DSK7ZCZBW3PROD with $$_JOB
A BILL 
To amend the Public Health Service Act to establish certain 
duties for pharmacies to ensure provision of Food and 
Drug Administration-approved contraception and medica-
tion related to contraception, and for other purposes. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Access to Birth Control 
Act’’. 
SEC. 2. FINDINGS. 
Congress finds as follows: 
(1) Family planning is basic health care. Access 
to contraception helps people determine if and when 
to become pregnant. Contraception is also a corner-
stone of reproductive autonomy and can help people 
fulfill their educational, professional, and social aspi-
rations. 
(2) As a result of the enactment of the Patient 
Protection and Affordable Care Act (Public Law 
111–148), approximately 151,600,000 individuals in 
the United States were enrolled in private health in-
surance plans in the United States in 2020, includ-
ing 58,000,000 women between the ages of 19 and 
64 who had coverage of contraceptive methods ap-
proved, cleared, or authorized by the Food and Drug 
VerDate Sep 11 2014 
07:23 Aug 20, 2024
Jkt 049200
PO 00000
Frm 00002
Fmt 6652
Sfmt 6201
E:\BILLS\H9104.IH
H9104
kjohnson on DSK7ZCZBW3PROD with $$_JOB
Administration without cost-sharing under such 
plans. 
(3) The Patient Protection and Affordable Care 
Act saved women $1,400,000,000 on birth control 
pills alone in 2013. 
(4) According to the Centers for Disease Con-
trol and Prevention, nearly 2⁄3 of women between the 
ages of 15 and 49 are currently using a contracep-
tive method, and among sexually active women who 
were not seeking pregnancy, nearly 9 in 10 have 
used contraception. 
(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, people in the United 
States face a myriad of barriers in accessing birth 
control, including cost, geography, immigration sta-
tus, language access, discrimination, and stigma. 
These contraceptive barriers are rooted in systemic 
inequities, structural racism, and other forms of op-
pression in our health care system and society. 
(6) In 2019, approximately 2,293,000 preg-
nancies, nearly 42 percent of all pregnancies, in the 
United States were unintended. 
VerDate Sep 11 2014 
07:23 Aug 20, 2024
Jkt 049200
PO 00000
Frm 00003
Fmt 6652
Sfmt 6201
E:\BILLS\H9104.IH
H9104
kjohnson on DSK7ZCZBW3PROD with $$_JOB
(7) Systemic racism and discrimination, as well 
as lack of access to comprehensive sex education, ex-
acerbates severe health inequities and creates addi-
tional barriers to accessing contraception; for exam-
ple, due to high uninsured rates and barriers, His-
panic women with low-incomes experience a signifi-
cantly higher rate of unintended pregnancy (58 per-
cent) compared to their White counterparts (33 per-
cent). In a 2023 study exploring challenges access-
ing contraceptive care among people who identified 
as Asian American, Native Hawaiian, or Pacific Is-
lander, Black or African American, Indigenous, or 
Latina/Latinx, 45 percent of respondents reported 
experiencing at least one challenge accessing contra-
ception in the past year. 
(8) In addition to preventing pregnancy, contra-
ceptives are used for a range of medical purposes, 
such as treating abnormal uterine bleeding, irregular 
menstrual cycles, and endometriosis, as well as for 
people managing other chronic conditions, which are 
generally higher in communities of color due to sys-
temic discrimination. 
(9) The Food and Drug Administration has ap-
proved, cleared, or authorized multiple emergency 
contraceptive methods as safe and effective in pre-
VerDate Sep 11 2014 
07:23 Aug 20, 2024
Jkt 049200
PO 00000
Frm 00004
Fmt 6652
Sfmt 6201
E:\BILLS\H9104.IH
H9104
kjohnson on DSK7ZCZBW3PROD with $$_JOB
venting unintended pregnancy and has approved 
over-the-counter access to some forms of emergency 
contraception for all individuals, regardless of age. If 
taken soon after unprotected sex or primary contra-
ceptive failure, emergency contraception can signifi-
cantly reduce a person’s chance of unintended preg-
nancy. Additionally, in 2023, the Food and Drug 
Administration approved the first over-the-counter 
daily birth control pill which will give people of all 
ages greater access to birth control options without 
a prescription. 
