Policy makers, state and federal, have placed many hurdles between the public and health care. This is especially true for women hoping to prevent pregnancy.
So we’re glad a state proposal to create a standing order for hormonal birth control remains viable in the Iowa Legislature, allowing pharmacists to dispense pills, vaginal rings and patches — even as we lament the broader lack of access that sparked Gov. Kim Reynolds to advocate on behalf of the bill.
Currently, obtaining birth control in Iowa requires a doctor’s visit for a prescription, which can be a barrier to those without health insurance, who have difficulty taking time off work, who live in areas that lack health care professionals willing to write prescriptions for the prevention of pregnancy, or who have experienced recent closure of specialized family planning services.
In 1960, when birth control pills were first introduced to consumers, a by-prescription-only mandate was prudent. Over the years, however, pill formulations changed, making the drug as benign, if not more so, than others sold unregulated in drugstore aisles.
The legislative proposal, amended this week in a Senate subcommittee, does not move hormonal contraceptive from behind the pharmacists’ counter, but would change the landscape for Iowa women, age 18 and above, by having the state department of health issue a standing order for birth control. After completing training, Iowa pharmacists could offer an initial three-month supply to women who have successfully completed a self-assessment and screening for high blood pressure. If the woman chooses to stay with the same birth control, a follow-up disbursement of a 12-month supply could be provided. Women opting to use the state’s standing order for birth control would undergo minimal counseling at the pharmacists’ counter, mostly centered on the correct use and storage of the birth control.
In addition to limiting birth control by age, the Iowa proposal is limited to self-administered contraceptives. Although Iowa pharmacists can attend training and offer consumers certain vaccinations, birth control injections are not included in the current bill. There is nothing in the bill that requires pharmacists to undergo training, or to forgo objections to dispensing birth control.
With a standing order in place, however, birth control will continued to be covered by insurance. By limiting the number of times the standing order can be used, the state buys itself some time to make other adjustments that will, hopefully, increase capacity so that men and women, regardless of geography, can access more comprehensive reproductive health care.
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