Paying for Birth Control
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PEGGY PAPSDORF: Pick up my prescription?
LEE HOCHBERG: Peggy Papsdorf of Seattle has health insurance, but like most American women, she knew she’d have to dig into her purse to pay for her birth control pills.
PEGGY PAPSDORF: How much are they?
LEE HOCHBERG: The 43-year-old mother of one was out of work, paying almost $300 a month for health insurance. But the pills were extra.
PEGGY PAPSDORF: My insurance doesn’t cover birth control pills.
SPOKESPERSON: Okay, so that will be $38.
LEE HOCHBERG: In Washington State, 59 percent of women have no contraceptive coverage in their health plans. Other states are similar.
PEGGY PAPSDORF: Your doctor recommends something for your health, but then the same… you know, the insurance company won’t pay for it. So, what’s the sense in that?
LEE HOCHBERG: Nationally, while almost all health plans cover prescription drugs, fewer than half cover the most common forms of prescription contraceptives– birth control pills, the Depo-Provera injection, the IUD, and the Norplant implant. Each is used solely by women. Last summer, a federal court in Seattle ruled excluding them from prescription drug benefits discriminates against women. The court ordered Seattle-based Bartell Drugs, which self- insures its employees, to add contraceptives to its coverage. Bartell pharmacist Jennifer Erickson had filed the case.
JENNIFER ERICKSON, Pharmacist: Here I was, my own pills aren’t covered, and I’m telling women all day long that theirs aren’t covered either, and they’d get very frustrated with that. Men’s needs are covered and yet women’s aren’t. Women’s health needs aren’t.
LEE HOCHBERG: Erickson’s attorney argued without contraception the average woman would become pregnant 15 times in life, with enormous health consequences.
ROBERTA RILEY, Attorney: How is it that we created a system that covers so many other needs, but yet singles out the one most fundamental basic need that women have for 20 years of their lives?
LEE HOCHBERG: Women’s advocates say the system forces low-income women to use less expensive and less reliable methods of birth control. Peggy Papsdorf said she might stop using the pill to save money.
PEGGY PAPSDORF: I am 43 and might want to risk it for a while until, you know, just to alleviate that stress of all the financial pressures.
ROBERTA RILEY: We hear those stories all the time, and we know it’s true, that the lack of access, the lack of insurance attorney coverage does, in fact, harm women and lead to unplanned pregnancies.
LEE HOCHBERG: Bartell has appealed the court ruling and refused to be interviewed. But the insurance industry says there’s no proof that covering the pill will reduce pregnancies. James Reed an insurance industry consultant, Milliman USA.
JAMES REED, Insurance Industry Consultant: These drugs cost $21 to $32 locally per month. I mean, that’s the cost of a movie and a dinner out once a month. It’s a small amount of money to pay. If they’re concerned about the pregnancy, they’re buying it out of their own pockets already.
LEE HOCHBERG: He questions why insurers should cover such an expense.
JAMES REED: Most women could budget for this. The purpose of insurance is to cover events that are random, that are not budgetable, that you’re… that you have little or no control over. When you buy car insurance and you’re buying it for accidents, but you’re not usually buying your car insurance to change your oil, and so it’s the same analogy.
LEE HOCHBERG: Businesses say full contraceptive coverage would cost them $15 a year per employee, an amount some say they can’t afford. Betty Neighbors is president of a Seattle-area temp agency with 25 mostly female employees.
BETTY NEIGHBORS, Employer: What I see is the government intruding into are area, or making a decision that is going to be cost… be costly to everyone. I don’t believe the government or the courts know what’s best for my employees; I do.
LEE HOCHBERG: The federal ruling in the Bartell case is the first of its kind and will set precedent in other states. But it only applies to businesses that operate their own insurance plans. It doesn’t cover the big insurance companies that provide most health insurance. Another Seattle court case seeks to go farther. Psychiatrist Shulamit Glaubach is suing Washington’s largest health insurance company, Regence BlueShield. She alleges companies like Regence also must provide contraceptives.
DR. SHLUMAIT GLAUBACH, Plaintiff: For me, I’m a physician, and, yes, I can afford it. But there are a lot of people out there that can’t afford it, and they shouldn’t have to pay for it. They’re paying a premium, and they should be covered.
LEE HOCHBERG: And another lawsuit filed in October goes after the world’s largest retailer, Wal-Mart. More than 600,000 female employees of the company joined a class-action suit alleging the company discriminates by covering birth control for only some of its female workforce. Some state governments also have joined the fight. Washington insurance commissioner Mike Kriedler imposed a rule that does the same thing the women are trying to accomplish in court.
MIKE KREIDLER, Washington State Insurance Commissioner: The simple fact is that if it was men who had to take contraception as opposed to women, contraception would have been covered a long time ago. We wouldn’t even be having this debate.
LEE HOCHBERG: 14 states already require insurance companies to cover contraceptives; and six, including Washington State, are starting this year. Glaubach will go ahead with her suit anyway, trying to establish a permanent legal precedent. Her suit also asks Regence to reimburse women who’ve had to spend their own money on non- covered contraceptives.
SPOKESPERSON: Clerk will call the roll.
LEE HOCHBERG: Congress has considered a national law to require insurers to cover contraceptives, but the bill hasn’t made it out of committee.