Utah Weighs Mandatory Birth Control Coverage

For Utah lawmakers, making insurance companies pay for contraceptives may be a hard pill to swallow.

But the women who pay an average of $30 a month because their insurance won’t cover contraception have taken a keen interest in the issue. According to the Conference of State Legislatures, women spend almost 70% more in out-of-pocket health care expenses than men, mostly due to birth control costs.

Utah state Sen. Paula Julander, a Salt Lake Democrat, wants to force private insurers to pick up the tab, and has introduced a bill to do so for the fourth year in a row.

This year’s bill now sits in the Senate Rules Committee, where last year’s version died.

Julander hopes the bill will be enacted this year. But if it isn’t, she said, she will keep bringing the issue back to lawmakers.

The Utah Pharmaceutical Assn. estimates that about 50% of the state’s insurance carriers pay for contraceptives, said vice president C. Neil Jensen.

Thirteen states have enacted prescription equity laws since 1998, and more states are debating the issue.

Proponents, including Julander, hope the bills get a boost from a recent EEOC ruling. The federal agency said an employer who denied coverage of contraceptives but paid for other preventive treatments and prescriptions violated the 1978 Pregnancy Discrimination Act.

The ruling only applied to one case filed by two women, but Elizabeth Cavendish, legal director of the National Abortion Reproductive Rights Action League, a national abortion-rights organization, said she hopes the decision sets a precedent for other employers.

This year, lawmakers in 12 states are debating proposed laws which, to varying extents, would cover contraception. Those states are: Alaska, Arizona, Florida, Illinois, Indiana, Missouri, Montana, Nebraska, New Jersey, New Mexico, New York and Utah, according to the National Conference of State Legislatures.

“I look at it as an equity issue, not a health care mandate,” said Julander, a retired nurse.

As with similar legislation around the country, Utah’s bill was a reaction to insurance providers paying for Viagra, a drug to treat male impotence, but not women’s contraceptives, she said.

Critics of the plan see the issue as a mandate that hurts small businesses by increasing health insurance costs and dictating what their insurance must cover.

“We call this an anti-choice bill,” said Kelly Atkinson, spokesman for Utah Health Insurance Assn. He said it picks on the small insurance carriers that want to cater to a particular business’ needs.

David Leo, president of Western Mutual Insurance Company in Salt Lake, said the costs of prescription drugs are increasing by 18% a year, a trend that’s projected to continue until at least 2004.

He cautions that adding mandatory prescription coverage could drive up insurance premiums. And for every 1% that insurance premiums increase, about 2.6% of small businesses drop their insurance coverage altogether, Leo said.

Both Atkinson and Leo said that most women in Utah will not be covered by this bill if it becomes law.

Atkinson said about 65% to 70% of businesses, including many of the state’s largest, are self-insured and wouldn’t be affected by the change because they follow federal, not state, rules. Of the 25% he said would be affected by the bill, most already have policies covering at least some contraceptives.

He said about 5% are uninsured.

Proponents acknowledge that many insurance policies will be left out of state legislation.

“Rarely does legislation fix a problem completely, but it’s a step,” Cavendish said.

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Utah State Legislature: https://www.le.state.ut.us/

National Conference of State Legislatures: https://www.ncsl.org

NARAL: https://www.naral.org/