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Who Should Cover the Cost of Contraception?


WebMD Health News

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 discrimination 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.

"Contraception is a fundamental part of health care, just like vaccinations," says David A. Grimes, MD. "It's good, cost-effective, 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 contraceptives 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 nondiscriminatory." 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.

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