Association for Public Policy Analysis & Management

Between 1999 and 2011, 26 states passed some form of additional legislature regarding access to contraception, largely due to the emergency contraceptive Plan B becoming available.  This paper examines the effect of state legislations that pertain to pharmacists’ ability to refuse to fill prescriptions for emergency contraceptives.  I identify the effect of these policies on the quantity of emergency contraceptive prescriptions being filled through Medicaid and on birthrates among different groups of women.  I focus on states with restrictive access policies, where pharmacists have the explicit legal right to refuse to fill prescriptions that conflict with their personal beliefs and states that have instituted expanded access policies where pharmacists are legally required to fill valid prescriptions regardless of conscience-based objections.  I use a difference-in-difference framework to identify the effect of the aforementioned policies on quantities of emergency contraceptives and birthrates.  The difference-in-differences model compares the difference in number of prescriptions and various birthrates between treated and untreated states before and after the policy implementations, allowing me to identify changes over time within states that can be attributed to the policy changes.  I find that expansive policies positively affect the quantity of prescriptions filled in subsequent quarters and that restrictive quantities both reduce the amount of filled prescriptions and lead to higher birthrates among certain groups of women.