i will never understand why a company would rather pay for the medical costs related to pregnancy and the possible subsequent 18 years of healthcare for a dependent on the policy than to pay for abortion, or in this case, contraceptives. that logic, as well as the one that allows erection-aids to be a copay while birth control pills be at considerable retail cost, is grossly misguided.

oh my god what BULLSHIT. i hate this country.

Cry havoc, and let slip Valenti's War Kittens!!

Seriously.

Fuckers.

Hey, there needs to be an "email this" button on the blog entries, I want to email it to my dad without sending him through the whole site (I don't think his heart could take it :) )

Seriously, UP SUCKS.

Well Naz, in the meantime you can just cut and paste. or send him the direct URL: http://feministing.com/archives/006708.html

i will never understand why a company would rather pay for the medical costs related to pregnancy and the possible subsequent 18 years of healthcare for a dependent on the policy than to pay for abortion, or in this case, contraceptives.

Perhaps the company doesn't see the cause and effect you're implying. I mean, the company can't force you to take contraceptives in order to save money on dependent insurance coverage, now, can it?

And, just because a person doesn't have insurance coverage for the pill doesn't mean they're going throw caution to the wind and go without contraception.

Seriously, is there a correlation between pregnancy and lack of insurance coverage for contraceptives?

How expensive are they, anyway? How big of a deal is this, really? Please pardon my ignorance, I really don't know.

I know there's already much state-by-state regulation on insurance companies, and I understand how many of these laws came to be. I'm just not sure I favor any more government telling businesses how to operate.

(Regarding UP, I know many people in the railroad industry, and I could easily throw in a snarky remark about people working on the railroad not needing contraceptives at all because they're never home, due to their work schedules. But I'll refrain from joking around for now.)

But strictly from a business perspective, I have no idea why an insurance company would not cover the pill. I've gotta believe that it's a cost/risk analysis for them; that's how they decide what to cover and for how much. Evidently they've looked at the costs and no coverage is the favorable way to go. Would be interesting to see the actual figures.

But the appellate judges rejected the argument on the basis that the PDA does not specifically mention contraception.

On the topic of Title VII in general, it was disclosed that Union Pacific did not cover any contraception, for men or women, and the court decided (showing some obvious bias that I'll get to in a bit) that the district court was wrong to compare sexual health coverage between men and women, restricting the comparison to coverage of contraception alone. Since that was equivalent, the court found no violation of Title VII.

There was one line in particular that caught my eye when reading. The district court, which decided in favor of women, compared the “medicines or medical services [that] prevent employees from
developing diseases or conditions that pose an equal or lesser threat to employees’ health than does pregnancy.� The judges in the 8th Circuit, however, reduced this to: "We decline to address whether pregnancy is a “disease.�".

This snarky comment just screams "outcome reasoning" to me, and makes everything else suspect. Bye correctly notes in his dissent that a failure to provide contraception, either as used by men or as used by women, results in a health risk increase for women alone. He contrasts this with the infertility decision by noting that the results of infertility are shared between men and women. I'm not sure if I find that comparison persuasive, but his history of rulings under the PDA make a fairly compelling support for his interpretation that Title VII with the PDA mandates that "comparable coverage" refer to a comparison of health advantages, not a comparison of specific benefits, and by that metric the majority decision is clearly wrong. I know this triggers the "well, duh" reflex in a lot of the people here, but keep in mind that lower courts are bound by existing precedent, not by what is just.

All in all, I found this an awful decision to read, both in the majority opinion and in the dissent. The reasoning is just messy everywhere, and the arguments sort of wobble over a variety of topics without really forming connected supports. I'm hoping it gets appealed and looked at more carefully by the Supreme Court.

Scarbo, I bet you are right that companies are counting on women and their partners to cover the cost of some kind of birth control.

I searched the Walgreens website for a few different contraceptives--including pills, patch, and nuvaring, and it's $50-60/month, maybe a little less if you buy in bulk. The generic, where available, was about $35/month. Condom cost would depend on how frequently you have sex and in what quantities you buy them. If you need financial assistance, Planned Parenthood will dispense the meds for less depending upon your income. It's a significant amount of money, in my mind, and I'm one of the lucky ones who could afford it if I needed to.

i think some folks that can afford (or have insurance that covers) birth control choose not to get it, but i certainly believe there to be a lot of women who stop buying, thus using, pills because of cost. and that doesn't even consider women who couldn't or didn't ever even start a prescription.
i work at a repro health clinic and even with our discounted rates, a lot of women cannot make that type of monthly financial commitment.

and legallyblondeez has it about right from what i've seen, pricewise, at pharmacy retail. prohibitively expensive for a lot of women.
and, i worked in a pharmacy about 8 years ago and viagra was something like $80 for four pills. just saying.

Anyone else feel like going on a killing/castration spree?

Anyone else feel like going on a killing/castration spree?

ME!!!

Damnit! Now I need to change my seminar paper that I am in the process of writing on this issue.

Plus, it sucks for women.

That's insane. Let's hope this ruling gets changed quickly so as little damage as possible is done.

Anyone else feel like going on a killing/castration spree?

Real nice.

Pathetic. I can really understand not covering Viagra. The Pill, for those who missed the memo, is about a lot more than birth control. Bad cramps? Take the pill. Endometriosis? Take the Pill. Heavy bleeding? Irregular cycles? Take the Pill. Abdominal pain? Ovarian cysts? Yeah, you guessed it: birth control.

It constantly amazes me how people do not see the Pill as MORE than just birth control. For so many women, it's an absolute life-saver. Many women could not physically function without it.

If a health plan doesn't cover prescription medication, I can understand it not covering the Pill. That's just a really basic health plan. Must say, though, when my excellent health care covered fifty-two cents of my health-required Pill prescription, I was freakin livid.

Incidentally, health insurers believe that people won't be on the plan for more than a few years. So if you get pregnant a year from now because the condom broke, chance are you won't be on that health plan when you deliver. As a general rule, too, health plans are incredibly short-sighted and refuse to act in an economically rational manner.

Pathetic. I can really understand not covering Viagra. The Pill, for those who missed the memo, is about a lot more than birth control. Bad cramps? Take the pill. Endometriosis? Take the Pill. Heavy bleeding? Irregular cycles? Take the Pill. Abdominal pain? Ovarian cysts? Yeah, you guessed it: birth control.

Being male, I wasn't on the distribution list for the memo, but now that you mention it, I do believe I have heard of the pill as treatment for those conditions.

Based on your post alone, I can now more clearly understand why you all would be very upset at an insurance plan which didn't cover this medication.

But, I'd like to know what kind of plan it is that doesn't cover it. I'm thinking there may be lots of other medicines that plan doesn't cover as well. The reason I say this is simply, I looked at MY plan I get through my company, and YES, THEY DO COVER THE PILL (Ortho Tri-Cyclen 28). A 90-day supply is $80 (that's the co-pay). If you take the generic, it's only $16 for 90 days.

My plan also covers expensive drugs like celebrex.

So, I'm thinking there are good plans and bad, and which one you get probably depends on the company you work for. If my company were to drop coverage for the pill later, or raise the co-pay for it, I don't think there's any way to prevent it. In fact, they HAVE raised co-pays steadily over the years.

Come work for us: Tyco Healthcare (soon to be re-named Covidien)!

The courts were correct, as is the insurance company. It is really not an insurable item.

Insurance does no good for high-frequency, low-cost events such as a decision to take a birth control pill. Insurance is for low-frequency, high-cost events, such as a dread disease or traumatic injury.

You want to take birth control? Fine. