Covering Birth Control
Why one woman sued.
Erickson, who grew up in Lafayette, Ind., moved to Seattle in 1999. She has
worked for Bartell for 18 months and was recently promoted to pharmacy manager.
She says she loves her job and considers Bartell -- which operates a chain of
45 drugstores in Washington -- a progressive workplace. But she hates telling
customers that their health plans don't cover the contraceptives they need.
Even more, she hates watching them turn away angrily.
"One woman recently said to me, 'I have to make rent this month, I have
five kids to feed, I can't afford to pay for birth control pills,' "
Erickson says. "I want to say to her, 'Don't leave without these!' I feel
But Erickson's efforts aren't simply aimed at helping others. The fact that
her own company's insurance plan doesn't cover contraceptives forces Erickson
-- who says she's not ready to have children -- to pay $360 a year
out-of-pocket for birth control pills.
While she can afford this expense, she thinks it's unfair that she has to.
And there were times in the past when she couldn't. Like many women, she turned
to Planned Parenthood, where she was a regular client and a strong supporter.
So when representatives from the local chapter said they would help her file a
complaint against Bartell with the Equal Employment Opportunity Commission last
December, she didn't hesitate.
The resulting lawsuit has made waves for its landmark legal strategy. It
charges that a company whose insurance plan covers most prescription drugs but
excludes contraceptives violates federal discrimination laws because only women
use prescription contraceptives.
Family planning advocates argue that excluding birth control from
prescription coverage is not only discriminatory, it's also economically
short-sighted. Contraception is far cheaper than the cost of either a pregnancy
or an abortion. In 1996, the Health Insurance Association of America estimated
it would cost about $16 per person to provide birth control coverage for
members of group plans. Compare that to the average cost of an abortion:
"Services for men get covered much quicker than services for women,"
says Judith DeSarno, president and CEO of the National Family Planning and
Reproductive Health Association. It was only 25 years ago that insurance
companies agreed to cover the cost of prenatal care. "There's a very clear
pattern here," she says. "It's the nickel-and-diming of women's
A recent nationwide survey found that two-thirds of Americans want insurers
to cover contraception. Currently 13 states have passed laws requiring health
plans to pay for contraceptives if they cover prescription drugs to include
contraceptives, and 21 states are considering such legislation. Federal
legislation has been stalled in Congress since 1997.
The big problem with the state laws, says Roberta Riley, the Planned
Parenthood attorney who filed the lawsuit, is that they generally don't apply
to self-insured companies like Bartell, which put together their own medical
coverage for their workers. Because self-insured companies account for half of
all employer-sponsored health insurance, that leaves a large gap. And that,
Riley says, was one reason Planned Parenthood decided it was time to go to