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S. 1200. A bill to require equitable coverage of prescription contraceptive drugs and devices, and contraceptive
[Page: S6858] GPO's PDF
EQUITY IN PRESCRIPTION INSURANCE AND CONTRACEPTIVE COVERAGE ACT
Ms. SNOWE. Mr. President, I rise today with my colleague from Nevada, Senator HARRY REID, to reintroduce the Equity in Prescription Insurance and Contraceptive Coverage Act. We are back today, with the support of 30 Members of the Senate, to finish the work we began in the last Congress.
Why are we back again this year? Because the need behind the Equity in Prescription Insurance and Contraceptive Coverage Act has not abated. There are three million unintended pregnancies every year--half of all pregnancies that occur every year in this country. And frighteningly, approximately half of all unintended pregnancies end in abortion.
I am firmly pro-choice and I believe in a woman's right to a safe and legal abortion when she needs this procedure. But I want abortion to be an option that a woman rarely needs. So how do we prevent this? How do we reduce the number of unintended pregnancies?
The safest and most effective means of preventing unintended pregnancies are with prescription contraceptives. And while the vast majority of insurers cover prescription drugs, they treat prescription contraceptives very differently. In fact, half of large group plans exclude coverage of contraceptives. And only one-third cover oral contraceptives--the most popular form of reversible birth control.
When one realizes the insurance ``carve-out'' for these prescriptions and related outpatient treatments, it is no longer a mystery why women spend 68 percent more than men in out-of-pocket health care costs. No woman should have to forgo or rely on inexpensive and less effective contraceptives for purely economic reasons, knowing that she risks an unintended pregnancy.
In last year's Omnibus Appropriations Bill, Congress instructed the health plans participating in the Federal Employees Health Benefit Plan--the largest employer-sponsored health insurance plan in the world--to provide prescription contraceptive coverage if they cover prescription drugs as a part of their benefits package. The protections we afford to Members of Congress, their staff, other federal employees and annuitants, and to the approximately two million women of reproductive age who are participating in FEHBP need to be extended to the rest of the country.
Unfortunately, the lack of contraceptive coverage in health insurance is not news to most women. Countless American women have been shocked to learn that their insurance does not cover contraceptives, one of their most basic health care needs, even though other prescription drugs which are equally valuable to their lives are routinely covered. Less than half--49 percent --of all large-group health care plans cover any contraceptive method at all and only 15 percent cover the five most common reversible birth control methods. HMOs are more likely to cover contraceptives, but only 39 percent cover all five reversible methods. And ironically, 86 percent of large group plans, preferred provider organizations, and HMOs cover sterilization and between 66 and 70 percent of these different plans do cover abortion.
The concept underlying EPICC is simple. This legislation says that if insurers cover prescription drugs and devices, they must also cover FDA-approved prescription contraceptives. And in conjunction with this, EPICC requires health plans which already cover basic health care services to also cover outpatient services related to prescription contraceptives.
The bill does not require insurance companies to cover prescription drugs. What the bill does say is that if insurers cover prescription drugs, they cannot carve prescription contraceptives out of their formularies. And it says that insurers which cover outpatient health care services cannot limit or exclude coverage of the medical and counseling services necessary for effective contraceptive use.
This bill is good health policy. By helping families to adequately space their pregnancies, contraceptives contribute to healthy pregnancies and healthy births, reduce rates of maternal complications, and reduces the possibility of low-birthweight births.
Furthermore, the Equity in Prescription Insurance and Contraceptive Coverage Act makes good economic sense. We know that contraceptives are cost-effective: in the public sector, for every dollar invested in family planning, $4 to $14 is saved in health care and related costs. And all methods of reversible contraceptives are cost-effective when compared to the cost of unintended pregnancy. A sexually active woman who uses no contraception costs the health care provider an average of $3,225 in a given year. The average cost of an uncomplicated vaginal delivery in 1993 was approximately $6,400. And for every 100 women who do not use contraceptives in a given year, 85 percent will become pregnant.
Why do insurance companies exclude prescription contraceptive coverage from their list of covered benefits--especially when they cover other prescription drugs? The tendency of insurance plans to cover sterilization and abortion reflects, in part, their long-standing tendency to cover surgery and treatment over prevention. Sterilization and abortion is also cheaper. But insurers do not feel compelled to cover prescription contraceptives because they know that most women who lack contraceptive coverage will simply pay for them out of pocket. And in order to prevent an unintended pregnancy, a woman needs to be on some form of birth control for almost 30 years of her life.
The Equity in Prescription Insurance and Contraceptive Coverage Act tells insurance companies that we can no longer tolerate policies that disadvantage women and disadvantage our nation. When our bill is passed, women will finally be assured of equity in prescription drug coverage and health care services. And America's unacceptably high rates of unintended pregnancies and abortions will be reduced in the process.
