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Case Studies 11 HOW IT WOULD HAVE WORKED The bill would permit pharmacists to prescribe oral contraceptive pills. The pharmacist could prescribe the pills to women over age 18 regardless of whether the woman has evidence of a previous birth control prescription, and to women under age 18 who had evidence of a previous prescription from a primary care or women’s health care provider. However, the woman must see a primary care or women’s health provider within three years of receiving an initial pharmacist prescription, and upon prescription the pharmacist is required to refer the woman to her primary care or women’s health care practitioner. The pharmacist must have undergone a training program approved by the board of pharmacy and administer a risk assessment (H.B. 1679, 2016). The bill also included a requirement that health insurance plans cover contraceptives by reimbursing the health care provider or dispensing entity for dispensing these contraceptives. The plan must cover an initial 3-month supply, and then a 12-month supply for any subsequent dispensations of the same contraceptive. This requirement applies to all contraceptive prescriptions, not just those written by pharmacists (ibid). Missouri’s passage of HB 1679 would have benefitted numerous women. The state estimated that 2,648 women covered by Medicaid, which is 10% of Medicaid beneficiaries who use oral contraceptives, would use this option annually, in addition to other women who have private insurance or are uninsured (Committee on Legislative Research Oversight Division, 2016). With a strong advocate in Representative Solon, the bill may pass in future sessions. Regardless, North Carolina can draw many lessons from the conservative arguments that gained traction in the Missouri House.  