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Sex and sensibility

Congress must act to ensure that health plans cover prescription contraceptives for women.

March 30, 2007

IS IT COVERED? Every American with health insurance faces this question at some point in any odyssey through the healthcare system. When it comes to contraception, the question has special relevance for women.

Many health plans do cover prescription contraceptives for women. Earlier this month, however, a federal appeals court ruled that if they don't, it's not discrimination. The decision flies in the face of both the law and logic, and it should give Congress added incentive to pass a bill that would ensure that health insurers provide the same level of coverage for prescription drugs and services for men and women.

The decision, issued by the U.S. 8th Circuit Court of Appeals, relied on an odd interpretation of the Pregnancy Discrimination Act. An amendment to the 1964 Civil Rights Act, the law prohibits discrimination "on the basis of pregnancy, childbirth or related medical conditions."

The court ruled that contraception was not a "related medical condition" to pregnancy and that no discrimination existed if an employer denied contraception coverage to men as well as women.

Neither argument is persuasive. First, there is no such thing as a prescription contraceptive for men. Second, because only women can get pregnant, denying them contraceptives can amount to discrimination.

The law (and biology) aside, there are other reasons to provide coverage for contraception. Most employers understand that providing contraceptives leads to savings in healthcare costs. Even Union Pacific Corp., the defendant in this case, came to that sensible conclusion and voluntarily opted to include them in its plan. Still, the appeals court's ruling could be cited by other courts and companies across the country.

Congress passed the Pregnancy Discrimination Act in 1978. Since then, 24 states, including California, have passed laws requiring healthcare plans to cover contraceptives. Oregon passed such a law the day the appeals court ruling was issued. But state laws are not the solution.

Congress must correct this misguided decision. In January, Sen. Harry Reid (D-Nev.) introduced the Prevention First Act, aimed at reducing unintended pregnancies. It would provide women better access to contraceptives and would require health insurance firms to provide coverage for contraceptives if they also provide coverage for other prescriptions. The bill, which stalled in the last Congress, now has new urgency.

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