Contraceptive Coverage Mandate Bills Died In 2000

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LANSING — Seventy-three percent of Americans support contraceptive methods, yet Planned Parenthood Federation of America says far too many insurance policies exclude such coverage.

Michigan is one state in which such coverage is not required.

At this writing, 13 states require health insurers to cover all prescription contraceptives approved by the U.S. Food and Drug Administration.

Such a mandate would be the thrust of a package of bills introduced into the Michigan House and Senate last year. The measures would require insurers to include contraceptive drugs or devices in prescription drug coverage.

The bills were in the House Committee on Insurance and Financial Services. But Andrew Doerr, legislative aide to Alan Sanborn, R-Richmond, the committee chair, said no action was expected on them before the legislative session ends.

In the Senate, the bills were in the Health Policy Committee and, likewise, no action was expected on them before the session ends.

One sponsor of the legislation, Rep. Lynne Martinez, D-Lansing, argues for the legislation, saying lack of contraceptive coverage is costly both for insurers, who may have to pay for maternity care or abortion as a result, and families, whose physical and financial well-being may be threatened by an unintended pregnancy.

"Women of child-bearing age spend 68 percent more in out-of-pocket health care costs than men because of reproductive health-related supplies and services," Martinez said.

"Add that expense to women earning only 74 percent of men's income, and it gets expensive.”

In sponsoring the bills, she said, "I'm ensuring women have the health care they need."

Blue Cross Blue Shield of Michigan Director of State Government Affairs, Tracy Baker, said the health care insurer opposes mandates for employers in prescription coverage.

"Employers must pay for the mandated coverage whether employees want or need it," Baker said. "Employers should decide employee benefits based on affordability and the work force's interests and needs.

"An optional insurance rider for contraceptives is available," she said. "It's up to employers to include it."

According to Planned Parenthood, most insurance policies provided by employers in the United States cover prescription drugs, but the majority do not include a full range of contraceptives.

Baker said some employers limit other drugs, such as Viagra, providing an optional insurance rider as well.

But theWashington Postreported more than half of Viagra prescriptions received partial insurance reimbursement within two months after it hit the U.S. market in 1998.

Overall coverage for oral contraceptives didn't reach that level for 40 years, and coverage for diaphragms and IUDs still lags far behind.

Drugs currently covered, such as heart, thyroid or Viagra medicines, restore normal physiological functions, Baker said.

"Viagra corrects a dysfunction, which is different from preventing pregnancy. Contraceptives don't restore normal functions."

Prescription drugs are the fastest-growing component in health-care costs today, she said.

"It's difficult to add a prescription benefit when drug costs increased 16 percent in 1999," Baker said. "Employers are scrutinizing these costs."

Other sponsors of the bills include Sens. Raymond Murphy, D-Detroit, Beverly Hammerstrom, D-Temperance, Arthur Miller, D-Warren and Burton Leland, D-Detroit.

© 2000, Capital News Service, Michigan State University School of Journalism

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