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Who Pays for the Pill? Women See Progress in Getting Birth Control Covered by Health Insurance
abc.com ^ | June 19,2002 | Geraldine Sealey

Posted on 06/19/2002 1:37:41 PM PDT by baxter999

Who Pays for the Pill? Women See Progress in Getting Birth Control Covered by Health Insurance

By Geraldine Sealey

June 19 — Within weeks of hitting the U.S. market in 1998, more than half of Viagra prescriptions received health insurance coverage. If many women weren't already outraged that they had to pay for birth control out of pocket, they were infuriated at the preference given to the anti-impotence pills.

But the fury over Viagra may have given the fight for contraception covered under insurance plans just the momentum it needed. Women's groups say they're making significant progress in their battle to get reimbursed for birth control, even though insurers still argue that covering contraception will boost already skyrocketing health-care premiums.

This week, New York became the 20th state to require that insurers and employers provide contraceptive coverage. That means that half of U.S. women now live in states requiring at least some birth control coverage, according to Planned Parenthood. Massachusetts and Arizona passed similar bills earlier this year that will go into effect in 2003.

So far, women's groups have fought the battle piecemeal: state by state and insurer by insurer. But today, a congressional subcommittee is taking up a bill that would fill what women's groups say is a gaping hole in birth control coverage by requiring plans that fall under federal law to reimburse for contraception.

Although the bill has been introduced for several years in a row without being passed, women's rights activists are more optimistic this time around.

"I think there's a big groundswell right now," said Gloria Feldt, executive director of Planned Parenthood, which also filed a discrimination complaint against the Dow Jones Co. for not covering birth control. "I would say it's an idea whose time has come — it's past time. When it comes to health insurance, men have been getting a better deal."

Twenty states require employers and insurers to offer some health insurance coverage for birth control. (ABCNEWS.com)

Studies have shown that women of reproductive age spend about two-thirds more than men on out-of-pocket health-care costs. Birth control and reproductive health-care services are believed to account for much of the difference.

Since the most effective forms of birth control, such as the pill, are only available by prescription and can be relatively expensive for some, a lack of insurance coverage can put contraception out of reach for some, women's groups say. Birth control pills cost an estimated $30 a month plus doctor's fees.

Women's activists say they cannot understand why, given what they see as the "cost-effectiveness" of birth control, employers and insurers wouldn't jump to cover it. They point to studies that found for every $1 of public funds invested in family planning, $4 to $14 of public funds is saved in pregnancy and health care-related costs.

"Insurance companies have got to realize there's no financial disincentive," Feldt said. "[Covering contraception] saves so much on the other end. Over the long term, contraception coverage seems to save money."

Insurers: Are Higher Costs Worth $30 a Month?

Insurers, though, say the cost-effectiveness figures cited by women's groups are misleading. While investing public money in family planning for poor women may make good economic sense, women in middle- and upper-income brackets, who are more likely to have health insurance, will not likely risk pregnancy just because their health insurance does not cover birth control.

"It's inappropriate to take cost-effectiveness figures and propagate them to a higher-income, employed population," said Tom Wildsmith, policy research actuary for the Health Insurance Industry of America, a trade association.

Forcing employers and insurers to cover birth control will only exacerbate high health insurance costs, Wildsmith said.

"It's understandable why if you think something is important you would want someone to pay for it for you. But you can add on nice things to the point where insurance is less affordable than it is now," he said.

An estimated half of traditional indemnity plans and preferred provider organizations, 20 percent of point-of-service networks, and 7 percent of health maintenance organizations cover no contraceptive methods other than sterilization.

Some States Allow Religious Exemption

Although women's activists say the best "prescription equity" laws cover the full range of contraceptive needs with no loopholes, 11 states allow an exemption on religious grounds. That's OK, some women's advocates say, as long as the employer or insurer is not just tangentially connected to a religious institution, such as a religiously affiliated hospital.