(10) Contraception is a protected fundamental 
right in the United States and access to contracep-
tion should not be impeded by one individual’s per-
sonal beliefs. Providers, including pharmacists, play 
a key role in providing contraceptive services and 
important information about prescription and over- 
the-counter birth control options to people across the 
country. It is critical that contraceptive care is pro-
vided to people of all ages in a supportive way that 
is culturally appropriate and delivered without stig-
ma, bias, or delay. 
(11) Reports of pharmacists refusing to fill pre-
scriptions for contraceptives, including emergency 
contraceptives, or provide emergency contraception 
VerDate Sep 11 2014 
07:23 Aug 20, 2024
Jkt 049200
PO 00000
Frm 00005
Fmt 6652
Sfmt 6201
E:\BILLS\H9104.IH
H9104
kjohnson on DSK7ZCZBW3PROD with $$_JOB
over-the-counter have surfaced in States across the 
Nation, including Alabama, Arizona, California, the 
District of Columbia, Georgia, Illinois, Louisiana, 
Massachusetts, Michigan, Minnesota, Missouri, Mon-
tana, New Hampshire, New Mexico, New York, 
North Carolina, Ohio, Oklahoma, Oregon, Rhode Is-
land, Tennessee, Texas, Washington, West Virginia, 
and Wisconsin. 
(12) Since the Supreme Court decision in 
Dobbs v. Jackson Women’s Health Organization 
(142 S. Ct. 2228 (2022)), there have been increased 
reports of people being denied birth control at phar-
macies. 
(13) In 2022, the Department of Health and 
Human Services issued guidance clarifying that re-
fusing to dispense birth control can be sex discrimi-
nation under section 1557 of the Patient Protection 
and Affordable Care Act (42 U.S.C. 18116). 
SEC. 3. DUTIES OF PHARMACIES TO ENSURE PROVISION OF 
CONTRACEPTION 
AND 
MEDICATION 
RE-
LATED TO CONTRACEPTION. 
Part B of title II of the Public Health Service Act 
(42 U.S.C. 238 et seq.) is amended by adding at the end 
the following: 
VerDate Sep 11 2014 
07:23 Aug 20, 2024
Jkt 049200
PO 00000
Frm 00006
Fmt 6652
Sfmt 6201
E:\BILLS\H9104.IH
H9104
kjohnson on DSK7ZCZBW3PROD with $$_JOB
‘‘SEC. 249. DUTIES OF PHARMACIES TO ENSURE PROVISION 
OF CONTRACEPTION AND MEDICATION RE-
LATED TO CONTRACEPTION. 
‘‘(a) IN GENERAL.—Subject to subsection (c), a 
pharmacy that receives drugs or devices approved, cleared, 
or authorized by the Food and Drug Administration 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-
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— 
VerDate Sep 11 2014 
07:23 Aug 20, 2024
Jkt 049200
PO 00000
Frm 00007
Fmt 6652
Sfmt 6201
E:\BILLS\H9104.IH
H9104
kjohnson on DSK7ZCZBW3PROD with $$_JOB
‘‘(i) locate a pharmacy of the cus-
tomer’s choice or the closest pharmacy 
confirmed to have the contraceptive or the 
medication related to a contraceptive in 
stock; and 
‘‘(ii) refer the customer or transfer 
the prescription to that pharmacy. 
‘‘(B) If the customer prefers for the phar-
macy to order the contraceptive or the medica-
tion related to a contraceptive, the pharmacy 
shall obtain the contraceptive or the medication 
related to a contraceptive under the pharmacy’s 
standard procedure for expedited ordering of 
medication and notify the customer when the 
contraceptive or the medication related to a 
contraceptive arrives. 
