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Contraceptives and Medical Coverage Considerations

Contraceptives and Medical Coverage Considerations

The debate about how health insurance should relate to birth control has been a contentious one, to put it lightly. One of side of the equation, people argue contraceptives such as The Pill should be covered under every insurance plan, especially since more than half of prescriptions for erectile dysfunction drugs such as Viagra are covered. On the other side, some people argue birth control should be the responsibility of consenting adults, not subsidized by the general subscriber base. It is estimated that approximately half of all major policies do not include routine contraceptive benefits for women subscribers. Some states have addressed this concern, although some feel there hasn't been enough progress in the fight to have birth control subsidized.

A Look at the Numbers

Close to 50% of states have attempted some sort of legislation requiring providers that extend prescription drug benefits to include at least some sort of contraceptive services. Women's rights activists claimed a major victory in 1998 when it was ruled all federal employees were entitled to receive coverage for birth control. Some compare insurer's reluctance to include contraceptives under prescription benefits with a former hesitation to include prenatal care. As little as 30 years ago, providers didn't extend prenatal care to customers. Here are a couple other things to consider in the midst of the debate:

  • 49% of major group plans don't include birth control
  • 97% of major group policies include prescription medicine, but as little as 33% of those offerings include oral contraceptives, the most popular form of female contraceptives available on the market
  • Only 15% of these aforementioned offerings include the five most popular types: pills, diaphragms, IUDs, Depo Provera, and Norplant
  • Female policyholders ages 15-44 typically pay 68% more for health care costs out-of-pocket than male counterparts, mostly based on the costs of family planning treatments and medicine

The Arguments For and Against Contraceptive Coverage

Those who support subsidization by insurers argue reimbursing women for the monthly cost of family planning products would be a paltry average of $30, which is much less expensive than paying for unplanned pregnancies down the road. Some commentators estimate that offering full coverage for these benefits would be approximately $16 extra per policyholder. Activists feel it is a double standard to provide anti-impotence drugs but exclude birth control.

Those who are against subsidization argue pregnancy or pregnancy prevention shouldn't be classified as a medical condition, while erectile dysfunction should be. Additionally, some groups don't want to be included in the subsidization of birth control, arguing their beliefs are infringed on if they are forced to pay into it. Others don't want to see rate increases.

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