119-hr4084

[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[H.R. 4084 Introduced in House

    (IH) ]

<DOC>

119th CONGRESS
 1st Session
 H. R. 4084

To amend the Public Health Service Act to establish certain duties for 
pharmacies to ensure provision of Food and Drug Administration-approved 
 contraception and medication related to contraception, and for other 
 purposes.

_______________________________________________________________________

 IN THE HOUSE OF REPRESENTATIVES

 June 23, 2025

 Ms. Kelly of Illinois (for herself, Mr. Foster, Ms. Norton, Ms. 
Brownley, Ms. Scanlon, Ms. Garcia of Texas, Ms. Stansbury, Ms. Sewell, 
 Ms. Castor of Florida, Mr. Pocan, Ms. Barragan, Mr. Thanedar, Ms. 
Crockett, Mr. Vargas, Ms. Salinas, Ms. McCollum, Mr. Tonko, Ms. Clarke 
of New York, Mr. Larson of Connecticut, Ms. Strickland, Ms. Williams of 
 Georgia, Mr. Mfume, Ms. Matsui, Ms. Lois Frankel of Florida, Ms. 
 McClellan, Mr. Garamendi, Ms. DeGette, Mr. Swalwell, Mr. Moulton, Mr. 
 Cohen, Ms. Chu, Mrs. Ramirez, Ms. Tlaib, Mrs. Trahan, Mr. Johnson of 
 Georgia, Mr. Deluzio, Mr. Gomez, Mrs. Foushee, Mr. Garcia of 
 California, Ms. Sherrill, Ms. DeLauro, and Mr. Bera) introduced the 
 following bill; which was referred to the Committee on Energy and 
 Commerce

_______________________________________________________________________

 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 medication related to contraception, and for other 
 purposes.

 Be it enacted by the Senate and House of Representatives 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 cornerstone of reproductive 
 autonomy and can help people fulfill their educational, 
 professional, and social aspirations.

    (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 insurance plans in the United States in 2020, 
 including 58,000,000 women between the ages of 19 and 64 who 
 had coverage of contraceptive methods approved, cleared, or 
 authorized by the Food and Drug 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 Control and 
 Prevention, nearly \2/3\ of women between the ages of 15 and 49 
 are currently using a contraceptive 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 published list of the Ten Great 
 Public Health Achievements in the 20th Century, people in the 
 United States face a myriad of barriers in accessing birth 
 control, including cost, geography, immigration status, 
 language access, discrimination, and stigma. These 
 contraceptive barriers are rooted in systemic inequities, 
 structural racism, and other forms of oppression in our health 
 care system and society.

    (6) In 2019, approximately 2,293,000 pregnancies, nearly 42 
 percent of all pregnancies, in the United States were 
 unintended.

    (7) Systemic racism and discrimination, as well as lack of 
 access to comprehensive sex education, exacerbates severe 
 health inequities and creates additional barriers to accessing 
 contraception; for example, due to high uninsured rates and 
 barriers, Hispanic women with low-incomes experience a 
 significantly higher rate of unintended pregnancy (58 percent) 
 compared to their White counterparts (33 percent). In a 2023 
 study exploring challenges accessing contraceptive care among 
 people who identified as Asian-American, Native Hawaiian, or 
 Pacific Islander, Black or African-American, Indigenous, or 
 Latina/Latinx, 45 percent of respondents reported experiencing 
 at least one challenge accessing contraception in the past 
 year.

    (8) In addition to preventing pregnancy, contraceptives 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 systemic discrimination.

    (9) The Food and Drug Administration has approved, cleared, 
 or authorized multiple emergency contraceptive methods as safe 
 and effective in preventing 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 contraceptive failure, 
 emergency contraception can significantly reduce a person's 
 chance of unintended pregnancy. 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 contraception should not be impeded 
 by one individual's personal 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 provided to people of 
 all ages in a supportive way that is culturally appropriate and 
 delivered without stigma, bias, or delay.

    (11) Reports of pharmacists refusing to fill prescriptions 
 for contraceptives, including emergency contraceptives, or 
 provide emergency contraception 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, 
 Montana, New Hampshire, New Mexico, New York, North Carolina, 
 Ohio, Oklahoma, Oregon, Rhode Island, 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 pharmacies.

    (13) In 2022, the Department of Health and Human Services 
 issued guidance clarifying that refusing to dispense birth 
 control can be sex discrimination 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 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 CONTRACEPTION 
 AND MEDICATION RELATED 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 contraceptive 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 related to contraception, the 
 pharmacy shall immediately inform the customer that the 
 contraceptive or the medication related to a contraceptive is 
 not in stock and without delay offer the customer the following 
 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 customer'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 pharmacy to 
 order the contraceptive or the medication 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 related to contraception;
 ``
        (B) its employees do not interfere with or 
 obstruct the delivery of services relating to a request 
 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 related 
 to contraception or its mechanism of action;
 ``
            (D) its employees do not breach medical 
 confidentiality with respect to a request for 
 contraception or a medication related to contraception 
 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 customer 
 request.
 ``

    (b) Contraceptives or Medication Related to a Contraceptive Not 
Ordinarily Stocked.--Nothing 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 related to a 
contraceptive in the normal course of business.
 ``
            (c) Refusals Pursuant to Standard Pharmacy Practice.--This 
section does not prohibit a pharmacy from refusing to provide a 
contraceptive or a medication related to a contraceptive to a customer 
in accordance with any of the following:
 ``

    (1) If it is unlawful to dispense the contraceptive 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 contraceptive.
 ``

    (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 clinical 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 Freedom 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 made applicable by a State 
board or other entity responsible for licensing or discipline of 
pharmacies or pharmacists, 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 violates 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 jurisdiction, commence a civil action 
 against the pharmacy 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 paragraph

    (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 allegedly engaged in the violation involved.
 ``

    (g) 

=== Definitions. ===
-In this section:
 ``

    (1) The term `contraception' or `contraceptive' means any 
 drug or device approved, cleared, or authorized 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 contraception' or 
 `medication related to a contraceptive' means any drug or 
 device approved, cleared, or authorized by the Food and Drug 
 Administration that a medical professional determines 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 retail; 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 to form a clinical 
 judgment, in accordance with prevailing 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 
 contraception, means within the usual and customary timeframe 
 at the pharmacy for providing, providing a referral for, or 
 ordering other products, or transferring the prescription for 
 other products, respectively.
 ``

    (h) Effective Date.--This section shall take effect 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.''.
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