health care insurance;
contraceptive coverage
HB 2234 requires any health care plan providing prescription drug coverage to cover contraceptives at the same level of coverage as other prescription medications.
Currently there are five reversible contraceptive methods approved by the FDA. These include the birth control pill, injectables (such as Depo-Provera), implants (Norplant), the intrauterine device (IUD) and the diaphragm. According to a William M. Mercer study Women’s Health Care Issues: Contraception as a Covered Benefit, the birth control pill is the most popular type of reversible contraceptive. In addition to their primary function of preventing unintended pregnancies, contraceptives may also be used for other medical purposes, such as decreasing the risk of ovarian cancer or alleviating the symptoms of menopause.
In December 2000, the Equal Employment Opportunity Commission (EEOC) ruled that an employer’s failure to cover prescription contraceptives as part of an employee’s health plan constitutes unlawful sex discrimination under Title VII of the Civil Rights Act (1964) and the Pregnancy Discrimination Act (1978). The EEOC stated that in order to avoid violating Title VII in the future, the expenses of prescription contraceptives must be covered to the same extent and on the same terms as other types of drugs, devices and preventative care. In addition, the coverage must extend to the full range of available prescription contraceptives and that coverage should be provided whether the contraceptives are used for birth control or other medical purposes.
According to a survey of insurance companies by the Arizona Family Planning Council in 2000, 38% of the respondents indicated that contraceptives were covered on an equal basis with other prescriptions in their benefits package. In addition, 18% indicated that their plan covered all 5 FDA approved methods of birth control.
HB 2234 would require insurers that cover prescription drugs to cover all five FDA approved methods of contraception at an equal level with other prescriptions. In addition, the bill requires insurers covering outpatient services or experimental procedures to also cover contraceptive services under the same categories.
· Requires all health insurance plans (hospital or medical services corporation, health care service organizations, disability insurance policies, group disability policies, blanket disability policies and accountable health plans) providing coverage for prescription medications to also provide coverage for all FDA approved prescription methods of contraception.
· Prohibits an insurer placing a different copayment, coinsurance level or fee on a contraceptive or reducing the allowable reimbursement for a contraceptive.
· Specifies that any contract that provides outpatient health care services must also provide outpatient contraceptive services.
· Requires any policy that covers experimental procedures to also cover experimental procedures for contraceptive services.
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45th
Legislature
Second
Regular Session 2 March 15, 2002
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