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Case Studies 5 OREGON On July 6, 2015, Governor Kate Brown signed House Bill 2879, which enables Oregon women 18 years or older in to obtain birth control from pharmacies, without having to visit a doctor's office (Oregon Pharmacist n.d.). The bill took effect January 1, 2016 and will remain in effect through 2020. HB 2879 received overwhelming support, passing the House 49-10 and the Senate 24-4 (Committee on Healthcare, 2015) Under the law, women who are 18 and older are able to obtain hormonal contraceptive methods directly from the pharmacist, without a prior doctor’s prescription. Women who are under 18 years old are still required to visit their clinician for an initial prescription. However, if they have evidence of a previous prescription, a pharmacist can prescribe them hormonal contraceptives. The two types of hormonal contraception available under this law are the oral contraceptive pill and the hormonal patch (Yang et al., 2016). This new birth control law reduces barriers to access, which ultimately may reduce unintended pregnancies. In 2006, 46% of pregnancies in Oregon were unintended (Kost, 2015). Of those 31,000 unintended pregnancies, 32% led to abortion. Further, in 2010, 70% of all teen pregnancies in Oregon were unintended (Kost, 2015). It is expected that by decreasing the barriers to hormonal contraceptives, the unintended pregnancy rate will decrease, as will the number of abortions. POLITICS This law was initially introduced the summer of 2015 and gained bipartisan support. Republicans have been a driving force behind the law, arguing that the law may decrease poverty if it does reduce unintended pregnancies (Yang et al, 2016). The legislature set HB2879 to expire in 2020, so that the state can evaluate whether the law has had a positive effect on costs and unintended pregnancies in its first four years and decide whether the policy should be continued. The driving force behind these this law was Representative Knute Buehler (Joseph 2015). Also, the Oregon Medical Association, the Oregon Health and Science University, the Oregon Academy of Family Physicians, The American Congress of Obstetricians and Gynecologist, the Oregon Nurses Association, and all the physicians in the legislature supported and endorsed this legislative idea. A study by ACOG showed that women who are more likely to be at risk for unintended pregnancies would be in favor and would readily use these contraceptive methods (OSPA, n.d.). Of the 50 members of the House who voted for the bill, 35 were Democrats and 14 were Republican. Of the 24 members of the Senate who voted for the bill, 17 were Democrats and 16 were Republican (Committee on Healthcare, 2015). All 10 House members and 4 Senate members who voted against the bill were Republican. COSTS The new birth control law in Oregon aims to reduce overall costs. In 2010, unintended pregnancies cost the federal government nearly $122.7 million, and an additional $47.2 million to the state of Oregon. (Kost, 2015). The law is designed to have minimal fiscal impact and no revenue impact (O.R. Legis. Assemb., 2015). However, overall costs are expected to decrease as the number of unnecessary doctor visits and the number of unintended pregnancies decreases.