Women's groups say they're facing less opposition now than when they started pressing the issue years ago. Some companies are even starting to offer contraception coverage on their own, such as the Chrysler Group, the American subsidiary of German automaker DaimlerChrysler AG, which this month expanded its employee benefits package to include coverage for prescription contraceptives.

While some anti-abortion activists may have reservations about the government requiring coverage for contraception and reproductive services, they have not lined up in overwhelming numbers on the contraceptive coverage issue.

However, in some parts of the country, anti-abortion activists are fighting public funding for birth control. In Kentucky, hard-line abortion foes are lobbying a public health board to turn down federal family planning money used to dispense birth control pills to women, saying the contraceptives are the equivalent of an abortion.

Both sides of the abortion debate will be watching that vote when it takes place tonight.

Overall, though, Janet Krepps, staff attorney for the New York-based Center for Reproductive Law and Policy, says attitudes about insurance coverage for birth control are changing.

"As people have become more educated about the issue they've realized that this is basic fairness and health care," she said. Also, predictions about the economic effects of contraceptive coverage just did not bear out, she said.

"There was all of this doom and gloom that [birth control coverage] would cause increases in premiums and costs, but that hasn't been realized," Krepps said.


TOPICS: Constitution/Conservatism; Culture/Society; Government; News/Current Events
KEYWORDS: birthcontrol; religion; socialism; socializedmedicine
This article contains so many things that are wrong about America. And although it should be repugnant to force an insurer like the Catholic church to cover a practice that it considers immoral, the main issue here is increasing government control.

Birth control is a minor issue. Pills are cheap and there are tons of ways to get them free or deeply discounted already. (Planned Parenthood and other abortionists being easily found almost anywhere)

The point of this movement is to get government involved in saying what is and isn't covered in "private" insurances. Once this is done all kinds of bad things ensue.

First, costs go up leading to higher health spending. This higher health spending is then used by liberals to justify even more government intervention in a system that is already socialized (even though the liberals caused the increase).

Second, higher costs mean that more employers will drop insurance, leading to more uninsured. This, too, will be used to justify further government intervention.

Third, insurers that won't comply, like a religion that opposes contraception, will be forced out of business, decreasing competition and increasings costs, which will be used to justify more government.

Once government can do this, why not require coverage of that neutraceutical product whose company gave so much money to Congressman X's campaign? And why not force coverage of abortion, cloning, month long vacations for queers with AIDS, etc. ?

Obviously there is no end in sight once the precedent is established. Note that this precedent is established in many states and will probably soon be nationally established.

Although we are probably fighting a losing battle with the current RINO in chief and liberal control of Congress and the judiciary, it's still a battle worth waging if for no other reason than delaying the deluge of socialism a few more days.

Here in Utah I contact all the representatives every year and get this perennial bill voted down. But with even the local AMA affiliate, the Utah Medical Association, fighting for its passage, it is just a matter of time. Apres mois, le deluge? Perhaps it is time to take a book from the old Romans who, seeing their Republic in ruins, retired to their villas in the country and awaited the onslaught of the barbarians?

1 posted on 06/19/2002 1:37:41 PM PDT by baxter999
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To: baxter999
It is a rediculous concept to equate birth control pills with viagara. This has been an ongoing cry from liberals and women for some time. The two do not handle similar functions.

From the insurer's standpoint, I hate to see it happen because it is going to be one more nail in the coffin of private insurance. Anyone who advocates covering birth control pills because viagara is covered doesn't know basic anatomy.

2 posted on 06/19/2002 2:14:42 PM PDT by Dad was my hero
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To: Dad was my hero
Viagra is for something that isn't working correctly, and Birth Control Pills are for something that is working exactly as it should.....
3 posted on 06/19/2002 3:54:41 PM PDT by tarawa
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To: tarawa
Well not necessarily. While it's true that the vast majority of BCP perscriptions are given to simply halt pregnancy there are a number of... issues... down there that the enforced regularity of ovulation and cleaning that BCPs create helps. So they can help things that aren't working (note, the vast majority of women with these issues aren't fertile anyway).

