Contraception

Citizens Count Editor

There are many forms of contraception available in New Hampshire.  Birth control methods that can be accessed ‘over-the-counter’ in New Hampshire include:

  • Male and female condoms
  • Spermicide
  • Sponges
  • Emergency contraception pills
  • Natural or rhythm-based family planning
  • Oral contraceptive pills (starting January 2019)

Methods that require a prescription or doctor’s visit in New Hampshire include:

  • IUD (intrauterine device)
  • Birth control injections, patches and rings
  • Diaphragms
  • Male or female sterilization

Learn about laws related to surgical abortion or the abortion pill in New Hampshire

Emergency contraception

Emergency contraception pills are available over-the-counter in New Hampshire. This means patients can get the drug directly from a pharmacist, without first seeing a doctor.

Emergency contraception pills can prevent pregnancy if taken within three to five days of unprotected sex. They prevent ovulation or implantation of a fertilized egg, but cannot end an existing pregnancy.

Age restrictions

There are no specific restrictions on the age when minors can access contraceptive drugs or services. This means the state’s general law regarding medical treatment of minors applies.

In New Hampshire, persons aged 17 and under generally need permission from a parent or guardian before they can receive medical treatment.

However, state law does allow “any minor of sound mind… and sufficient maturity” to consent to medical treatment without parental permission or notification. This includes services related to contraception, such as getting an IUD or prescription for a birth control pill, but not abortion.

Whether or not a patient has reached “sufficient maturity” is left to the discretion of his or her physician.

Insurance coverage

New Hampshire state law requires that insurers provide coverage for prescription contraception in a manner that is similar to coverage for other prescription drugs.  

The federal Affordable Care Act requires insurance plans to cover contraception without a co-pay. However, in 2017, the Trump administration eliminated this requirement for any company with a religious or moral objection.

This means that companies located in New Hampshire that object to paying for birth control must still offer insurance coverage for contraception, per state law, but may require a co-pay similar to that paid for other types of drugs.

Insurers are also required to cover receiving up to a twelve-month supply of oral contraceptive pills in a single pharmacy visit.

NH Family Planning Program

New Hampshire offers free family planning and contraception to some low-income adults through the New Hampshire Family Planning Program, part of New Hampshire’s Medicaid program. This is funded through a combination of state and federal dollars.

Men and women whose family incomes total 185% of the federal poverty level or less are eligible.

The program covers the costs of doctor’s visits, tests and screenings related to family planning or contraception, as well as the costs of drugs and services. This includes prescriptions for oral contraception pills, having an IUD put in, or even sterilization procedures.

The program does not cover the costs of abortions, fertility treatments, or emergency room visits.

Get more information about the New Hampshire Family Planning Program

Patients who aren’t eligible for the Family Planning Program may still be able to get financial assistance from a clinic or health care provider that uses a sliding fee scale.

Policy debates

Religious exemptions to insurance coverage

Several states allow insurers or employers to exclude coverage of contraception from their plans if they have a religious objection.

Supporters argue this option is an important protection of religious freedom and that employers shouldn’t be forced to pay for products or services they morally object to.

Opponents counter that the move allows companies to treat female employees unfairly, denying them coverage of important health services.

Under New Hampshire law, companies and insurers cannot eliminate coverage for contraception because of religious objections.

Pharmacist obligations and opt-outs

In some states, pharmacies and pharmacists have a protected right to refuse to dispense contraception if they have a religious or moral objection.

Other states only allow the religious objection for prescriptions for emergency contraception.

On the other side of the divide, some states have laws that actually require pharmacies or pharmacists to fill valid prescriptions for emergency contraceptive pills.

PROS & CONS

"For" Position

By Citizens Count Editor

 “New Hampshire should increase access to birth control.”

