Copyright 2000 P.G. Publishing Co.
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August 9, 2000, Wednesday, SOONER EDITION
SECTION: EDITORIAL, Pg. A-19
LENGTH: 761 words
CONTRACEPTION IS HEALTH CARE VIAGRA IS COVERED. WHY NOT THE PILL?
BYLINE: ELLEN GOODMAN
By any standard, Jennifer Erickson is a Planned
Parenthood poster plaintiff: She's 26. She's married. She's pre-parental. She's
even a pharmacist for heaven's sake.
Erickson was the one behind the
counter at Bartell Drug telling customers that their insurance
plan covered nearly every pill except the one known far and wide as the pill. So
it's not surprising that the Seattle woman spoke up when she realized that her
own company's insurance plan left her in the lurch. She too was
spending more than $ 300 a year for contraceptives. Hers is, in
some ways, an old story. Women have been paying for
contraceptives ever since the first diaphragm was smuggled into
But a few years ago, when insurance plans
began picking up the tab for Viagra, the lightbulb went on over the medicine
cabinet. How come employee health care plans covered pro and not contra-ception?
Some of us thought it was time to redefine the pill as a female impotence drug.
What greater turn-off, after all, than the fear of pregnancy?
case, some 13 state legislatures have now mandated that private
insurance plans which pay for prescription drugs must also pay
for contraceptives. But today only half of
insurance plans cover any of the five
contraceptives for women -- from pills to Norplant -- and the
issue has been stalled in Congress.
Now Erickson has filed the first
class-action suit of its kind, citing Title VII of the Civil Rights Act to win
contraceptive coverage for women at Bartell. When men get their
basic health care covered and women don't, the suit charges, it's employment
Employers have long maintained that
contraceptives aren't covered because they aren't "medically
necessary." Many have described pills and diaphragms as a "lifestyle choice" on
par with Retin-A or cosmetic surgery or -- as one California legislator put it
But this time, they'll be girding their lawyers to
defend against sex discrimination charges. And be prepared for some
One of the arguments already being aired rests
on the notion that as long as the same policy is applied the same way to both
men and women, there's no illegal bias. Companies may well claim they are
discriminating not against women but against contraceptives.
Why, they don't pay for the pill for men, either!
Of course, all five
methods of prescription contraceptives are for women. So, this
is like saying that women are equally covered for prostate exams and men for pap
There is a history to this sort of "equality." Some 25 years
ago, health insurance plans excluded vaginal deliveries. The
Supreme Court actually ruled that denying insurance for
pregnancy was not sex discrimination. The employer merely had two categories of
workers: pregnant and nonpregnant persons.
The tortured absurdity of
this ruling led Congress to pass the Pregnancy Discrimination Act. This banned
sex discrimination on the basis of "pregnancy, childbirth or related medical
conditions" in all employment areas, including benefits.
um, a pre-existing condition for a huge number of working women. And the need
for contraception is nothing if not a "related medical condition."
policy that covers the cost of basic health care for men but makes women pay for
contraceptives discriminates quite simply because it has a
disparate impact -- on the woman and her pocketbook. Women are the ones who get
pregnant. Without contraceptive coverage, women end up paying
68 percent more of their own money for health care.
Ironically, the cost
of adding this coverage would be $ 22 a year. Yet more
insurance companies pay for abortion than for contraception.
Indeed, more pay for sterilization than contraception.
Gloria Feldt, the
president of Planned Parenthood, says that employers have counted on the fact
that "women want contraceptives so badly, they'll pay anything.
And they do."
But there is something larger at stake in this
discrimination suit. As Feldt says, "men's health and bodies have always been
the norm in designing health plans. Women's have been the abnorm." What if women
were the norm? Would contraception still be considered medically unnecessary?
This is one area in which anatomy is destiny. We can't treat
insurance coverage the same anymore than we can treat bodies
the same. Until -- let us pray -- a male contraceptive pill
comes on the market, separate is the only way to get equal.
Goodman is a columnist for The Boston Globe. Her e-mail is
LOAD-DATE: August 10, 2000