Legislation requiring insurers, including Medicaid, to cover 12-month prescriptions of birth control cleared the House today with the support of several Republicans who called the measure a common-sense approach to reducing unwanted pregnancies.
The provisions in House Bill 17, authored by Fairbanks Democratic Rep. Ashley Carrick, have long been sought after by progressive legislators, health advocacy groups and women, especially those living and working in remote parts of Alaska without regular access to a pharmacy. The legislation would require insurance providers to cover up to a 12-month supply of contraceptives.
The latest measure is narrowly tailored, covering only birth control and not emergency contraceptives or abortifacients. It also contains a limited religious exemption policy that Republicans added via a floor amendment on Tuesday.
In her closing comments, Rep. Carrick reiterated that the measure is narrowly tailored and noted that regular access to birth control has been shown to reduce unplanned pregnancies.
“At the end of the day, this only has an impact on the quantity of medication dispensed at a pharmacy counter, and it does not allow pharmacists to dispense more than what is prescribed or allowed,” she said. “This bill is about Alaskan women having the ability to make their choices in consultation with their doctors about their health care. It’s about them being able to make private decisions in a state where we have folks living far away from providers and in a state where providers are becoming more and more limited.”
The reasons for supporting the bill were broad, ranging from seeing it as a straightforward matter of convenience to seeing dependable contraceptive access as a meaningful tool in protecting women against domestic violence. Several noted that depriving people of contraceptive access has been identified as a coercion tool in abusive relationships. Others pointed out that birth control is prescribed for many reasons beyond just reducing the chance of a pregnancy.
For whatever reason, many said they supported it because it ultimately empowered women to have better control over their health.
“A lot of people who are going to be impacted by this bill are people who are trying to take responsibility and navigate that system,” said Rep. Genevieve Mina, D-Anchorage. “I see this as a way to increase access in a way that ensures more people can have personal responsibility for their decisions. If there are concerns about health, etc., it should be up to a person and their provider.”
The bill faced a small but vocal group of opposition from conservative legislators, who suggested the measure encouraged abortions or that prescription contraceptives have a high risk of harmful side effects — reflecting a recent surge in disinformation about birth control. Some complained that the measure would be giving contraceptives a special status, noting that their medications are only available to be filled 90 days at a time.
Others said they opposed it because Planned Parenthood’s advocacy arm supported it.
“As the user of some other prescription medications for blood pressure and all sorts of things, I only get a 90-day supply,” said Big Lake Republican Rep. Kevin McCabe, turning to a Planned Parenthood graphic outlining the group’s legislative priorities for the session. “I’m not sure where the difference between men and women comes in this discussion. I had considered voting yes for this — because frankly, it is just an insurance bill — but the Planned Parenthood association with birth control, tying it to gender-affirming care and abortion, just doesn’t sit right with me.”
Some Republican opponents had built a convoluted hypothetical situation where a woman’s health is so rapidly changing that they must consult a doctor every 90 days to ensure they should still be taking birth control. Based on what others said was wrong or intentionally misleading research, they claimed these hypothetical situations could see a steep and dangerous rise if the yearlong prescriptions are offered.
The whataboutism and anti-abortion dog whistles weren’t shared by all Republicans.
Several supported the bill, calling it a sensible approach to ease the challenges women face in controlling their health care, with many noting that the bill doesn’t have anything to do with abortions or emergency contraceptives.
A few said they had shared others’ frustrations in accessing birth control in Alaska.
“I appreciate all my male colleagues commenting on this bill, but I’ve lived this, and I’m supporting this bill because I’m pro-life,” said Anchorage Republican Rep. Julie Coulombe. “This is a woman taking personal responsibility in trying to prevent a pregnancy when she’s not able to care for a baby … The thought that somehow a woman doesn’t know her own body, that her body’s changing all the time and I have to go talk to a doctor every three months, is not the way I taught my daughter to deal with her own health issues and it’s not how I’ve dealt with mine … Women can figure out for themselves when they have to go see a doctor.”
And a few said they supported the measure because, simply, who were they to dictate the health care decisions of others?
“Let the ladies take care of their business, and we should stay out of it,” said Rep. Tom McKay, R-Anchorage. “It’s kind of an IQ test. Guys, let’s not tell women what to do. It’s very dangerous territory.”
The legislation passed 29-11. It now heads to the Senate, where similar legislation has already been introduced and is working its way through the legislative process.
Matt Acuña Buxton is a long-time political reporter who has written for the Fairbanks Daily News-Miner and The Midnight Sun political blog. He also authors the daily politics newsletter, The Alaska Memo, and can frequently be found live-tweeting public meetings on Twitter.