The philosophy behind the bill is that contraceptives should be treated no differently than any other prescription drug or device. It does not give contraceptives any type of special insurance coverage , but instead seeks to achieve equity of treatment and parity of coverage . For that reason, the bill specifies that if a plan imposes a deductible or cost-sharing requirement on prescription drugs or devices, it can impose the same deductible or cost-sharing requirement on prescription contraception. But it cannot charge a higher cost-sharing requirement or deductible on contraceptives. Outpatient contraceptive services must also be treated similarly to general outpatient health care services.
Time and time again Americans have expressed the desire for their leaders to come together to work on the problems that face us. This bill exemplifies that spirit of cooperation. It crosses some very wide gulfs and makes some very meaningful changes in policy that will benefit countless Americans.
As someone who is pro-choice, I firmly believe that abortions should be safe, legal, and rare. Through this bill, I invite both my pro-choice and pro-life colleagues to join with me in emphasizing the rare.
Mr. REID. Mr. President, I am proud to introduce today, with Senator SNOWE, the Equity in Prescription and Contraception Coverage Act of 1999. Senator SNOWE and I first introduced this bill in 1997.
The legislation we introduce today would require insurers, HMO's and employee health benefit plans that offer prescription drug benefits to cover contraceptive drugs and devices approved by the FDA. Further, it would require these insurers to cover outpatient contraceptive services if a plan covers other outpatient services. Lastly, it would prohibit the imposition of copays and deductibles for prescription contraceptives or outpatient services that are greater than those for other prescription drugs.
I hope that we have the success this year that we had last year in directing the Federal Health Benefit Plans to cover contraception. As many of you recall, after a tough fight, Congresswoman LOWEY and I were able to amend the Treasury Postal Appropriations bill so that Federal Health Plans must cover FDA approved contraceptives.
EPICC is about equality for women, healthy mothers and babies, and reducing the number of abortions that are
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The health industry has done a poor job of responding to women's health needs. According to a study done by the Alan Guttmacher Institute, 49 percent of all large-group health care plans do not routinely cover any contraceptive method at all, and only 15 percent cover all five of the most common contraceptive methods.
Women are forced to use disposable income to pay for family planning services not covered by their health insurance--``the pill'' one of the most common birth control methods, can cost over $300 a year. Women who lack disposable income are forced to use less reliable methods of contraception and risk an unintended pregnancy.
If our bill was only about equality in health care coverage between men and women, that would be reason enough to pass it. But our legislation also provides the means to reduce abortions, and have healthier mothers and babies. Each year approximately 3 million pregnancies, or 50 percent of all pregnancies, in this country are unintended. Of these unintended pregnancies, about half end in abortion.
Reliable family planning methods must be made available if we wish to reduce this disturbing number.
Ironically, abortion is routinely covered by 66 percent of indemnity plans, 67 percent of preferred provider organizations, and 70 percent of HMO's. Sterilization and tubal ligation are also routinely covered. It does not make sense financially for insurance companies to cover these more expensive services, rather than contraception. But insurance companies know that women will bear the costs of contraception themselves--and if they can not afford their method of choice, there are always less expensive means to turn to. Of course less expensive also means less reliable.
This just seems like bad business to me. If a woman can not afford effective contraception, and she turns to a less effective method and gets pregnant, that pregnancy will cost the insurance company much more than it would cost them to prevent it. According to one recent study in the American Journal of Public Health, by increasing the number of women who use oral contraceptives by 15 percent, health plans would accrue enough savings in pregnancy care costs to cover oral contraceptives for all users under the plan. Studies indicate that for every dollar of public funds invested in family planning, four to fourteen dollars of public funds is saved in pregnancy and health care-related costs. Not only will a reduction in unintended pregnancies reduce abortion rates, it will also lead to a reduction in low-birth weight, infant mortality and maternal morbidity.
Low birth weight refers to babies who weigh less than 5.5 pounds at birth. How much a baby weighs at birth is directly related to the baby's survival, health and development. In Nevada, during the past decade, the percent of low birth weight babies has increased by 7 percent. These figures are important because women who use contraception and plan for the birth of their baby are more likely to get prenatal care and lead a healthier life style. The infant mortality rate measures the number of babies who die during their first year of life. In Nevada, between the years of 1995 and 1997, the infant mortality rate was 5.9, this means that of the 77,871 babies born during this period, 459 infants died before they reached their first birthday. The National Commission to Prevent Infant Mortality determined that ``infant mortality could be reduced by 10 percent if all women not desiring pregnancy used contraception.''
