ARIZONA STATE SENATE
Phoenix, Arizona
health care coverage;
contraceptive coverage
Requires health insurance
companies that offer prescription drugs and devices to their members to also
provide equal coverage of Federal Drug Administration (FDA) approved
contraceptive drugs and devices.
Since 1973, states have been
required to cover family planning services for Medicaid beneficiaries. However, a 2000 survey carried out by the
Arizona Family Planning Council found that 62 percent of Arizonans’ health care
plans did not cover contraceptives on an equal basis to other
prescriptions. On December 13, 2000,
the United States Equal Employment Opportunity Commission (EEOC) issued a
commission decision finding merit in two charges of discrimination in the
denial of health insurance coverage for prescription contraceptives. The EEOC found that this denial violated
Title VII of the Civil Rights Act of 1964, as amended by the Pregnancy
Discrimination Act, which prohibits sex discrimination by employers with 15 or
more employees. The EEOC based its
decision on the grounds that the respondents in the charges excluded the cost
of prescription contraceptive drugs – available only to women – from their
employee health plan while covering a number of other preventive drugs, devices
and services.
The FDA has approved five
contraceptive methods: Norplant implants, Depo-Provera, Intrauterine Device
(IUD), diaphragm and contraceptive pill.
In addition to birth control,
contraceptives are medically necessary for a variety of problems that women may
incur including regulating a woman's cycle and endometrial and ovarian
cancer. According to the National
Council of State Legislatures, 19 states have passed legislation requiring
insurers who cover prescription drugs to offer coverage for prescription
contraceptives.
This legislation applies to
subscription insurance contracts, health care service organizations, disability
insurance policies, group disability policies, blanket disability policies and
accountable health plans. Under this
legislation, plans already covering prescription drugs and devices would
include equal coverage for prescription contraceptive drugs and devices. Also, plans that include coverage for
outpatient medical services would include outpatient contraceptive services in
that coverage.
The health insurance
purchased by the State on behalf of its employees covers some forms of
prescription contraceptives depending on the employee’s plan coverage. The fiscal impact to the state general fund
for this legislation is not currently discernable.
Provisions
1. Requires insurers that provide coverage for:
a.
prescription
drugs to also provide coverage for FDA approved contraceptives.
b.
outpatient
health care services to also provide coverage for outpatient contraceptive
services.
c.
experimental
or investigational outpatient prescription drugs, devices or outpatient health
care services to also provide coverage for experimental or investigational
contraceptive drugs, devices or contraceptive services.
2. Prohibits insurers from imposing any reduction in reimbursement that is not equally imposed on all members in the same benefit category, class, coinsurance or copayment level.
3. Provides for a general effective date.
Prepared by Senate Staff
January 29, 2002