H.R. 4084: Access to Birth Control Act
Sponsor
Robin Kelly
Democrat · IL-2
Bill Progress
Latest Action · Jun 23, 2025
Referred to the House Committee on Energy and Commerce.
Why it matters
Pharmacists in at least 25 states have refused to fill birth control prescriptions based on personal beliefs — and since the Dobbs decision in 2022, those refusals have increased. H.R. 4084 would make it a federal duty for every pharmacy in the country to dispense FDA-approved contraception, with penalties up to $100,000 and a private right of action for anyone who gets turned away.
The bill creates a straightforward federal mandate: if a pharmacy receives FDA-approved drugs through interstate commerce, it has to fill contraception prescriptions. No exceptions for personal, moral, or religious objections.
If your prescription is in stock, the pharmacy has to provide it without delay. If it's out of stock, the pharmacy has to immediately tell you and either find another pharmacy that has it or order it through their standard expedited process. They can't hold your prescription hostage, can't intimidate you, can't lie about availability, and can't breach your medical confidentiality.
The teeth matter here. A pharmacy that refuses faces up to $1,000 per day in federal civil penalties, capped at $100,000 per proceeding. But the real enforcement power goes to you: anyone turned away can sue for actual damages, punitive damages, injunctive relief, and attorney's fees. You have five years to file.
The bill explicitly blocks the Religious Freedom Restoration Act as a defense — pharmacies can't use RFRA to challenge or defend against enforcement. Three narrow exceptions survive: no valid prescription, customer can't pay, or a refusal based on genuine professional clinical judgment.
Pharmacies would have 31 days to comply after enactment — no waiting for federal rulemaking or guidance.
What does H.R. 4084 do?
Every pharmacy must fill birth control prescriptions
Any pharmacy that receives FDA-approved drugs through interstate commerce has a federal duty to dispense contraception without delay. If it's out of stock, the pharmacy must find you one that has it or order it through their expedited process.
Personal beliefs are no longer a valid reason to refuse
Pharmacies and staff cannot deny contraception based on personal, moral, or religious objections. The Religious Freedom Restoration Act explicitly cannot be used as a defense.
Penalties up to $100,000 and a private right to sue
Pharmacies face up to $1,000 per day in federal civil penalties, capped at $100,000 per proceeding. Anyone turned away can sue for actual and punitive damages, injunctive relief, and attorney's fees within five years.
Pharmacies can't hold your prescription or breach confidentiality
Pharmacies cannot refuse to return your prescription, intimidate or harass you, lie about whether a drug is available, or disclose your medical information when handling contraception requests.
31-day compliance window — no waiting for federal rulemaking
The requirements take effect 31 days after enactment, regardless of whether the HHS Secretary has issued any guidance or rules.
Who benefits from H.R. 4084?
Anyone who's been refused birth control at a pharmacy
If a pharmacist has ever turned you away based on their personal beliefs — and people in at least 25 states have reported exactly this — you'd have a federal law backing you up and a private right of action if it happens again.
The 19 million women living in contraceptive deserts
If you live in a county without a full-service reproductive health center, you're already limited to whatever your local pharmacy stocks. Losing access at the pharmacy counter because of one employee's beliefs can mean driving hours for medication you need.
People using birth control for medical conditions
Contraceptives treat endometriosis, abnormal uterine bleeding, irregular cycles, and other chronic conditions. A pharmacy refusal doesn't just block family planning — it blocks medical treatment.
Low-income and uninsured people
With an estimated 10 million people potentially losing health coverage from Medicaid changes and ACA premium credit expirations, pharmacy-counter access becomes even more critical for people who can't afford to shop around.
Who is affected by H.R. 4084?
Pharmacies and pharmacists nationwide
Every pharmacy that sells prescription drugs at retail — and every employee — must comply with the new dispensing requirements within 31 days of enactment or face federal penalties.
States with existing refusal laws
At least seven states, including Tennessee (which passed its pharmacy refusal law in July 2025), have laws allowing pharmacists to refuse based on personal beliefs. This bill overrides those laws, though it preserves any state protections that go further than the federal floor.
Religious liberty advocacy organizations
The explicit RFRA preemption removes the primary legal tool these groups have used to defend conscience-based refusals. This provision is likely to draw immediate legal challenges.
H.R. 4084 Common Questions
Can a pharmacist refuse to fill my birth control under H.R. 4084?
