Copyright 2000 / Los Angeles Times
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December 15, 2000, Friday, Home Edition
SECTION: Part A; Part 1; Page 1; National Desk
LENGTH: 1028 words
INCLUDE BIRTH CONTROL IN HEALTH PLAN, EEOC SAYS;
CONTRACEPTIVES: RULING AFFECTS ONLY COMPANY NAMED IN
COMPLAINT. AGENCY CALLS THE FAILURE TO COVER SUCH ITEMS SEX DISCRIMINATION.
BYLINE: ALISSA J. RUBIN, TIMES STAFF WRITER
In a significant victory for many women, the Equal Employment Opportunity
Commission ruled Thursday that it is discriminatory for an employer's health
plan to not pay for contraceptives if prescription drugs and
preventive care are otherwise covered.
The EEOC's ruling does not have
the force of law and applies only to the employer against whom the complaint was
brought. But the agency's determination that failing to cover
contraceptives can constitute sex discrimination under the
Civil Rights Act and Pregnancy Discrimination Act sends a strong signal to
"At a minimum, you can be certain that employers will examine
this ruling relative to their own plan and determine whether changes are needed
in a systematic way," said Paul Dennett, vice president for health policy at the
American Benefits Council, which represents large and medium-size employers. The
EEOC reasoned that, because the Pregnancy Discrimination Act prohibits
discrimination against women based on their ability to become pregnant, it
"necessarily includes a prohibition on discrimination related to a woman's use
By extension, the commission said,
an employer may not "discriminate in their health insurance
plan by denying benefits for prescription contraceptives when
they provide benefits for other drugs and devices."
Although most health
plans now cover prescription drugs, relatively few include comprehensive
coverage for birth control pills and other prescription
Only 15% of all health plans cover all
prescribed methods of contraception, according to the nonpartisan Alan
Guttmacher Institute, a New York-based reproductive health research group. Only
half of traditional, fee-for-service plans and preferred provider organizations
cover any form of contraception. HMOs offer the most complete coverage, with
about 90% covering at least one reversible method of contraception.
Reproductive health groups hailed the ruling. Marcia Greenberger,
president of the National Women's Law Center, said employers "should take heed
of the EEOC decision and add coverage of contraceptives as
required by law." Greenberger's organization represented a coalition of 60
health and women's groups that asked the EEOC to study the issue.
Planned Parenthood Federation of America called the decision a victory but said
it is only a first step because the commission's findings apply only to the
individual employer in the case and do not assure the 60 million women of
childbearing age in the U.S. that they now will have
"Because this ruling is only
binding on the employers of the two women who brought charges with the EEOC,
much work needs to be done to ensure that other employers around the country
start covering contraception," said Roger Evans, director of litigation for
The organization supports legislation pending in
Congress that would require all health plans that cover prescription drugs to
include prescription contraceptives. California already has
such a requirement.
But the measure is strongly opposed by many
employers, who fear it would raise health benefit costs, as well as the National
Conference of Catholic Bishops, which rejects any form of contraception other
than natural family planning, in which couples engage in sex when women are
least likely to be fertile.
In the absence of congressional action,
another route to mandatory coverage is through litigation on behalf of
individual women. A class-action lawsuit filed by Planned Parenthood in Seattle
on behalf of employees of a Washington state drugstore chain argues that
employers whose plans cover other prescription drugs also must cover
contraceptives. A lawyer at the National Women's Law Center
said she expects the EEOC ruling would be admitted as evidence in the case.
"We think the ruling will be very helpful," said Judy Appelbaum, a vice
president at the law center.
The EEOC finding grew out of two
complaints, both filed by registered nurses who worked for the same employer.
Under law, the EEOC does not divulge the identities of the employees or
employers in a case.
One nurse wanted to use oral
contraceptives for birth control. She also wanted medication to
alleviate symptoms of dysmenorrhea, or menstrual cramping, and premenstrual
syndrome. The other nurse wanted to use Depo Provera, an injectable form of
Their employer's health plan covered a range of
preventive services, including vaccinations, physicals, mammograms, dental care
and drugs intended to prevent development of medical conditions such as high
blood pressure. But it omitted prescription contraceptives, a
category that includes birth control pills, injectable medications such as Depo
Provera, intrauterine devices, diaphragms and implanted
contraceptives such as Norplant.
The employer argued
that its plan only covered treatment of medical conditions considered
"abnormal," that contraceptives are too expensive to cover and
that the exclusion of prescription contraceptives does not
discriminate between men and women, as it denies coverage to employees of both
sexes. The EEOC rejected all of those arguments, including the cost of coverage
"The cost defense doesn't work legally or factually," EEOC legal
counsel Ellen Vargyas said. She said Congress has made it clear in previous
legislation that it does not consider cost to be an acceptable reason for
denying health coverage. As a practical matter, she said,
contraceptive coverage is relatively inexpensive: about $ 22
per worker per year, according to a recent estimate by the Guttmacher Institute.
"You can buy years and years of prescription
contraceptives for the cost of one pregnancy," Vargyas said.
Nonetheless, employers consider cost a key issue.
government again telling employers what they are going to have to cover in their
health plans," said Kate Sullivan, director of health policy for the U.S.
Chamber of Commerce. "The employers say, 'Well, maybe we should look at scaling
back our coverage,' and they are looking at how they can shift more of the costs
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