Proposal loosens controls on birth control prescriptions

Insurance companies will be required to fill up to a 12-month supply of birth control pills, if a bill by Sen. Emily Alvarado, D-Seattle, is approved.

"I experience difficulty and frustration every month when I need to return to the pharmacy and fill my birth control," testified Elena Vega de Soto to the House Health Care and Wellness Committee.

As a University of Washington student, she said she relies on public transportation or her friends to make it to the pharmacy.

"While this isn't convenient for me," she said, "I often think about constituents in rural areas, people who are disabled, those without the resources or time to travel and people who live in areas where public transportation is unavailable or insufficient."

In 2017, Washington was one of the first states to require insurance to cover 12 months of birth control. However, there was some "hesitation" about being such early implementers of 12-month contraception coverage, according to Rep. Nicole Macri, D-Seattle.

As a result, insurance companies require patients to refill prescriptions every three months or less.

"There's a greater likelihood of having an unintended pregnancy," said Alvarado. "The barrier disproportionately impacts younger people and people with lower incomes."

Calypso Bettis testified it can be painful when she misses pills and her digestion and her mood can be affected as well.

"It made it difficult to do my regular life and do homework," she said. "It made it increasingly difficult to get work done."

Bettis and de Soto are both part of the University of Washington chapter of the Planned Parenthood-affiliated Generation Action.

HB 1090 is simple: it would amend RCW 48.43.195 to use the words "12-month supply" instead of "twelve-month refill."

"This just makes it so that the insurance company is not deciding how long the prescription is and how often a person has to come back to fill the prescription," said Alvarado.

Patients do not have to get a full year's supply, but they have that option based on their doctor's recommendations.

A study published in the JAMA Health Forum in Aug 2024 says that a 12-month supply of contraceptives results in fewer trips to the pharmacy, greater prevention of unwanted pregnancies and reduced costs for clinics.

"We try to make progress, we hear back from residents – how it works on the ground, in real life – and then we make tweaks," said Macri on why it took so long to close the loophole. "Now, patients, legislators [and] providers are a lot more comfortable with the ability for folks to get access to contraception."

HB 1090 was unanimously voted to move forward by the House Health and Wellness Committee.