Copyright 2000 The Atlanta Constitution
The Atlanta
Journal and Constitution
May 9, 2000, Tuesday, Home Edition
SECTION: Features; Pg. 1C
LENGTH: 761 words
HEADLINE:
Healthy Living: TUESDAY'S GUIDE to MEDICINE and HEALTH CARE;
Insurers slow
to see benefits of the pill
BYLINE: Diane Lore, Staff
SOURCE: CONSTITUTION
BODY:
When it gets down to paying the bill, many insurers still prefer babies to
birth control.
The birth control pill turns 40 today, but insurance
companies nationwide still balk at covering its cost. That's despite the fact
that they're willing to shell out the money for unplanned pregnancies,
sterilizations and, of course, that other little pill --- a blue newcomer called
Viagra, used to treat impotence.
"The pill is clearly the most preferred
form of contraception among young women," said Dr. Michael Randell, who
practices at Northside Hospital. "But I see only about half of the insurance
policies covering it."
Nationally the numbers are even lower, with only
34 percent of women in a recent survey reporting that their insurance covered
the cost of contraceptives. Of those, only half said the pill was covered,
according to a survey released last week by the American College of
Obstetricians and Gynecologists.
That's despite the fact that 80 percent
of all American women born since 1945 have used the pill at some time, according
to the Johns Hopkins School of Public Health.
Even when insurance covers
the cost, companies attach a laundry list of conditions. Although 93 percent of
health maintenance organizations provide some coverage, most require patients to
pay the lion's share of the cost or pick their prescriptions from an approved
drug list.
It's frustrating for women such as Pam Rosenthal, 33, an
Alpharetta mother of two who decided to go back on the pill. Her prescription
was rejected for reimbursement by Cigna HealthCare of Georgia Inc., so she and
the pharmacist called to find out what pills were covered. Another prescription
was written, and it was rejected too.
Finally, Rosenthal went to Cigna's
Web site to get a list of approved pills. Then she had to sit down with her
doctor and pick from the handful of choices, so she would pay $ 10 instead of $
25.
Many Georgia women, however, are more fortunate than most. A state
law that took effect last July requires insurance plans to cover the cost of
contraceptives if they cover other prescriptions. That means that, if they will
pay for antibiotics or Viagra, they must also pay for the pill. But, like other
insurance legislation, the law doesn't apply to self-insured companies ---
mostly large corporations --- which are exempt.
Georgia, the second
state in the nation to enact such legislation, is now one of 11 to mandate that
insurers provide some sort of contraceptive coverage.
"This was a victory," said Julie Edelson, director of public policy for
Planned Parenthood of Georgia. "It was a solid recognition by the state that a
critical part of health benefits is to allow women to have better access to
birth control."
Several national studies indicate that almost half of
pregnancies are unintended, with half of those resulting in abortions.
Some insurers got the message long before they were forced to comply
with the state mandate. Blue Cross & Blue Shield of Georgia, for example,
has provided reimbursement for the pill for more than two decades, according to
spokesman Charles Harman.
And the data are convincing enough that even
Medicaid, the government health plan, is reconsidering its contraceptive
policies. Medicaid in Georgia now covers new mothers' contraceptive needs for 60
days after the birth of a child. But the state has submitted a waiver to the
federal government to lengthen that coverage.
Instead, the state would
prefer to offer contraceptives, including the pill, for two years, with the
goal, of course, of preventing more unplanned pregnancies.
"Family
planning coverage, from every perspective, is a good idea," said Joyce Goldberg
of the Georgia Department of Community Health. "It lowers the risk of a
complicated (second) pregnancy and improves the health of the mother."
And, in a weird way, women should also thank the makers of Viagra. At $
10 a pop, Viagra forced insurers to re-evaluate what is fair in reproductive
health. Insurers have traditionally viewed birth control or fertility drugs as a
luxury, not a necessity. But once they covered Viagra, it became more difficult
to turn their back on women.
"We allow our insurance companies to be
biased against women," Dr. Mitchell Creinin, director of family planning at the
University of Pittsburgh, said in a recent interview. "If men were the ones who
got pregnant, you know it would be different."
Our consumer health
columnist
Call: Diane Lore at 404-526-7590
Write: P.O. Box 4689,
Atlanta, GA 30302
e-mail: dlore@ajc.com
GRAPHIC:
Photo
The pill, which marks its 40th year today, has been used by 80 percent
of all American women born since 1945. / MIKE DERER / Associated Press
LOAD-DATE: May 9, 2000 
