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Tennessee enacted legislation in July 2025 allowing healthcare providers—including individuals, institutions, and insurers—to refuse to participate in or pay for healthcare procedures, treatments, or services that conflict with their personal beliefs. While birth control was not specifically mentioned in the bill, the bill's author confirmed it would allow pharmacists to refuse to dispense contraception based on personal objections.
The law represents a significant expansion of healthcare refusal provisions beyond abortion to encompass contraception and potentially other reproductive healthcare services. By enabling pharmacists and other healthcare providers to deny contraception based on personal beliefs rather than medical judgment, the law creates barriers to accessing birth control that disproportionately affect women in rural areas with limited pharmacy options.
According to the National Women's Law Center, pharmacists have refused to fill prescriptions for birth control or provide emergency contraception over the counter to patients in 24 states and the District of Columbia. These refusals, based on personal beliefs rather than medical contraindications, can negatively impact patients' health by delaying or preventing access to time-sensitive contraception.
The Tennessee law was part of a broader 2025 legislative trend targeting contraception access through: (1) enshrining fetal personhood that could classify certain contraceptives as abortifacients; (2) targeting specific methods of birth control; (3) allowing refusals of birth control; and (4) blocking Right to Contraception Acts in at least eleven states.
More than 19 million women of reproductive age living in the United States are in need of publicly funded contraception and live in contraceptive deserts—counties lacking reasonable access to health centers offering the full range of contraceptive methods. The Tennessee refusal law exacerbated this crisis by allowing individual provider discretion to further restrict already limited access.
The legislation exemplified how abortion restrictions serve as a gateway to broader reproductive healthcare restrictions, with contraception access increasingly threatened despite its legal status and widespread public support.