‘‘(3) The pharmacy shall ensure that— 
‘‘(A) it does not operate an environment in 
which customers are intimidated, threatened, or 
harassed in the delivery of services relating to 
a request for contraception or a medication re-
lated to contraception; 
‘‘(B) its employees do not interfere with or 
obstruct the delivery of services relating to a re-
VerDate Sep 11 2014 
07:23 Aug 20, 2024
Jkt 049200
PO 00000
Frm 00008
Fmt 6652
Sfmt 6201
E:\BILLS\H9104.IH
H9104
kjohnson on DSK7ZCZBW3PROD with $$_JOB
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 con-
traception or a medication related to contracep-
tion or threaten to breach such confidentiality; 
or 
‘‘(E) its employees do not refuse to return 
a valid, lawful prescription for contraception or 
a medication related to contraception upon cus-
tomer 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-
VerDate Sep 11 2014 
07:23 Aug 20, 2024
Jkt 049200
PO 00000
Frm 00009
Fmt 6652
Sfmt 6201
E:\BILLS\H9104.IH
H9104
kjohnson on DSK7ZCZBW3PROD with $$_JOB
cation related to a contraceptive to a customer in accord-
ance with any of the following: 
‘‘(1) If it is unlawful to dispense the contracep-
tive or the medication related to a contraceptive to 
the customer without a valid, lawful prescription and 
no such prescription is presented. 
‘‘(2) If the customer is unable to pay for the 
contraceptive or the medication related to a contra-
ceptive. 
‘‘(3) If the employee of the pharmacy refuses to 
provide the contraceptive or the medication related 
to a contraceptive on the basis of a professional clin-
ical judgment. 
‘‘(d) RELATION TO OTHER LAWS.— 
‘‘(1) RULE
OF
CONSTRUCTION.—Nothing in 
this section shall be construed to invalidate or limit 
rights, remedies, procedures, or legal standards 
under title VII of the Civil Rights Act of 1964. 
‘‘(2) CERTAIN
CLAIMS.—The Religious Free-
dom Restoration Act of 1993 shall not provide a 
claim concerning, or a defense to a claim under, a 
covered title, or provide a basis for challenging the 
application or enforcement of a covered title. 
‘‘(e) PREEMPTION.—This section does not preempt 
any provision of State law or any professional obligation 
VerDate Sep 11 2014 
07:23 Aug 20, 2024
Jkt 049200
PO 00000
Frm 00010
Fmt 6652
Sfmt 6201
E:\BILLS\H9104.IH
H9104
kjohnson on DSK7ZCZBW3PROD with $$_JOB
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 
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: 
VerDate Sep 11 2014 
07:23 Aug 20, 2024
Jkt 049200
PO 00000
Frm 00011
Fmt 6652
Sfmt 6201
E:\BILLS\H9104.IH
H9104
kjohnson on DSK7ZCZBW3PROD with $$_JOB
‘‘(1) The term ‘contraception’ or ‘contraceptive’ 
means any drug or device approved, cleared, or au-
thorized by the Food and Drug Administration to 
prevent pregnancy. 
‘‘(2) The term ‘employee’ means a person hired, 
by contract or any other form of an agreement, by 
a pharmacy. 
‘‘(3) The term ‘medication related to contracep-
tion’ or ‘medication related to a contraceptive’ 
means any drug or device approved, cleared, or au-
thorized by the Food and Drug Administration that 
a medical professional determines necessary to use 
before or in conjunction with contraception or a con-
traceptive. 
‘‘(4) The term ‘pharmacy’ means an entity 
that— 
‘‘(A) is authorized by a State to engage in 
the business of selling prescription drugs at re-
tail; and 
‘‘(B) employs one or more employees. 
‘‘(5) The term ‘product’ means a drug or device 
approved, cleared, or authorized by the Food and 
Drug Administration. 
‘‘(6) The term ‘professional clinical judgment’ 
means the use of professional knowledge and skills 
VerDate Sep 11 2014 
07:23 Aug 20, 2024
Jkt 049200
PO 00000
Frm 00012
Fmt 6652
Sfmt 6201
E:\BILLS\H9104.IH
H9104
kjohnson on DSK7ZCZBW3PROD with $$_JOB
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. 
‘‘(h) EFFECTIVE DATE.—This section shall take ef-
fect 31 days after the date of enactment of this section, 
without regard to whether the Secretary has issued any 
guidance or final rule regarding this section.’’. 
Æ 
VerDate Sep 11 2014 
07:23 Aug 20, 2024
Jkt 049200
PO 00000
Frm 00013
Fmt 6652
Sfmt 6301
E:\BILLS\H9104.IH
H9104
kjohnson on DSK7ZCZBW3PROD with $$_JOB