Access to Birth Control Act
- Sponsor
- Rep. Kelly, Robin L. [D-IL-2]
- Committees
- Energy and Commerce Committee (primary)
- Last action
- Jun 23, 2025
Bottom line
This bill aims to guarantee access to FDA-approved contraception and related medications by imposing specific dispensing and customer service duties on pharmacies, backed by federal enforcement mechanisms, and limiting religious freedom defenses.
What it actually does
This bill establishes federal duties for pharmacies that receive Food and Drug Administration-approved drugs in interstate commerce to ensure the timely provision of contraception and related medications. It mandates that pharmacies provide in-stock items without delay, and for out-of-stock items, offer customers the option of referral to another pharmacy or expedited ordering. The bill also prohibits specific discriminatory practices by pharmacy employees and establishes civil penalties and a private cause of action for violations, while explicitly stating that the Religious Freedom Restoration Act cannot be used as a defense against its provisions.
Proponents argue
Proponents argue that the bill is essential to protect the fundamental right to contraception, address systemic barriers and discrimination in access, and ensure that personal beliefs of pharmacists do not impede access to essential healthcare. They contend that this legislation is particularly critical in light of increased reports of contraception denials following the Supreme Court's decision in Dobbs v. Jackson Women's Health Organization, and that it will help reduce unintended pregnancies and promote reproductive autonomy.
Opponents contend
Opponents might argue that the bill infringes upon the religious freedom and conscience rights of pharmacists and pharmacy owners, potentially forcing them to participate in activities that conflict with their deeply held moral or religious beliefs. They may contend that the explicit carve-out of the Religious Freedom Restoration Act is an overreach that undermines constitutional protections, and that existing professional clinical judgment clauses are insufficient to protect individual liberties.
The bill is concise and clearly written, allowing for a quick and comprehensive understanding of its provisions and their implications.
Section 3, Subsection (a)
General Duties for Pharmacies Regarding Contraception
This subsection mandates that pharmacies receiving FDA-approved drugs in interstate commerce must ensure the prompt provision of contraception and related medications. If a requested item is in stock, it must be provided without delay. If an item is out of stock but ordinarily stocked by the pharmacy, the pharmacy must immediately inform the customer and offer two options: locate another pharmacy for referral or transfer of the prescription, or expedite ordering the medication and notify the customer upon arrival.
Supporters argue
Supporters argue this provision is crucial for ensuring consistent and equitable access to essential reproductive healthcare, preventing arbitrary denials, and upholding reproductive autonomy, especially for vulnerable populations who face systemic barriers.
Critics contend
Opponents may contend that these mandates place an undue burden on pharmacies, particularly smaller ones, potentially leading to operational challenges or forcing them to stock items against their business model or moral objections.
Tradeoffs
This provision balances the individual right to access healthcare with the operational autonomy and potential conscience concerns of pharmacies, aiming to create a federal standard for contraception provision.
Section 3, Subsection (a)(3)
Prohibited Conduct in Contraception Provision
This subsection explicitly prohibits pharmacies and their employees from engaging in certain behaviors related to contraception requests. These include operating an intimidating environment, interfering with or obstructing services, intentionally misrepresenting availability or mechanism of action, breaching medical confidentiality, or refusing to return a valid prescription upon customer request.
Section 3, Subsection (c)
Permissible Refusals Based on Standard Pharmacy Practice
This subsection outlines specific, limited circumstances under which a pharmacy is permitted to refuse to provide contraception without violating the Act. These exceptions include situations where it is unlawful to dispense without a valid prescription and none is presented, if the customer is unable to pay for the medication, or if a pharmacy employee refuses based on a professional clinical judgment, which is defined elsewhere in the bill as being in accordance with prevailing medical standards.
Section 3, Subsection (d)(2)
Limitations on Religious Freedom Restoration Act Claims
This subsection explicitly states that the Religious Freedom Restoration Act of 1993 (RFRA) shall not provide a claim concerning, or a defense to a claim under, the new section 249 of the Public Health Service Act established by this bill. Furthermore, RFRA cannot be used as a basis for challenging the application or enforcement of this new section.
Section 3, Subsection (f)
Enforcement Mechanisms and Penalties
This subsection establishes two primary enforcement mechanisms for violations of the Act. First, a pharmacy found in violation is liable to the United States for a civil penalty not exceeding $1,000 per day of violation, with a maximum of $100,000 for all violations adjudicated in a single proceeding. Second, any person aggrieved by a violation can commence a civil action in court to obtain appropriate relief, including actual and punitive damages, injunctive relief, and reasonable attorney's fees and costs. Both types of actions are subject to a 5-year statute of limitations.
This provision explicitly states that the Religious Freedom Restoration Act of 1993 (RFRA) cannot be used as a claim or defense against the provisions of this Act, nor as a basis for challenging its application or enforcement.
Section 3, Subsection (d)(2)
Why it matters:This is a standard legislative technique for addressing potential conflicts with existing law, but its placement can make its significant impact on religious freedom arguments less immediately apparent to a casual reader. It's a critical legal carve-out.
Case for: Supporters argue this carve-out is necessary to prevent religious objections from undermining guaranteed access to essential healthcare, ensuring the bill's effectiveness in protecting reproductive autonomy.
Case against: Opponents contend it is a direct assault on religious freedom and conscience rights, arguing it forces individuals and businesses to act against their deeply held beliefs without legal recourse, setting a dangerous precedent.
Estimated impact: Significantly alters the legal landscape for religious exemptions related to contraception dispensing, removing a major legal defense for those with religious objections.
This provision defines 'professional clinical judgment' as 'the use of professional knowledge and skills to form a clinical judgment, in accordance with prevailing medical standards.'
Section 3, Subsection (g)(6)
Why it matters:Definitions are typically placed at the end, which is standard legislative practice. However, this specific definition is critical because it clarifies that any refusal based on 'clinical judgment' must be medically justified, not based on personal moral or religious beliefs, which could be seen as intentionally limiting the scope of conscience protections.
Case for: Proponents argue this definition ensures that any refusal based on 'clinical judgment' is genuinely rooted in objective medical standards, preventing misuse of the exception to deny care based on personal biases.
Case against: Opponents might argue that by explicitly tying it to 'medical standards,' it implicitly excludes moral or religious judgments, thus narrowing the scope of conscience protections for pharmacists beyond what some believe is appropriate.
Estimated impact: Clarifies and limits the grounds upon which a pharmacist can legitimately refuse to dispense contraception, ensuring such refusals are based on medical rather than personal reasons.
This provision defines 'without delay,' with respect to a pharmacy providing, referring for, or ordering contraception or related medication, or transferring a prescription, to mean '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.'
Section 3, Subsection (g)(7)
Why it matters:Standard placement for definitions, but critical for understanding the practical expectation of timeliness. Its specific wording prevents pharmacies from intentionally delaying contraception relative to other medications, which could be a subtle form of obstruction.
Case for: Supporters argue this definition provides a clear, objective standard for timeliness, preventing pharmacies from intentionally delaying access to contraception compared to other medications, thereby ensuring equitable service.
Case against: No strong specific case against this definition, as it aligns with standard pharmacy practice. Some might argue it could be difficult to enforce objectively across all pharmacies given variations in 'usual and customary' timeframes.
Estimated impact: Ensures that contraception is handled with the same urgency and efficiency as other medications, preventing discriminatory delays in access.