Alaska House expands pharmacist prescribing powers in 32-8 vote

The Alaska House of Representatives voted 32-8 Friday to let pharmacists prescribe and administer medications for minor ailments and chronic conditions, clearing legislation tied to $272 million in federal rural health funding.

House Bill 195 spells out that pharmacists can provide limited primary care services including prescribing for flu, strep throat, urinary tract infections, and chronic conditions like diabetes. Under the bill, pharmacists must work under collaborative practice agreements with doctors and follow written protocols approved by a practitioner. The legislation also requires pharmacists to recognize the limits of their education, training, and experience, and to consult with or refer to other practitioners when cases exceed their training. The bill is required under Alaska's Rural Health Transformation Program application and must be enacted by December 31, 2027, to secure the federal funding.

In 2022, the Alaska Legislature passed House Bill 145, which added the phrase "other patient services" to pharmacy services but did not spell out what those services would include. HB 195 builds on that earlier law by explicitly authorizing pharmacists to prescribe and administer drugs under collaborative practice agreements.

The Alaska Pharmacy Association and the Alaska Board of Pharmacy worked together on the legislation. Over the interim, the pharmacy association met with the Alaska State Medical Association to address concerns, and many of those compromises were integrated into the bill.

Before final passage, the House adopted the Finance Committee substitute, which made five changes to the bill. The changes included amendments to align statutory references for the Prescription Drug Monitoring Program, a requirement that only pharmacists with federal Drug Enforcement Agency licenses can prescribe controlled substances, reinforcement that pharmacists cannot prescribe high-risk specialty medications designated by the Food and Drug Administration under Risk Evaluation and Mitigation Strategies plans, provisions requiring providers to offer prescriptions for opioid overdose drugs such as naloxone under certain high-risk conditions, and a change in terminology from physician assistants to physician associates.

Opponents including the Alaska State Medical Board and Alaska Right to Life have argued that the bill could expand access to abortion medications. In February 2026, the medical board urged lawmakers to vote against HB 195 and its companion Senate Bill 147, warning that broad prescriptive authority would allow pharmacists to diagnose and treat medical conditions, which the board views as the practice of medicine.

Abortion amendment tabled

Before the final vote, the House tabled 23-17 an amendment that would have prohibited pharmacists from prescribing, administering, or dispensing abortion-inducing drugs. The amendment targeted selective progesterone receptor modulators and other drugs that can induce abortion.

Rep. Genevieve Mina, the bill sponsor, opposed the amendment, saying it was ambiguous and could invite litigation. She said the bill is about basic primary care access, not abortions, and that there are three layers of prohibition preventing pharmacists from providing abortions: it is out of their scope of practice, federal laws require certain conditions to be met for prescribing medications like mifepristone, and state law prohibits anyone other than physicians from performing abortions.

Supporters cite rural access, cost savings

Supporters said the bill will expand access to care in rural areas and reduce healthcare costs by allowing pharmacists to practice at the top of their training.

One representative who worked at the Alaska VA said pharmacists there already provide diabetes care, prescribe medications, and order labs, and that the system is an enormous gift to medical providers. The representative said it was a shock to learn that pharmacists outside the VA could not do this work.

Another representative said the bill would have helped survivors of a flood in the Yukon-Kuskokwim Delta who had to be airlifted to Bethel because they could not get their medications locally. The representative said many people missed their medication because of the delay.

After passage, notice of reconsideration was served on HB 195. The bill now moves to the Senate. According to advocacy materials from the Alaska Pharmacy Association, if enacted, Alaska would join nine other states that have passed similar legislation expanding pharmacist prescriptive authority.