  • Spacing out or avoiding pregnancy has profound implications for women’s health and financial well-being. For example, according to the American Public Health Association, access to contraception is linked to better birth outcomes and lower maternal death rates. New Hampshire should therefore increase access to birth control to improve outcomes for women.
  • Some forms of birth control can be very expensive. By taking steps to make it more affordable, the state helps ensure that all women have access to safe, reliable ways of preventing pregnancy.
  • If women lose access to affordable birth control, it will lead to more unintended pregnancies, which through Medicaid and other social services can be very costly for taxpayers.  
  • Policies that restrict access to birth control, or allow insurers to reduce or deny coverage, target a single medical service used disproportionately by women. This amounts to discrimination.
  • Allowing moral objections to covering essential health services opens the door to employers or insurers denying coverage for anything from substance abuse treatment to vaccines. 

"Against" Position

By Citizens Count Editor

“NH should not increase access to birth control.”

  • Increasing access to birth control could promote immoral sexual behavior, particularly among teens.
  • Abstinence remains a free, effective, and morally sound method of preventing unwanted pregnancy.
  • Prescription and doctor’s visit requirements should be reinstated so that women are fully appraised of the risks of various contraceptive methods, know procedures for proper use, and are regularly monitored for issues or complications.
  • Employers, insurers and pharmacists should not be forced to violate their own religious beliefs by paying for services and medications they object to. Women who want insurance coverage for contraception can choose to work for an employer who provides it, or can purchase a plan that includes it.
  • Birth control lowers the risk of unintended pregnancy, but conversely, this could increase engagement in risky sexual behaviors that have negative implications for women’s health.
  • Birth control is not preventative medicine, as pregnancy is not an illness. Women who don’t want to get pregnant have free ways of avoiding doing so, therefore taxpayers shouldn’t be asked to subsidize the cost of more expensive options. 

LEGISLATIVE HISTORY

Signed by Governor

Allows pharmacists to dispense hormonal birth control through a signed protocol authored by a qualified physician or APRN. This bill also requires health insurance to cover birth control dispensed by a pharmacist.

Signed by Governor

Requires health insurers to cover outpatient contraceptive services the same as other outpatient services. This bill also requires insurers to cover all prescription contraceptive drugs and contraceptive devices approved by the U.S. Food and Drug Administration, including 12-month contraception prescriptions, with no extra cost to the insured person.

Signed by Governor

Allows pharmacies to dispense oral contraceptives to persons 18 years of age or older without a prescription. The House amended the bill to instead establish a commission to study making oral contraceptives available over-the-counter.

Interim Study

Allows pharmacies to dispense oral contraceptives to persons 18 years of age or older without a prescription.

Tabled in the Senate

Requires insurers and employers offering insurance to notify policy holders/employees about the details of contraceptive coverage.

Killed in the Senate

Allows pharmacies to dispense oral contraceptives to persons 18 years of age or older without a prescription.

Should NH act to increase access to birth control?

Comments

Chris Jay
- Manchester

Wed, 10/31/2018 - 1:23pm

Why should the State pay for your birth control? I thought the state was supposed to "stay out of the bedroom" - it seems like we now think that the State MUST come into the bedroom AND pay. We can't have it both ways.

Besides that, most of these mechanisms are downright harmful. Anyone with a basic knowledge of NFP (think Billings Method, etc.) knows that we don't need to pump massive amounts of hormones into our bodies. Eat organic but take birth control? See the book "Estrogeneration" by Dr. Jay - think twice about this.

Kevin Drees
- Madbury

Mon, 11/06/2017 - 5:04pm

Birth control pills and especially emergency contraception should be available over-the-counter, and regulations should be put in place to keep the price affordable to all.

Jackie Benson
- Kensington

Mon, 11/06/2017 - 9:48am

Making birth control more readily available to women is a win for everyone, but lawmakers need to be careful that increasing access doesn't end up decreasing affordability. If birth control pills are available without a prescription, insurance companies may no longer cover them, making the pills cost-prohibitive for women. New Hampshire legislators should empower pharmacists to actually issue the prescriptions, so that insurance plans will still cover the costs.

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Issue Status

This year, a bill to make birth control pills available directly from a pharmacist, without first getting a prescription from a doctor, became law. A bill mandating insurance coverage for 12-month supplies of birth control bills was also passed by the Legislature.

See what NH citizens had to say about over-the-counter birth control

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