Judge Orders Health Plan to Cover the Pill

Finds that failure to do so is bias against women

WEDNESDAY, June 13, 2001 (HealthDayNews) -- Citing a bias against women, a U.S. District Court judge has ordered a drugstore chain to cover the cost of birth control pills in its employee health insurance plan.

Judge Robert S. Lasnik yesterday ruled that Bartell Drugs of Seattle, the nation's oldest family-owned drugstore chain, violated federal law by not covering the cost of the contraceptives when its self-insured health plan paid for the basic needs of men. He told the company to include the costs for Jennifer Erickson, a pharmacist with the company.

Bartell says it will comply, but is considering an appeal.

"Male and female employees have different sex-based disability and health care needs, and the law is no longer blind to the fact that only women can get pregnant, bear children or use prescription contraceptives," Lasnik wrote. "Although [Bartell Drugs' health care] plan covers almost all drugs and devices used by men, the exclusion of prescription contraceptives creates a gaping hole in the coverage offered to women, leaving a fundamental and immediate health-care need uncovered."

Erickson sued Bartell Drugs for sex discrimination in July 2000 after the company refused to expand its non-union health care coverage to include contraceptives.

Bartell contends that the "company's health care plan was non-discriminatory. In the 37 years Title VII has been on the books, there had been no court ruling demonstrating that the exclusion of contraceptives constituted discrimination," the company adds. Title VII, part of the Civil Rights Act of 1964, forbids employers from discriminating against anyone in terms of the "privileges of employment."

"It was never our intention to discriminate, and we had planned to offer contraceptive coverage well before this judgment," Jean Bartell Barber, the company's chief financial officer, says in a statement.

"Last year we offered to provide prescription contraceptive coverage for Jennifer Erickson and other non-union employees," says Barber. "Planned Parenthood rejected our proposal. Despite this, we made the decision to move forward and provide the coverage."

Barber says that, since April 1, the company added prescription contraceptive benefits to the medical plan for union employees. "Consistent with the company's historical practice, Bartell planned to add these benefits to coverage for non-union employees, Jennifer Erickson included."

The case was closely watched because it was the first challenge to a private company that didn't include oral contraceptives in its health plan. Women's groups became outraged upon learning that the erection pill Viagra was covered under many plans.

"We are considering an appeal," says Mike McMurray, Bartell's assistant vice president of marketing. "After the decision of the judge, which we are going to promptly comply with, there are court costs and other issues of that nature that we need to consider. The attorneys have to get together and consider those things, and at that point we will make a decision," he says.

There are approximately 60 million women in the United States who are within the childbearing years --roughly between the ages of 15 and 44 -- according to the Alan Guttmacher Institute. Of those, 61 percent use some form of contraception.

According to the William Mercer Company, a human resources consulting firm, only 39 percent of health maintenance organizations (HMOs) and 15 percent of indemnity plans routinely cover all five female reversible contraceptive methods: oral contraceptives, IUDs, diaphragms, implants and injectables. Providing full insurance coverage for contraceptives would cost employers about $17 per year -- or $1.42 a month for each employee.

Erickson is delighted with the ruling. However, she says, "it won't really feel real until I'm filling prescriptions for employees knowing that all they will be doing is paying the co-pay for their contraceptives."

She adds, "What I hope my effort and this court case will do is to inspire other women to go to their employers and ask them why their birth control pills are not covered, and then work to get them to do just that."

Planned Parenthood of Western Washington supported Erickson's class-action lawsuit.

"This case is based on a federal law that applies to every employer across the nation that has 15 employees or more," says Erickson's attorney, Roberta Riley, legal counsel for the local Planned Parenthood in Seattle.

"A lot of people are confused about what this ruling means for them," Riley adds. "Women need to go to their employers and approach them about developing this kind of coverage. Many women are having success doing just that, and many companies are thanking women for bringing the issue to their attention."

What To Do

If you are interested in reading the ruling, see the United States District Court Western District. And if you're interested in talking to your employer about contraceptive coverage, check out Cover My Pills.

Or you can read these other HealthDay stories on health insurance.

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