It is vitally important to the health of our country that quality contraception is not beyond the financial reach of women. Providing access to contraception will bring down the unintended pregnancy rate, insure good reproductive health for women, and reduce the number of abortions. It is a significant step, in my opinion, to have support from both pro-life and pro-choice Senators for this bill. Prevention is the common ground on which we can all stand. Let's begin to attack the problem of unintended pregnancies at its root.
By Mr. SCHUMER:
S. 1201. A bill to prohibit law enforcement agencies from imposing a waiting period before accepting reports of missing persons between the ages of 18 and 21; to the Committee on the Judiciary.
SUZANNE'S LAW
Mr. SCHUMER. Mr. President, I am introducing legislation today to remedy what I believe is a significant shortcoming in federal law relating to missing person reports. My bill is entitled ``Suzanne's Law,'' to serve as a continuing reminder of the plight of Suzanne Lyall. Suzanne, a resident of Ballston Spa, New York, disappeared last year at age 19 during the course of her senior year at the State University of New York at Albany. All indications are that her disappearance was due to foul play. She has never been found, despite investigations by campus security, the local police, and the FBI. Suzanne's family, friends and relatives dearly miss her and have undertaken admirable efforts to secure improvements in campus security and in missing person reporting.
The Lyall family has brought it to my attention that federal law currently prohibits state and local law enforcement officials from imposing a 24-hour waiting period before accepting a report regarding the disappearance of a person under the age of 18, yet it does not extend similar protection for reports of missing persons between the ages of 18 and 21. This is an oversight that must be remedied. Prompt action on the part of law enforcement authorities is of the essence in missing person cases. Thus, my bill would prohibit state and local law enforcement officials from imposing a 24-hour waiting period before accepting ``missing youth'' reports--defined as reports indicating that a person of at least 18 years of age and less than 21 years of age was missing under suspicious circumstances. Enactment of this legislation would enhance the prospects for family reunification in missing person cases and may spare other families the pain and sacrifice experienced by the Lyalls.
By Mr. CAMPBELL:
S. 1202. A bill to require a warrant of consent before an inspection of land may be carried out to enforce any law administered by the Secretary of the Interior; to the Committee on Energy and Natural Resources.
PRIVATE PROPERTY PROTECTION ACT OF 1999
Mr. CAMPBELL. Mr. President, today I introduce the Private Property Protection Act of 1999.
This bill would require that Interior Department personnel obtain either the property owner's permission or a properly attained and legal search warrant before they enter someone's private property.
America's law abiding private property owners, especially our ranchers and farmers, should not be subject to unwarranted trespassing and egregious random searches by federal bureaucrats. They deserve to be treated fairly and according to the law, just like other Americans. They deserve the same private property rights that other Americans enjoy.
Under our legal system, if appropriate sworn law enforcement officers can demonstrate to a judge that there is probable cause to believe that a person has broken the law, and that there is a justified need to enter a property, then those law enforcement officials can obtain a search warrant to enter and search a private property. This is reasonable, just and how it should be. I have a firsthand understanding of this from the time I served as a Deputy Sheriff.
However, all too often our ranchers, farmers and other private property owners are being denied these same basic legal property rights when it comes to federal employees operating under endangered species laws. Interior Department employees are trespassing on private property without the owner's permission or a search warrant. Many of these Interior Department employees who are trespassing have no sworn legal authority whatsoever.
Disturbing incidents of federal agency personnel operating outside of the law, and willfully trespassing on private property without any legal just
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A February 5th, 1999 article entitled ``Federal employee pleads no contest to trespassing'' in the AG JOURNAL illustrates this El Paso County case. Last fall, a U.S. Fish and Wildlife Service biologist pleaded no contest to a charge of second degree criminal trespassing. This individual is one of the many thousands employed by the Interior Department, and had no legal basis to be on a private ranch located near Colorado Springs. His sentence included a $138 fine and 30 hours of community service.
I applaud the El Paso County District Attorney's Office for standing up to federal lawyers and pursuing this case to its rightful conclusion. It is a small but important victory for American private property owners. It also illustrates a disturbing ability of some federal employees to act as though they are above the law.
Furthermore, the American taxpayers are picking up the tab for the legal defense of these trespassers. When I inquired with both the Interior Department and the Justice Department as to how much taxpayer money was spent to defend the convicted U.S. Fish and Wildlife Service trespasser, they did not disclose the specific dollar amount. These agencies seem to be sending federal personnel the message: ``Go ahead and trespass on private property. If you get caught, we'll go ahead and fix it because we think that the benefits of trespassing outweigh the costs of getting caught.'' This is not acceptable.
Unfortunately, the El Paso County incident is far from isolated. It is certain that every year, hundreds of private property owners, ranchers and farmers are subject to trespassing by federal employees. We will never know how many trespassing cases go unreported because Americans feel that they can not beat the federal government's bureaucrats and lawyers, and fear that if they do, there may be retribution.
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