Employers Ordered to Increase Coverage of Birth Control
Dec. 14, 2000 (Washington) -- The U.S. Equal Employment Opportunity Commission has ruled that it's unlawful for employers not to cover prescription birth control if they cover a range of other preventive drugs and services.
The commission's ruling only officially addresses confidential complaints filed by two women against their employer's health plans, but women's health advocates say the decision has national implications for increased contraceptive coverage. On the other hand, those in the business community say the move will have negative cost implications for consumers.
The commission based its decision on the Pregnancy Discrimination Act, enacted by Congress in 1978 as an extension of 1964 Civil Rights legislation. The act -- which bars discrimination against women on the basis of pregnancy -- extends to fringe benefits. And since a 1991 U.S. Supreme Court decision, it also extends to acts of discrimination because women have the ability to get pregnant, not just because they already are pregnant.
Under the ruling, not only must employers cover birth control if they cover other preventive benefits, the commission says, but they also must "offer the same coverage for contraception-related outpatient services as are offered for other outpatient services." Moreover, the coverage "must extend to the full range of prescription contraceptive choices," which would include pills, injectables, implants, IUDs, and diaphragms.
Gloria Feldt, president of Planned Parenthood Federation of America, says, "I applaud the [commission] for acknowledging that it's sex discrimination, plain and simple, when an employer covers prescription drugs and excludes contraception. The ruling means that contraception coverage is a right, not an option."
Marcia Greenberger, co-president of the National Women's Law Center, says, "Employers across the country should take heed of the ... decision and add coverage of prescription contraceptives as required by law."
Similarly, Cynthia Dailard, a senior public policy associate at the Alan Guttmacher Institute, tells WebMD, "It's wonderful news for women. It really puts employers on notice that it is sex discrimination to cover other prescription drug needs but to exclude contraceptives."
According to this reproductive law center, the ruling may influence the court in Erickson v. Bartell Drug Co., the case of a woman who has sued her employer for excluding coverage of prescription birth control.
Since the ruling is only binding on the two women who filed the complaints, women's health advocates say they are looking at possible further lawsuits -- or for Congress to pass a law guaranteeing such coverage to all women.
According to a Kaiser Family Foundation survey of employers that was released in September, 60% of employer fee-for-service plans cover birth control pills. That percentage rose to 87% for HMO plans, 62% for point-of-service plans, and 75% for PPOs.
Employer representatives are not happy with the decision. Kate Sullivan, director of healthcare policy at the U.S. Chamber of Commerce, tells WebMD, "There needs to be an element of personal responsibility, that if you don't want to have a baby, you need to take those steps. If it's not covered by your employer, you need to take that financial responsibility. When you have every single cost covered, you're going to wind up saying, 'Gee, my health plan has gotten awfully expensive.'"