Can pharmacies refuse to fill prescriptions for abortion pills?

The reversal of Roe vs. Wade, the landmark Supreme Court case that guaranteed abortion rights at the federal level, has sparked many changes and questions about reproductive rights in America. Now it’s up to states to set their own rules on access to abortion.


But, even in states where abortion is legal, there are reports of pharmacists refusing to fill prescriptions for people who have a prescription for a drug that could end a pregnancy. With that, the U.S. Department of Health and Human Services (HHS) issued guidelines to approximately 60,000 pharmacies across the country “reminding them of their obligations under federal civil rights laws,” according to a press release. of the HHS.


The guidelines stated that as recipients of federal financial assistance, such as Medicare and Medicaid payments, pharmacies are prohibited under federal law from discriminating on the basis of race, color, national origin, sex, age and disability in their programs and activities.


This, HHS said, includes providing prescribed medications, determining the adequacy of prescribed medications for a patient, and counseling patients on prescribed medications and how to take them.


“We are committed to ensuring that everyone can access health care, without discrimination,” HHS Secretary Xavier Becerra said in the press release. “This includes access to prescription drugs for reproductive health and other types of care.”


You probably have a lot of questions right now about what rights you have and don’t have regarding the enforcement of certain orders. Here’s what you need to know.


Which pharmacies must comply with federal civil rights laws?


Pharmacies that receive federal financial assistance, including Medicare and Medicaid payments, are subject to federal civil rights laws, according to the guidelines. And, again, they cannot discriminate against you based on your gender, race, color, national origin, age, and disability.


“The law at issue here is Section 1557 of the Affordable Care Act,” Michelle Banker, director of reproductive rights and health litigation at the National Women’s Law Center, told Health. “This is the first federal law to broadly prohibit gender discrimination in health care.”


However, pharmacies that do not receive federal assistance are not subject to this particular legal status.


What constitutes discrimination?


Anything that discriminates against you based on your gender, race, color, national origin, age and disability is considered discrimination under federal law, according to the guidelines.


In fact, the councils gave a few examples of what this discrimination might look like in the real world, including:


  • A person with a prescription for emergency contraception to prevent her from getting pregnant after a sexual assault and a pharmacy refusing to fill that prescription while selling other contraceptives like condoms
  • A pharmacy refusing to stock or fill a prescription for methotrexate, a drug that can help relieve symptoms of rheumatoid arthritis but could also end a pregnancy
  • A pharmacy refusing to fill a person who suffered a first trimester miscarriage with a prescription for mifepristone followed by misoprostol treatment to help with a successful miscarriage because the drugs can be used to terminate a pregnancy


Can a pharmacist refuse to dispense Plan B?


Plan B One-Step, in case you don’t know, is a form of emergency contraception that contains the hormone levonorgestrel which can prevent ovulation, block fertilization, or prevent a fertilized egg from implanting in the body. ‘uterus.


Taking Plan B isn’t an abortion, it’s a form of contraception, said Lauren Streicher, MD, associate professor of clinical obstetrics and gynecology at Northwestern University Feinberg School of Medicine.


But, under federal law, Banker said a pharmacy that “otherwise provides comprehensive offerings of prescription drugs for birth control” like condoms or barrier methods “cannot refuse to provide plan B.” to customers. “That would constitute sex discrimination,” she added.


What could it can happen, however, if a particular pharmacist will refuse to dispense the drug, but the store itself. “There are pharmacists who will refuse to fill Plan B and/or birth control for personal and/or religious reasons,” Jamie Alan, PhD, associate professor of pharmacology and toxicology at Michigan State, told Health. University. Walgreens even said in a recent tweet that their company policy “permits pharmacists to refrain from filling a prescription for which they have a moral objection”. But, the company added, “at the same time, they are also required to refer the prescription to another pharmacist or service manager to meet the patient’s needs in a timely manner.”


Can a pharmacy refuse to dispense a contraceptive?


Maybe. If a pharmacy does not dispense any form of contraception (i.e. they do not sell condoms, other barrier methods, spermicides, etc.), then they may refuse to dispense a contraceptive. contraception. But, if they’re selling anything that’s used as contraception, “they can’t refuse to dispense birth control without violating section 1157,” Banker said.


What options do you have if you feel you have been discriminated against by a pharmacist?


If you’re having this problem – and reports are surfacing online of people who have – Alan said you should “absolutely” try another pharmacist or pharmacy, even if it takes extra time and legwork. from you. “If a pharmacist refuses to fill, they should, at a minimum, recommend another pharmacist or pharmacy to fill the prescription for you,” she said.


It is important to point out that, unfortunately, there is really nothing your doctor can do to help you. “As a doctor, you can write a prescription, but we don’t carry these drugs to the office,” Dr. Streicher said. It’s possible your doctor will be aware of pharmacies in your area that are less likely to try to make that kind of decision, she said, but that’s no guarantee.


Once you are able to get your order, Banker recommends filing a complaint with the Office for Civil Rights at (800) 368-1019 or OCRMail@hhs.gov. (You can also file a complaint online here.)


“I encourage people to press charges if this happens to them to let the administration know what’s going on,” Banker said. You also have the federal right to sue the pharmacy if they don’t follow the law, she said. (You can contact an organization like the National Women’s Law Center for help and next steps, if you decide to go this route.)


“It’s so horrific and egregious that this is happening,” Dr. Streicher said.


But Banker insists you need to make sure you take care of yourself first. “You can’t force the pharmacy to obey the law,” she said. “In these situations, people may have to go to another pharmacy or they may not get the care they need – and they will have to live with the consequences.”

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