Should health insurers cover contraception costs?

Women spend about 68 percent more in out-of-pocket money for health care than men. And one of the biggest contributors to that expense is birth control.

Birth control pills are the most widely used prescription drugs of women aged 15 to 44, but many insurers do not cover the cost. About 85 percent of all large group plans cover the cost of sterilization, 95 percent pay for prescription drugs, but only a third cover contraceptives. Some legislators would like to change this.

Since 1978, Texas has required through an administrative rule that insurers covering prescription drugs include contraceptive benefits. More recently, Virginia and Hawaii passed laws that require insurers to offer employers the option of including such coverage for their employees, but the laws do not mandate it. About 25 bills introduced in 16 states this session would require health plans to include contraceptive pills and devices. At press time, California's AB 160 had passed the Legislature, but was vetoed; Maryland's SB 335 passed both houses with amendments and was signed by the governor. And Connecticut's SB 400 and Alaska's HB 350 have passed one house.

"Making birth control affordable and accessible is in everyone's best interest - women, their families and society," says Connecticut Senate Minority Leader M. Adela Eads. She notes that birth control is considerably less expensive than prenatal care and childbirth, both of which are usually covered by insurance providers.

The out-of-pocket cost for oral contraceptives is approximately $25 per month, and the estimated increase in insurance premiums for coverage is about $16 annually per enrollee, according to the Health Insurance Association of America. The cost of childbirth without complications is between $3,000 and $5,000.

Insurers fear that adding birth control prescriptions to health insurance will increase the cost of insurance and may cause small employers, already strapped by health care premiums, to drop their insurance. The Roman Catholic Church and others opposing birth control say companies should not be forced to pay for something that they oppose on moral or religious grounds.

As for public sector coverage of contraceptives, family planning services have been mandated under Medicaid since 1973.

For more information, call Laura Tobler at [phone] or Jacob Herstek at [phone].