Opinion: Women Earn Right to Contraceptive Coverage

From the WebMD Archives

June 18, 2001 (Washington) -- Women seeking pharmaceutical and sexual equality no doubt cheered a federal court ruling in Seattle last week. The decision says, in effect, that an employer must provide insurance coverage for prescription contraceptives.

Is this one small step or a giant leap for womankind?

The plaintiff, Jennifer Erickson, a pharmacist for, of all things, a well-respected drug store chain, argued that she was a victim of discrimination.

The judge agreed that contraception is a primary health concern for women. The Equal Employment Opportunity Commission had said as much last year. Even if the EEOC had remained mum, the marketplace weighed in already with the male sex drug Viagra. It's now covered by many plans following an intense lobbying campaign.

One expert in women's health law says that companies not offering equal sex coverage are in a very risky position. After all, isn't what's good for the gander, good for the goose?

However, before women celebrate this legal victory in the march to reproductive rights, they must consider a turn to the right in sexual politics. With the election of George W. Bush, "compassionate conservatism" has meant a significant change in how the White House approaches women's issues.

Just two days after Bush took office, he took steps to further his anti-abortion agenda by rescinding an executive order allowing federal dollars to be spent on international organizations that either counsel women about or provide abortion services. The matter is still being debated in Congress, but many women's groups think that the new policy is nothing more than the old hard-right agenda advanced during the Reagan years.

The language on both sides is harsh, and likely to get harsher. And the debate over a woman's right to have an abortion is the clearest example. The Family Research Council, one of the most prominent groups opposing abortion, is endorsing a bill that backers say would protect a baby born alive after a failed abortion.

"If a child born alive after a botched abortion does not receive the protection of the law, what is to prevent an abortionist from simply delivering a child and then killing it?" asks the Family Research Council's Connie Mackey. Mackey's group says 41 states already have such laws in place.

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That kind of heated rhetoric tells Judith DeSarno, president and CEO of the National Family Planning and Reproductive Health Association, that the fabric of Roe v. Wade may be coming undone. For 21 years, that U.S. Supreme Court decision has given a woman the option of ending her pregnancy.

Given that in the next few years, two or three justices may step down, probably to be replaced by jurists at least as conservative, DeSarno fears many of Roe's protections will be nibbled away. "Pre-Roe, there were two states where it was legal to get an abortion. We would then go back to fighting this fight in 50 states," DeSarno tells WebMD.

Ultimately, DeSarno says the public wouldn't stand for overturning abortion rights, but the battle could be bloody.

Among the other reproductive rights issues percolating on the Hill include a move to deny female federal employees contraceptives in their health plans, even though such coverage is already in place. Further, conservative lawmakers want to ban emergency contraception, also known as the "morning after pills," from school health clinics.

The battle over RU-486, the French abortion pill approved last September by the Food and Drug Administration, could be fought again over the issue of whether it's safe for women. That in spite of the fact that the FDA has already put numerous safeguards in place for the controversial drug, which is sold under the name Mifeprex.

Finally, a bit of good news -- the CDC has announced that the teen pregnancy rate is the lowest it's been since 1997. Perhaps the massive education efforts about changing risky behaviors are paying off. Let's hope so.

With all the dissension over these issues, less emotion and more insight is desperately needed.

Jeff Levine is the Washington bureau chief for WebMD. He has covered health policy in Washington since 1989. His opinions do not necessarily reflect those of WebMD.

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