Coverage Sought For Birth Control Boise Republican Calls It ‘A Fairness Issue’

Women spend far more on health care than men - largely because private insurance plans don’t cover birth control.

A bipartisan coalition of Idaho legislators wants to change that by requiring plans that cover prescription drugs to also cover prescription contraceptives.

Many lawmakers are wary of the idea of any mandate on private businesses, but backers point to a precedent: In 1993, the Idaho Legislature required all plans that covered mastectomies to also cover mammograms.

Before that, back in 1978, it took an act of Congress to get health plans to cover pregnancy and childbirth. “Sometimes you have to stand up and say, `Wait a second, there’s something wrong here,”’ said Sen. Sheila Sorensen, a pro-business Republican from Boise who was in the Legislature when the mammogram bill passed. “It’s a fairness issue. It’s the right thing to do.”

Insurance companies see it differently. “We believe those decisions should be made by the people who are paying for them, our customers, and not the Legislature,” said Rich Wright, spokesman for Blue Cross of Idaho. The firm insures 306,000 Idahoans, a quarter of the state’s population.

Said Georgeanne Benjamin, spokeswoman for Lewiston-based Regence BlueShield of Idaho: “We oppose any mandated coverage because it limits our customers’ choice. We don’t oppose providing the coverage. It’s just our customers aren’t asking for it, and we design our product based on what they want.”

Regence BlueShield’s Idaho customer base is even larger than Blue Cross, at 319,000.

Last year, when Rep. Margaret Henbest, D-Boise, proposed a similar bill, insurance lobbyists lined up to oppose it and the measure died a quick death in the House Business Committee.

“They do seem able to put pressure on,” said Rep. Larry Watson, D-Wallace, a committee member who supported the bill. “If they line up, it’s tough to get past them.”

Advocates of the bill are hoping their bipartisan coalition will have a better chance this year, though they expect “significant opposition.” The proposal comes just after the 20th anniversary of the congressional action on pregnancy coverage, and at a time when many insurance plans are offering coverage for Viagra, the new drug for male impotency.

“If they can do that, contraception just seems like a no-brainer,” Watson said. “It seems like it has to eventually be a money-saver for the insurance companies, and it’s just a good woman’s health issue overall.”

“Contraception is not optional for women,” said Henbest, a nurse practitioner. “It’s a medical necessity for over 30 years in a woman’s life span.”

Similar laws have been enacted in seven states, and 25 states are considering the idea this year.

“Contraception is basic to our lives and health, but insurers see it differently,” said Sen. Betsy Dunklin, D-Boise. “They seem to see it as a frill.”

If the measure starts in the Senate this year, it would likely go to the Commerce Committee, which Sen.

Gordon Crow, R-Hayden, chairs. “Personally, I would on first blush probably oppose such legislation,” Crow said. “But I’ll listen. I’m open to the debate on it and the discussion.”

The issue of contraceptive coverage “doesn’t rise to the nature of covering maternity, the cost of maternity,” Crow said.

As far as Viagra coverage, Crow said: “We don’t mandate that. Insurance companies decided they were going to do that.”

Rep. Jeff Alltus, R-Hayden, an insurance agent who serves on the House Business Committee, said, “I’m not much into mandating private businesses do much of anything.”

“If I were a Blue Cross or a BlueShield, I would put contraceptive coverage in there because it would be cheaper in the long run than maternity coverage,” he said.

Alltus said the same goes for mammograms. “I think the companies would be stupid for not covering it, just like I think the companies are stupid for not covering preventive care. … But I’m not sure I agree with mandating coverage.”

Sen. Jack Riggs, R-Coeur d’Alene, a physician, said he thinks insurance plans should cover contraception, but “to make a law would be intrusive.”

“Insurance companies don’t cover immunizations. To me, it’s a similar concept,” he said. “I think it’s ridiculous. But am I ready to require insurance companies to cover them? No.”

Blue Cross classifies contraceptives along with infertility treatments, which it doesn’t cover in its standard policies. It does offer employers an option of paying a higher premium to get contraceptive coverage.

Of the 3,500 groups Blue Cross insures, 190 have opted to pay for the coverage. Most of those are larger employers, Wright said.

Some of BlueShield’s large-employer groups also have opted to add the benefit, Benjamin said. Though she didn’t know how much the additional coverage costs, “It definitely comes at a cost,” she said.

“Our members are definitely concerned about cost, and so are we.”