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A group that includes HIV patients has intervened in the case on the state’s behalf, arguing that if pharmacies can refuse to dispense Plan B for religious reasons, some might also refuse to dispense AIDS medications, for example.

According to filings in the case, eight states have rules requiring pharmacists to dispense all drugs. But most of those don’t require pharmacies to stock Plan B or similar drugs, so pharmacies in those states wouldn’t be required to dispense them, the plaintiffs argue.

Waggoner noted that the state showed no interest in rigidly enforcing the rule until groups such as Planned Parenthood began filing complaints and sending test-shoppers and picketers to pharmacies to see if they would dispense Plan B. She said it indicated the state’s true objective was to stamp out religious objection to the drug, an idea she called “repugnant to the Constitution.”

Hospital pharmacies in the state do not fall under the rules, which govern retail, outpatient pharmacies, and they can refuse to dispense certain drugs for reasons of conscience. Catholic hospitals won’t dispense Plan B except in cases of rape, Leighton noted.

That makes the state’s argument about promoting access to the drug a “red herring,” he said.

“The poor people who rely on emergency rooms don’t get the so-called benefit of the rule,” he said. “It’s riddled with exceptions and holes. It’s Swiss cheese.”

The state’s lawyers argued that exemptions to the rule increase the accessibility of drugs because it helps pharmacies stay competitive.

Plan B is kept behind the counter but is available without a prescription to anyone over 17. Federal regulators recently recommended that it be sold to anyone regardless of age, but the Obama administration overruled its own experts in December, outraging women’s rights groups and many in the president’s own party.

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Johnson can be reached at https://twitter.com/GeneAPseattle