Access to Emergency Contraception
States can facilitate access to emergency contraception (EC). EC provides women with a safe and effective way to prevent unintended pregnancies after unprotected sex or contraceptive failure.1 Studies show that EC works to prevent pregnancy in the exact same way that ordinary birth control pills do – mainly by preventing ovulation. Given that EC is most effective if used within the first 12 to 24 hours after unprotected intercourse, it is pivotal that women have quick and easy access to it.
All new health plans are required to cover certain preventive services--like cancer screenings and immunizations--for free. In 2011, the list of required preventive services will be updated to ensure that services women in particular need are included, and it is not clear yet whether emergency contraceptive coverage will be required (without copayments) at that point.
Beginning in 2014, new health plans sold to individuals and small businesses will be required to cover a package of "essential health benefits." The law lists ten broad categories of services that will be among the essential benefits--including prescription drugs, preventive services, and wellness care--but the package will be further defined in the coming year by the Secretary of Health and Human Services. It is not yet clear whether emergency contraception will be a required benefit.
Does the state have a policy that promotes access to emergency contraception?
A state receives a "meets policy" if it a) requires that women who go to an emergency room after a sexual assault be given information about EC; b) requires that EC be provided upon demand in the emergency room to a woman who has been sexually assaulted; and c) allows pharmacists to dispense EC without a prescription. A state receives a "limited policy" if it has two of the policies and a "weak policy" if it has only one policy. States with none of the policies receive a "no policy."
| State | Strength of Policy | Change from 2007 |
|---|---|---|
| Alabama | No Policy | Same |
| Alaska | Weak Policy | Same |
| Arizona | No Policy | Same |
| Arkansas | Weak Policy | Same |
| California | Meets Policy | Same |
| Colorado | Weak Policy | Same |
| Connecticut | Limited Policy | Better |
| Delaware | No Policy | Same |
| District of Columbia | Limited Policy | Better |
| Florida | No Policy | Same |
| Georgia | No Policy | Same |
| Hawaii | Weak Policy | Same |
| Idaho | No Policy | Same |
| Illinois | Weak Policy | Same |
| Indiana | No Policy | Same |
| Iowa | No Policy | Same |
| Kansas | No Policy | Same |
| Kentucky | No Policy | Same |
| Louisiana | No Policy | Same |
| Maine | Weak Policy | Same |
| Maryland | No Policy | Same |
| Massachusetts | Meets Policy | Same |
| Michigan | No Policy | Same |
| Minnesota | Limited Policy | Better |
| Mississippi | No Policy | Same |
| Missouri | No Policy | Same |
| Montana | No Policy | Same |
| Nebraska | No Policy | Same |
| Nevada | No Policy | Same |
| New Hampshire | Weak Policy | Same |
| New Jersey | Limited Policy | Same |
| New Mexico | Meets Policy | Same |
| New York | Limited Policy | Same |
| North Carolina | No Policy | Same |
| North Dakota | No Policy | Same |
| Ohio 2 | No Policy | Same |
| Oklahoma | No Policy | Same |
| Oregon | Limited Policy | Better |
| Pennsylvania 3 | Weak Policy | Better |
| Rhode Island | No Policy | Same |
| South Carolina | Weak Policy | Same |
| South Dakota | No Policy | Same |
| Tennessee | No Policy | Same |
| Texas 4 | No Policy | Same |
| Utah | Limited Policy | Better |
| Vermont | Weak Policy | Same |
| Virginia | No Policy | Same |
| Washington | Meets Policy | Same |
| West Virginia | No Policy | Same |
| Wisconsin | Limited Policy | Better |
| Wyoming | No Policy | Same |
Data Source: National Women's Law Center, "Providing Emergency Contraception to Sexual Assault Survivors," August 5, 2009, available at: http://www.nwlc.org/pdf/ECsexualassaultAug09.pdf, accessed September 13, 2010; National Women's Law Center, "Pharmacy Access to Emergency Contraception." November 2009, available at http://www.nwlc.org/pdf/PharmacyAccess11.09.pdf, accessed September 13, 2010; Guttmacher Institute, "State Policies in Brief: Emergency Contraception” September 1, 2010, available at
http://www.guttmacher.org/statecenter/spibs/spib_EC.pdf, accessed September 8, 2010.
Footnotes
1 Emergency contraception should not be confused with the early abortion option mifepristone, also known as RU-486. That FDA-approved drug terminates pregnancies of up to seven weeks, while emergency contraception prevents pregnancy after sexual intercourse. For more information, see NARAL Pro-Choice America “The Difference Between Emergency Contraception and Early Abortion Options (Mifepristone/RU-486),” January 2009, available at http://www.prochoiceamerica.org/media/fact-sheets/birth-control-ec-mifep..., accessed September 1, 2010.
2 Ohio was graded incorrectly in the 2007 Report Card. It should have received a "no policy" instead of a "limited policy." Since there is no change in the individual state law for this state, the comparison with 2007 is based on the underlying data, that is, there is no change from 2007.
3 Although Pennsylvania has a regulation requiring emergency rooms to provide information about EC and to dispense EC to sexual assault survivors upon request, the state was not given full credit because it allows hospitals to refuse to dispense EC based on religious or moral beliefs.
4 Texas was graded incorrectly in the 2007 Report Card. It should have received a "no policy" instead of a "weak policy." Although the state has a law that could be interpreted to require the provision of information about EC to sexual assault survivors, it should not have received credit because the language in the law is unclear and there are no regulations that clarify whether this is required. Since there is no change in the individual state law for this state, the comparison with 2007 is based on the underlying data. That is, there is no change from 2007.
