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A morality tale?

The administration has declined to fix a glitch keeping affordable birth control from students and the poor.

November 24, 2007

Because of a wording glitch in a law passed two years ago, the working poor and college students have been paying dramatically more this year for birth-control pills even though pharmaceutical companies are willing to offer the contraceptives at a fraction of the price. The only question about a bill that would correct this is: What's been taking so long?

The Deficit Reduction Act of 2005 sought, sanely enough, to curb aggressive marketing by pharmaceutical companies. The drug manufacturers were gaining customers by offering steep discounts of their products to hospitals and other healthcare providers, and at the same time treating those as charitable sales. Known as "nominal pricing," the charity sales enable companies to pay less in rebates on Medicaid drugs.

But the act, which was implemented this year, used such broad wording that it also precluded legitimate charitable sales to university clinics and many family-planning clinics that treat the uninsured working poor. Prices of the drugs have as much as quintupled, and some clinics have stopped offering them altogether.

Restoring the discounts for these clinics wouldn't cost the taxpayer -- though taxpayers might end up picking up the high cost of unintended pregnancies if women cannot afford contraception. This could be easily fixed by Secretary of Health and Human Services Michael Leavitt, simply by defining these clinics as part of the medical "safety net" entitled to discount prices, but so far he's declined to do so. Now Congress is going about it the slower, klutzier way, with a bill by Rep. Joseph Crowley (D-N.Y.) to restore the discounts.

Has the federal government really been so hung up over a minor wording fix, or was there an underlying reluctance about making contraceptives affordable to young college women, many of whom are single? It's hard to avoid the suspicion that this would have been easily resolved had it been about providing, say, insulin to the people least able to afford it.

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