Birth Control Coverage Nears Approval

Apparently deciding that the only way to reduce the demand for abortion is to increase access to contraception, Congress prepared Thursday to pass legislation that would let federal workers pay for their birth control medications through their health insurance.

Although the only women affected would be the roughly 1 million who are insured through the Federal Employee Health Plan, the measure is widely viewed as a bellwether for other insurers nationally.

The measure, which is expected to be signed into law as part of the gigantic spending bill Congress plans to send to President Clinton today, would require all health plans that offer insurance to federal workers to cover the costs of the five major forms of contraception: birth control pills; diaphragms; intrauterine devices; the long-acting implant NorPlant; and the injectable birth control medication Depo-Provera.

Supporters of the measure hope to expand it next year to cover all women in private health plans. Contraceptive service already is covered for low-income women who get their health care through the Medicaid program.

Other reproductive health provisions did not fare so well in this year’s omnibus spending bill, gratifying conservatives, who have opposed them for years.

The bill terminated all spending for the United Nations Family Planning Fund, which, congressional negotiators said, had received about $25 million annually from the United States. Conservatives objected to the spending in part because the program sends money to China, which has an aggressive population control policy.

Overall, however, Congress appeared to be drawing an increasingly sharp distinction between reproductive health policies related to abortion and those involving contraception.

“For so long, family planning has been embroiled in the abortion debate,” said Sen. Olympia J. Snowe (R-Maine), one of the measure’s strongest supporters.

“We really tried this year to move the debate away from the issue of abortion. And when we did that . . . even many anti-choice people were willing to support contraception,” said Snowe, who is working on legislation to ensure that all private health plans cover contraception on the same basis as other prescriptions.

In the House, Rep. Nita M. Lowey (D-N.Y.) called new federal coverage “a huge step forward in our efforts to prevent unintended pregnancies and reduce the number of abortions.”

The measure had been dropped from another spending bill because of heavy lobbying by antiabortion conservatives. But since it had passed both the House and the Senate by strong, bipartisan majorities, the White House and women’s groups lobbied hard for its revival.

“It’s a breakthrough,” said Susan Cohen, who tracks federal contraception legislation at the Alan Guttmacher Institute, a New York-based reproductive health research organization.

“If you want to do something about abortion, you have to give women and couples access to the best means possible to reduce unintended pregnancy,” Cohen said.

Support for the measure was strengthened by the recent debate over insurance coverage of Viagra, the anti-impotency drug, which the Pentagon recently decided to cover for its employees at a cost of $50 million a year.

Antiabortion advocates agreed that the success of the contraception mandate had much to do with its being framed solely as an issue of pregnancy prevention.

“Public opinion is favorable to contraception,” said Marty Dannenfelser, director of media and government relations for the Family Research Council, a leading group in the effort to limit access to abortion.

“The people who support abortion know they are losing on the direct abortion votes so they found another way to push their agenda. . . . So when the debate was framed as family planning, it won,” said Dannenfelser.

A primary opponent of the contraceptive measure, Rep. Tom A. Coburn (R-Okla.), who is a physician and strong abortion opponent, plans to attempt to remove the mandate next year, a spokesman said.

In other action on reproductive health, international family planning programs were funded at the same level as last year with no adjustment for inflation.

A separate bill, however, restricted the use of those funds. It prohibits any foreign organization that either provides abortion services or takes a public position on its country’s abortion policies from receiving any of the funding. President Clinton is expected to veto that bill, which would authorize State Department programs and pay for the country’s back dues to the United Nations, because of the family planning language.