One big step toward making it easier for Utah women to access birth control began as a simple class assignment at the University of Utah.

Wilson Pace, a U. pharmacy graduate student, said he’d heard about delays and added costs that his wife and other women sometimes faced in obtaining contraceptives in Utah, where a doctor’s visit is required to get a birth-control prescription.

So the 29-year-old drafted a “dream bill” for his leadership class, in what would become Senate Bill 184, letting Utah women obtain birth control directly from a pharmacist. Pace suggested it to a few state legislators, given that several other states have passed similar legislation in recent years.

“I thought, why can’t we do this here in Utah, you know?” Pace said in an interview.

(Rick Egan | The Salt Lake Tribune) Sen. Todd Weiler argues a bill in the Utah Senate, Thursday, Feb. 1, 2018.

Lawmakers liked the idea, as did key health care groups in the state. SB184 passed both chambers on Utah’s Capitol Hill without a single opposing vote. It and another birth-control related bill were signed this week by Gov. Gary Herbert.

“This was really his bill. I give him all the credit,” SB184 sponsor Sen. Todd Weiler, R-Woods Cross, said of Pace.

IUDs for low-income women

Supporters predict that another bill widening access to birth control — HB12 — will give thousands of very low-income women access to family-planning services, including costly but long-acting birth control such as intrauterine devices, or IUDs.

Sponsored by Rep. Ray Ward, R-Bountiful and family physician, the measure expands federal Medicaid coverage for family-planning services so that it extends to women making less than 100 percent of the federal poverty level, or $12,140 for a single woman.

The expansion will require federal approval.

The bill effectively gives low-income women access to IUDs that were previously out of reach due their price tag, which can hit $1,200. A recent study at the U. found that cost was a major factor in what type of birth control women choose, preventing them from selecting IUDs and similarly high-priced long-acting contraceptives.

“When you remove cost as a factor, people are more likely to select more effective contraception methods that are often the most expensive up front,” Jessica Sanders, a study author and research assistant professor in obstetrics and gynecology at the U., said in a statement.

“When we added education and outreach to the picture,” Sanders said, “we saw an increase in the demand for these methods.”

With HB12, lawmakers were also swayed by the fact that improved access to birth control would lead to fewer unplanned pregnancies — allowing women to better manage their lives by choosing when to pursue school and work, and potentially reducing state welfare assistance costs. Legislators also noted it would reduce the number of abortions.

HER Salt Lake, a birth-control advocacy organization, called HB12’s passage a “monumental win” that would improve family planning in Utah.

One stop for birth-control pills

SB184, meanwhile, will give all Utah women over 18 an easier path to obtaining birth-control pills and similar self-administered contraceptives. Under the measure, the state will issue a standing order that gives pharmacists authority to dispense the contraceptives directly.

Women have to fill out a risk assessment questionnaire beforehand. And they must demonstrate they have visited a doctor at least once every two years, under the bill.

But they won’t need to schedule a doctor’s visit each time they want to obtain or renew a prescription for birth-control pills.

Weiler said the state would issue a standing order similar to one the Utah Department of Health (UDOH) issued in late 2016, allowing pharmacies to dispense the opioid overdose-preventing drug naloxone without a prescription. Naloxone is considered life-saving and officials recently said more than 4,000 doses were handed out in 2017 thanks to the DOH order.

“We are in favor of preventing unwanted pregnancies, and this definitely would help,” UDOH Executive Director Joseph Miner said of SB184.

The bills passed the Republican-dominated Legislature that ended March 8 with relatively little controversy — in what Ward said was a sign of shifting attitudes on Capitol Hill.

Fifteen years ago, he said, there likely would have been an “apocalyptic nuclear explosion” had similar legislation been introduced.

(Steve Griffin | The Salt Lake Tribune) Rep. Ray Ward, R-Bountiful, right, summarizes HB12, which requires the Medicaid program to reimburse providers separately for the insertion of long-acting reversible contraception immediately after childbirth, during the House Health and Human Services Standing Committee meeting on Capitol Hill in Salt Lake City, Wednesday, Jan. 24, 2018.

Discussions on birth control, Ward said, have become less “inflammatory,” less a part of our “culture wars” — perhaps because most people have used contraceptives and the drugs are now seen as effective and beneficial.

When Pace realized his class assignment could become law, he rallied several fellow U. students and pharmacists to his cause, while contacting legislators and officials from influential health groups such as the Utah Medical Association and Utah Nurses Association.

“If you want to make a difference in health care, you have to be involved,” said Pace, now in his final semester. “You have to advocate for your profession.”