Lawmakers consider allowing a full year of birth control pills with a single prescription

  • Birth Control Pill Container Fuse

  • Kali Wampler sits on the front porch of her home in Weare on Wednesday. Wampler spoke at a Senate Commerce Committee hearing Feb. 20 in support of legislation that would raise the cap on birth control prescriptions from a three-month supply to a year’s worth. Elizabeth Frantz / Monitor staff

  • Kali Wampler of Weare at her home on Wednesday, Feb. 28, 2018. (ELIZABETH FRANTZ / Monitor staff) Elizabeth Frantz—Monitor staff

  • Kali Wampler of Weare at her home on Wednesday, Feb. 28, 2018. (ELIZABETH FRANTZ / Monitor staff) Elizabeth Frantz—Monitor staff

Monitor staff
Thursday, March 01, 2018

Preparing for a semester abroad, Kali Wampler knew one packing item was non-negotiable: birth control. The New England College student, then 20, soon found out that obtaining so many pills in advance of her multimonth, 25,000-mile trip across the world was nearly impossible.

New Hampshire has a three-month cap on birth control prescriptions in the state; and most prescriptions are dispensed monthly. She needed the pills to manage cramps and menstruation, but she kept hitting roadblocks when trying to get that much medicine all at once.

Absent a legal guarantee, it took an appeal to the insurance company to get the necessary multimonth prescription extension, and then only after presenting detailed evidence of her plans abroad. The final prescription still came up short; to conserve supply, Wampler was ultimately forced to choose between maintaining comfort at seas or cutting short her birth control by 10 days upon her return, she said.

Wampler, now 27, married and living in Weare, says she’s an example of the need to change the state’s prescribing laws.

“My story is unique,” she said, speaking at a hearing in the Senate Commerce Committee Feb. 20. “I was literally at sea and could not get to a pharmacy to refill my prescription, but the reality is that New Hampshire women face barriers to accessing the contraception they need every day.”

A bipartisan effort to give women a full-year supply of birth control pills with a single prescription is currently making its way though the State House.

Senate Bill 421 would lift the present three-month cap for contraceptive prescriptions, raising it to 12 months. Under the proposed law, doctors would prescribe 12 months of the medication, and insurance carriers would be mandated to cover it without imposing co-pays. Newly prescribed patients could walk into pharmacies and leave with a year’s supply of contraceptives.

The bill, championed by Planned Parenthood and health care industry groups, is meant to address a long-standing problem for those taking “the pill” – forgetfulness. Often distributed in packs of 28, and designed to be taken daily, the oral contraceptives require diligence to be effective. Having to obtain refill prescriptions every several months can prove difficult for some, setting up potential delays and lapses in use. Missing a week or even days can carry side effects for women who rely on the pill, or lead to unplanned pregnancy.

Broadening the potential length of prescriptions to a year can help smooth over the bumps that the current constant renewal periods create, advocates say.

Industry representatives appear to agree. The new legislation came out of a unanimous recommendation by a study commission last year, comprising organizations including the state’s Nurses Association, Hospital Association and Pharmacists’ Association.

Around a quarter of all women who use contraceptives report missing days due to difficulty getting prescription renewal, according to a 2011 study by the American College of Obstetricians and Gynecologists. Supporters say the bill would benefit low-income people with less time to organize renewed prescriptions.

The bill has been untested in the political arena, but advocates are nonetheless hopeful. In contrast to its controversial companion issue, abortion – on which bills are earning divisive committee votes in all corners of the State House – expanding access to contraceptives tends to enjoy bipartisan support.

The present bill – which is awaiting a vote in the Senate Commerce Committee – has bipartisan sponsorship. And on Feb. 8, the House voted in favor of House Bill 1822, which would allow pharmacists to prescribe oral contraceptives without a doctor’s visit, in a voice vote.

Sen. Andy Sanborn, R-Bedford, a member of the commerce committee and a staunch conservative, said he’s been pressing for broader access for years – first submitting a bill in 2012 – and is a supporter of allowing unlimited access to the medication without prescriptions. Sanborn’s past efforts have not advanced, with Democrats historically arguing they applied too broadly and could create health risks for those who may have allergic reactions and not be aware. But he said he supports the present bill.

“I believe in true equality,” he said. “I’ve always been frustrated that men can walk into a grocery store with access to birth control, but we don’t allow women to do it. I just think it’s wrong.”

At the commerce committee hearing, the reaction was largely positive. But some stakeholders raised some concerns. The bill could drive up costs for the Department of Health and Human Services, which helps pay for coverage through Medicaid, a representative said.

And Heidi Kroll, a representative for America’s Health Insurance Plans – a lobbying organization for the industry – pointed to the risk that first-time users receive a 12-month prescription for the wrong medication, necessitating a second prescription and adding to costs. Kroll recommended that the bill be tweaked to mandate a three-month trial period for first-time users, followed by the option for 12 months.

Still, supporters say the big-picture-level political support is there.

Kayla Montgomery, director of advocacy and organizing for Planned Parenthood New Hampshire, said that in a state that already has the lowest unintended pregnancy rate, lawmakers in Concord are receptive to bills increasing access to contraceptives. Still, at 43 percent, New Hampshire’s unplanned pregnancy rate is open to improvement, Montgomery said.

“New Hampshire has a long-standing bipartisan commitment to ensuring that women are able to access affordable contraception to manage their health and unintended pregnancy and I believe that the majority of the Senate agrees,” she said.

(Ethan DeWitt can be reached at edewitt@cmonitor.com, or on Twitter at @edewittNH.)