That being said I don't see why BCP should be different than any other drug, the insurance companies pick and chose what they'll allow, largely based on their own math, every day. Why should BCP be any different.
4 posted on 06/19/2002 4:03:45 PM PDT by discostu
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To: discostu
That's not correct. Insurance companies usually cover anovulatory drugs when they are prescribed for issues such as endometriosis, but not when presecibed to halt ovulation.

Insurers cover drugs that aid return to homeostasis (the normal functioning of the body), not drugs that interrupt the normal functioning of the body. That is why viagara is a covered item. If there were an equal drug that aided women with sexual dysfunction, it would be covered.

5 posted on 06/20/2002 4:33:55 AM PDT by Dad was my hero
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To: Dad was my hero
I don't know why the cover what they cover. I just know that where my wife works has switched insurance companies a number of times and there's never been even the slightest problem getting her BCP covered. They might be looking at her records and seeing that it's a medical necessity, but if they are they all did it on their own without even talking to us about it.
6 posted on 06/20/2002 7:51:25 AM PDT by discostu
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To: discostu
HMO's often cover them without a medical necessity issue attached such as endometriosis.

But insurers that don't shouldn't be made to do so under the false premise that this is descrimination based on gender because they don't perform similar functions. If a pharmaceutical manufacturer comes out with a drug that reduces spermatogenesis (production of sperm) and the insurer covered that, then I would say that BCP should be covered for women to avoid pregnancy.

7 posted on 06/20/2002 9:32:59 AM PDT by Dad was my hero
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To: baxter999
In Kentucky, hard-line abortion foes are lobbying a public health board to turn down federal family planning money used to dispense birth control pills to women, saying the contraceptives are the equivalent of an abortion.

Oh Brother!

If Catholics don't belive in birth control, then their policyholders shouldn't be turning in any claims for birth control pills.

BTW, I kind of agree with the Viagra argument myself.

8 posted on 06/20/2002 9:56:11 AM PDT by TX Bluebonnet
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Comment #9 Removed by Moderator

To: Dad was my hero
"If there were an equal drug that aided women with sexual dysfunction, it would be covered. "

http://www.psy.utexas.edu/psy/ARTICLES/news_meston.html

EXCERPT: "Some call the drug the female equivalent of Viagra, but unlike its male counterpart, it is not likely to be covered by insurance companies, Meston said. Insurance companies pay for Viagra because arousal is necessary for men to reproduce," Meston said. "But, there is no evidence linking female sexual satisfaction with their ability to reproduce. Unfortunately, this will keep most insurance companies from covering this type of drug in their policies."

Huh? Not wanting sex would seem to me a hinderance for women to reproduce, unless they are advocating rape.

10 posted on 06/20/2002 2:20:54 PM PDT by Lorianne
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To: baxter999
In terms of economics, not covering contraceptives would raise insurance costs because of:

___Pregnancy and childbirth costs (which include very high E&O insurance costs to doctors) The "sue" rate for pregnancy and birth related mishaps is very high compared to other health care services.

___Coverage of child health care (including the astronomically high health care cost of preemies and children with various birth defects).

From a cost standpoint, it would seem to me cheaper for everyone if contraceptives were covered.

In addition many health care plans cover fertility treatments and IVF, very high ticket items also with a high "sue" rate.
11 posted on 06/20/2002 2:29:38 PM PDT by Lorianne
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To: Dad was my hero
It is a rediculous concept to equate birth control pills with viagara. This has been an ongoing cry from liberals and women for some time. The two do not handle similar functions

I agree with you. I've brought this up among some liberal friends before who have ranted about this and I asked them if the equivalent of Viagra for women is covered(which would be measures to remedy sexual dysfunction in women) and if it is, than what is the stink. I've maintained that Viagra, when used properly, is to correct a valid medical problem. getting pregnant is not a medical problem that needs correcting and choosing to use birth control is a LIFESTYLE choice that should be supported by the parties using it and not the insurer(I won't mention the RARE situations where a woman may need birth control for the safety of a baby--where a medication is used that is not recommended in pg or the woman's life is at risk if she should become pg--that is another issue, but let's face it, most women don't get birth control to stave off pg for medical reasons or to protect a baby from a counterindicated medication).

