OPINION: Dunleavy’s birth control veto makes life harder for Alaskans

A college student who wants to see her regular ob-gyn and take her birth control pills to campus with her. A busy parent who can’t make it to the pharmacy after picking the kids up from child care. A rural Alaskan whose mail delivery isn’t reliable enough to count on her birth control pills arriving on time every month.

Each of these people could have benefited from being able to fill a yearlong supply of birth control with just one pharmacy visit. Unfortunately, because Gov. Mike Dunleavy vetoed a bipartisan bill that would have allowed Alaskans to have 12-month supplies of birth control, they won’t have that opportunity.

As ob-gyns, we write prescriptions for birth control pills every day, yet we know there are challenges for our patients to actually get that medicine when it’s time to refill it every month or every three months. It’s a shame that accessibility must be a consideration in people’s decisions about contraception, but when we’re counseling our patients about their options this is something we have to discuss because, disappointingly, not all of our fellow Alaskans can access their pills in time to use them as fully effective contraception. Research has demonstrated that timely access can be a real problem when it comes to birth control — one study showed that more than one-third of women using oral contraception have missed doses due to inability to get their next supply.

Not having immediate and consistent access to birth control is more than just an inconvenience; it can have significant consequences. Missing pills can increase someone’s chances of getting pregnant, and many of our patients simply can’t afford to risk an unplanned pregnancy. In California, dispensing a 12-month supply of birth control was associated with a 30% reduction in unintended pregnancy compared to one- or three-month long prescriptions, and we anticipate the results in Alaska to be even more pronounced.

Outside of pregnancy prevention, birth control is also used for menstrual suppression, and when a patient misses a dose, it can lead to breakthrough bleeding and other symptoms that interfere with people’s daily lives. There are patients who use birth control for the medical management of endometriosis, fibroids, heavy bleeding, polycystic ovary syndrome (PCOS) and other reasons. These medical problems require long-term treatment. Our patients in Alaska should not have to choose more expensive or invasive treatments just because there are barriers to birth control access.

When our Legislature voted with bipartisan support to require insurance companies to provide a year’s supply of birth control to residents, it was a shining example of how policymakers can work together effectively to improve people’s lives. However, Gov. Dunleavy’s veto of the bill was a setback for patients and a disappointment for us as doctors.

Making people jump through unnecessary and arbitrary refill schedules perpetuates inequities in access and deprives patients of ability to determine how and when they get their birth control. This is a bigger issue than a pharmacy visit. This is about reproductive autonomy.

Autonomy is part of our spirit as Alaskans. That should apply to birth control, too. If the opportunity arises again to require insurers to cover filling prescriptions for a full year’s supply of birth control, we hope our legislators will again support the measure and that our governor will reconsider and sign the bill into law, allowing our fellow Alaskans to determine when and where they access their vital birth control prescriptions.

Dr. Sarah Truitt, FACOG, is American College of Obstetricians and Gynecologists Alaska Section chair.

Dr. Jessica Bury, FACOG, is American College of Obstetricians and Gynecologists Alaska Section vice chair.

Dr. Tania Hall, FACOG, is American College of Obstetricians and Gynecologists Alaska Section legislative co-chair.

Dr. Reinou Groen, FACOG, is American College of Obstetricians and Gynecologists Alaska Section legislative co-chair.

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