Only in three narrow situations: you don't have a valid prescription, you can't pay, or the pharmacist makes a professional clinical judgment (a medical decision, not a moral one). Personal, moral, or religious objections are explicitly not valid reasons to refuse.
What can I do if a pharmacy refuses my birth control prescription?
You can sue. H.R. 4084 gives you a private right of action — you can take the pharmacy to court for actual damages, punitive damages, injunctive relief, and attorney's fees. You have five years from the date of the refusal to file.
How much can a pharmacy be fined for refusing birth control?
Up to $1,000 per day of violation in federal civil penalties, capped at $100,000 in a single proceeding. On top of that, anyone turned away can sue privately for additional damages — there's no cap on what a court can award in a private lawsuit.
Can a pharmacy use religious freedom laws to justify refusing birth control?
No. H.R. 4084 explicitly blocks the Religious Freedom Restoration Act (RFRA) from being used as either a legal claim or a defense. This is one of the bill's most contested provisions — it removes the primary legal tool that has been used to defend conscience-based refusals.
What happens if my pharmacy is out of my birth control?
The pharmacy has to tell you immediately and give you two options: they either find another pharmacy that has it in stock (your choice of pharmacy or the closest one) and transfer your prescription, or they order it through their standard expedited process and notify you when it arrives.
Does H.R. 4084 cover emergency contraception and over-the-counter birth control?
Yes. The bill covers any drug or device approved, cleared, or authorized by the FDA to prevent pregnancy — that includes emergency contraception and the first OTC daily birth control pill approved in 2023. It also covers related medications that a medical professional says you need to use in conjunction with contraception.
How quickly would pharmacies have to comply?
31 days after the bill becomes law. There's no waiting for HHS to issue guidance or finalize rules — the requirements kick in automatically, which is unusual for federal health mandates.
Can a pharmacy hold onto my prescription and refuse to give it back?
No. H.R. 4084 specifically prohibits pharmacies from refusing to return a valid prescription for contraception. They also can't intimidate you, lie about whether a drug is available, or disclose your medical information.
Based on H.R. 4084 bill text
HR4084 Legislative Journey
House: Committee Action
Jun 23, 2025
Referred to the House Committee on Energy and Commerce.
About the Sponsor
Robin Kelly
Democrat, Illinois's 2nd congressional district · 13 years in Congress
Committees: Energy and Commerce
View full profile →
Cosponsors (45)
All 45 cosponsors are Democrats. Cosponsors represent 23 states: Alabama, California, Colorado, and 20 more.
Bill Foster
Democrat · IL
Eleanor Norton
Democrat · DC
Julia Brownley
Democrat · CA
Mary Gay Scanlon
Democrat · PA
Sylvia Garcia
Democrat · TX
Melanie Stansbury
Democrat · NM
Terri Sewell
Democrat · AL
Kathy Castor
Democrat · FL
Mark Pocan
Democrat · WI
Nanette Barragán
Democrat · CA
Shri Thanedar
Democrat · MI
Jasmine Crockett
Democrat · TX
Committee Sponsors
Energy and Commerce Committee
9 of 54 committee members cosponsored
15 Democrats across this committee haven't cosponsored yet. Mobilize their constituents
What laws does H.R. 4084 change?
1 changes
Sections Amended
Section 1557 of Patient Protection and Affordable Care Act (42 U.S.C. 18116). SEC. 3. DUTIES OF PHARMACIES TO ENSURE PROVISION OF CONTRACEPTION AND MEDICATION RELATED TO CONTRACEPTION. Part B of title II of the Public Health Service Act (42 U.S.C. 238 et seq.)
adding at the end the following: ``SEC
H.R. 4084 Quick Facts
- Committee
- Energy and Commerce
- Chamber
- House
- Companion
- S. 2302
- Policy
- Health
- Introduced
- Jun 23, 2025
Referred to the House Committee on Energy and Commerce.
Jun 23, 2025
Constituent Resources
Official Sources
Companion Bill in the Senate
House · This Bill
H.R. 4084
Robin Kelly (D)In committee
Senate · Companion
S. 2302
Cory Booker (D)In committee
All-Democrat support in both chambers — no bipartisan crossover yet.
H.R. 4084 Bill Text
“To amend the Public Health Service Act to establish certain duties for pharmacies to ensure provision of Food and Drug Administration-approved contraception and medication related to contraception, and for other purposes.”
Source: U.S. Government Publishing Office
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