12 posted on 06/20/2002 2:30:41 PM PDT by glory
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To: tarawa
EXACTLY...
13 posted on 06/20/2002 2:34:24 PM PDT by glory
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To: Lorianne
In terms of economics, not covering contraceptives would raise insurance costs because of:

So you are trying to tell me that insurance is high right now because insurers can refuse to cover contraceptives?

14 posted on 06/20/2002 2:36:01 PM PDT by FreeTally
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To: Lorianne
ON another note, many surgical alternatives are covered. I remember seeing a show recently about a woman who had pain with intercourse and they found some kind of malformation or dysfunction of her vaginal area and it was corrected via surgery which they noted was covered by insurance(they threw that in in one of the lines about her surgery so that's how I know). Perhaps the medication you are speaking of is still quite emergent and I'm wondering also if there may be some contraindication with pregnancy that would make insurance companies hesitant because of liability. I don't know though, never heard of it.
15 posted on 06/20/2002 2:38:57 PM PDT by glory
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To: Lorianne
In terms of economics, not covering contraceptives would raise insurance costs

You could be right, but that should be for the market to decide, not the federal government.

16 posted on 06/20/2002 2:44:13 PM PDT by ThinkDifferent
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To: FreeTally
No, that would be true if women (and families including men) refused to USE contraceptives unless they were covered by insurance. But they don't. Insurance companies know women and families (including men) will buy them becuase it is cheaper than having a large number of kids to support.

Keep in mind contraceptives are NOT just for women. Men have a stake in them too or else they would have to support 7 or 8 kids instead of 2 or 3. The insurance companies know this, so they don't cover the cost. They know women and couples will pay out-of-pocket for contraceptives, so they don't have to worry about paying for the cost of maternity care and more kids on the rolls.

However, the same would be true of Viagra. If insurance companies didn't cover it, it would still be a very profitable drug as evidenced by the lucrative black market for the little blue pill. The insurance companies are in cahoots with the drug companies to make a profit of of Viagra (which only one company makes to the cost is relatively high) vs. oral contraceptives which many companies make so they are competitively priced.
17 posted on 06/20/2002 3:00:50 PM PDT by Lorianne
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To: glory
It is a rediculous concept to equate birth control pills with viagara. This has been an ongoing cry from liberals and women for some time. The two do not handle similar functions

Yes they do. Many women would be "dysfunctional" sexually if they had to face 12-15 pregnancies over a lifetime without contraceptives. Their choices would be to forego sex, or have a lot of pregnacies/kids.

Therefore, contraceptives are a "sexual aid" just like Viagra. And Viagra is not prescribed just to men who have "dysfunction". Dsyfunction has been redefined to suit the selling of this drug.

Men naturally have less ability to get erections as they age. This is a natural function of aging, just like pregnancy is a natural function for women. What the medical/drug monolith has done is pathologize natural functions of aging. (PS they've done this with menopause drugs too). This is done purely so drug companies can make more money. [Drug companies and insurance companies are in cahoots. For example Viagra makers contribute large sums of money to insurance PAC's in Washington.]

However, other natural functions such as pregnancy, are not pathologized. Expcept some insurance plans don't cover contracpetives but do cover abortions.

It is not really about saving you from higher insurance premiums I can assure you. That is not the goal of insurance companies, drug companies, or the health care industry as a whole.

18 posted on 06/20/2002 3:11:45 PM PDT by Lorianne
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