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Contraceptives Are Part of a Basic Health Care Program Most women in the United States, including three-quarters of women of childbearing age, rely on some form of private insurance through their own employer, a family member's employer, or the individual market to defray their medical expenses. The lack of contraceptive coverage in health insurance places many effective forms of contraceptives beyond the financial reach of many women. While most insurance companies state that prescription contraceptives are not "medically necessary," most women regard contraception as a fundamental component of basic health care. The vast majority of private insurers cover prescription drugs, but many exclude coverage for prescription contraceptives. Currently, most health insurance programs will cover permanent birth control methods but do not cover optional methods, which the majority of women prefer. Less than 15 percent of U.S. insurance plans cover all five FDA approved reversible methods of contraception (oral contraceptives, Norplant, IUD's, diaphragms, and Depo-Provera). Only about half of all plans cover any of these methods. A recent report noted that women currently earn 75% of what men earn for a comparable job. Yet women of reproductive age spend 68% more in out-of-pocket health care costs than men with contraceptives and reproductive health care services accounting for much of the difference. Contraceptive Coverage Is Extremely Cost-Effective It is estimated that the coverage of prescription contraceptives would increase the cost of health insurance by about $16 per enrollee per year, a little more than $1.30 a month. Research has also found that the cost to an insurance company over a five-year period for not providing contraceptive coverage comes to $14,663. Over that same period, the cost to insurers to cover oral contraceptives amounts to $1,784. Providing coverage for oral contraceptives would save insurers close to $13,000 due to the costs associated with high costs of unplanned pregnancies. Contraceptive Coverage for Federal Employees In 1998, Congress voted to ensure that all Federal Employees Health Benefit Program (FEHBP) participants have access to comprehensive contraceptive coverage. This coverage continues to be available to federal employees, but must be passed in the annual Treasury Postal Appropriation Bill. Currently, both the House and Senate versions of the Treasury Postal Appropriation Bill retain the provision which guarantees that the FEHBP plan covers prescription contraceptive drugs and devices. But what about all of the women who are not Federal Employees and need contraceptives covered in their insurance plans? Contraceptive Coverage for All? Jennifer Erickson, an employee of Bartell Drug Co. in Washington State has helped to bring national attention to this issue. Erickson sued her employer for excluding coverage for prescription contraception. The case was brought before a federal court, where Bartell was found guilty of sexual discrimination and ordered to include prescription contraceptive coverage in its health plan. While this case technically only applies to Erickson, it sets precedent for other cases. Coverage for contraceptives is currently determined on a state-by-state basis, with national legislation introduced in 1997, 1999, and 2001, but never passed. The 108th Congress did introduce legislation regarding passage of EPICC, however, no action was taken. States Taking the Lead Since Congress first required contraceptive coverage for federal employees, 23 states have followed and implemented laws demanding coverage. (AZ, AR, CA CT, DE, GA, HI, IL, IA, ME, MD, MA, MO, NJ, NV, NH, NC, NM, NY, RI, VT, WA and WV). There are currently 11 states working towards contraceptive equity. For more information, go to: http://www.covermypills.org/facts/statelaw/See a sample letter to the editor on EPICC for use in states where EPICC legislation has not yet been passed. Photo licensed to Sierra Club; used with permission. |
Increased access to a full range of safe, effective, affordable contraceptives is vital to reducing population growth. Therefore, Sierra Club supports initiatives to include contraceptive coverage in insurance plans.