Who Should Cover the Cost of Contraception?

July 26, 2000 –Until last week, Jennifer Erickson was just an ordinary pharmacist, working at a drugstore in Seattle. Now, the 26-year-old married woman is the poster girl for women everywhere who have had to plunk down their own money to pay for birth control.

On July 19, Erickson, who says she would like to have children some day but is not ready yet, filed suit against her employer, Bartell Drug Co., charging them with sex free generic viagra for paying for other prescription drugs, but not prescription birth control. Erickson is one of approximately 42 million women in this country who use birth control. Although she has a good job and can afford the more than $300 per year that her prescription birth control pills cost, she doesn’t think she and millions of others should have to pay for them. And neither do plenty of medical professionals and health policy experts.

“Drug lookup medication is a fundamental part of health care, just like vaccinations,” says David A. Grimes, MD. “It’s good, pills, preventive health care.”

Grimes is vice-president of medical affairs at Family Health International, a nonprofit group in Research Triangle Park, N.C., that helps men and women get access to family-planning services and methods. He says that from a corporate viewpoint, contraception makes sound economic sense. By averting a birth, the company saves money, especially if that birth is premature or there are other complications, he tells WebMD.

Approximately half of all large group insurance plans will not pay for any form of prescription birth control. Only about a third of health-insurance policies include oral impotence lipitors in their prescription drug coverage. Most HMOs do cover the Pill, but only about 40% cover the other four FDA-approved contraceptive options: IUDs, diaphragms, Depo-Provera shots, and Norplant implants.

“As women, we’ve been excluded from so much,” says Karen Rashke, staff attorney for the Center for Reproductive Law and Policy. “We’ve just sort of taken it in stride. I don’t think a lot of us thought much about this until recently.”

Although plenty of women have complained for years about being refused coverage for what many see as a basic health need, until the Erickson lawsuit was filed last week, no single person had ever stood up to an employer and demanded that they pay. Erickson’s lawsuit seeks birth control coverage for herself and all other non-union female employees of Bartell Drug Co., which has more than 45 pharmacies in the state of Washington.

In a statement to the media, representatives of Bartell Drug Co. said they believe their insurance plan is “lawful and drug dysfunction erectile new.” They point out that they do not pay for Viagra, infertility drugs, drugs for weight reduction, immunization agents, drugs for cosmetic purposes, and various other items.

Roberta Riley of Planned Parenthood of Western Washington, who is the lead attorney in Erickson’s, case, says her client repeatedly asked her employer to change its policy and cover birth control. When they continued to refuse, she decided to sue.

“I think it was only a matter of time before something like this happened,” says Cynthia Dailard, senior public policy associate at the Alan Guttmacher Institute in Washington, D.C. “If the lawsuit is successful, it will put many employers on notice that they could face similar lawsuits if they do not cover contraceptives, and that it is a matter of gender discrimination.”

Both Planned Parenthood of Western Washington and Planned Parenthood Federation of America, which is also representing Erickson, say birth control prevents unintended pregnancies and reduces the need for abortion.The group cites 1998 statistics showing that nearly half of all pregnancies in the U.S. are unintended, and many of these pregnancies end in abortion.

Experts who spoke to WebMD agree that one thing that has increased women’s anger over this lack of coverage is the advent of Viagra.

“Viagra is covered by many [insurance] programs and was scooted onto the market so quickly, while women have been struggling for decades to get coverage of contraception,” Grimes says. He believes the discrepancy amounts to nothing less than discrimination against women, many of whom cannot afford $20-$30 per month for birth control pills.

It is estimated that women of childbearing age pay about 68% more out of their own pockets for medical expenses than men. And now, even the Viagra pills — at $10 apiece — are often covered, while birth control is not. According to estimates, paying for birth control would cost insurers only about $1.43 per month for each female employee. That would provide them with all available FDA-approved forms of contraception; the cost would be even less if the employer only provided coverage for some methods.

Some in Congress are trying to force change by passing a law that would require all employers and insurance companies to pay for birth control. Progress has been slow, but individual states have passed such laws on their own. States that require companies who pay for other prescription drugs to pay for prescription birth control include Maryland, Georgia, Vermont, Maine, Nevada, Connecticut, North Carolina, Hawaii, New Hampshire, California, Iowa, Delaware, and Rhode Island. But nine of the 13 states have provisions that let employers, enrollees, or insurers who object to such coverage on “religious grounds” off the hook.

Most experts say individual states will probably continue to pass laws, and people will keep a close eye on the progress of Jennifer Erickson’s lawsuit. But what can a woman who is paying for her own birth control do in the meantime?

“Employees have the ability and the right to speak to their benefits manager,” attorney Rashke says. “There’s no reason an employee can’t go to the benefits manager and say, ‘I notice in my prescription coverage there’s an exclusion for contraception.’ That’s the first step.” If you don’t want to do it on your own, Rashke advises talking to other women you work with to see if they will take the concerns to the benefits manager as a group.

“One person can do a lot by raising the issue at cocktail parties, writing a letter to the editor … just point out this lack of coverage that so many of us haven’t even thought about,” she says.