Prescription birth-control coverage cannot be excluded from benefit plan, court rules.

In a case of first impression for the federal judiciary, a U.S. district court in Washington state has held that excluding prescription contraceptives from an employer's generally comprehensive prescription benefit plan violates Title VII of the Civil Rights Act of 1964. (Erickson v. Bartell Drug Co., 141 F. Supp. 2d 1266 (W.D. Wash. 2001).) Title VII prohibits employment discrimination based on sex.

"This first-of-its-kind decision establishes that it is sex discrimination, plain and simple, for an employer to provide comprehensive health insurance that excludes coverage for contraception," said Eve Gartner, senior staff attorney for Planned Parenthood Federation of America, who served as the plaintiffs' cocounsel. "The court recognized that because only women get pregnant, it is sex discrimination when basic health care needs related to pregnancy are not covered by employer-sponsored health insurance policies."

The case was brought by Jennifer Erickson and other female employees of Bartell Drug Co., which decided not to cover prescription contraceptives--including birth-control pills, Norplant, Depo-Provera, and intrauterine devices--under its prescription benefit plan for nonunion employees. Because these drugs and devices are used only by women, the plaintiffs claimed that Bartell's refusal to cover them violated Title VII.

Judge Robert Lasnik of the U.S. District Court for the Western District of Washington agreed. His decision focused on the Pregnancy Discrimination Act (PDA), which amended Title VII in 1978 and provides that discrimination because of pregnancy, childbirth, or related medical conditions is discrimination based on sex.

"Read in the context of Title VII as a whole," Lasnik wrote, "[the PDA] is a broad acknowledgment of the intent of Congress to outlaw ... all discrimination against ... women in the terms and conditions of employment, including the benefits that an employer provides to its employees."

While Title VII does not require an employer to offer any particular type of benefit, Lasnik noted, "when an employer decides to offer a prescription plan covering everything except a few specifically excluded drugs and devices, it has a legal obligation to ... provide equally comprehensive coverage for both sexes." Because prescription contraceptives are used only by women, he reasoned, "Bartell's choice to exclude that particular benefit from its generally applicable benefit plan is discriminatory."

"We hope this victory will inspire other American women to insist that their employers and insurance companies provide equitable benefits," Gartner said.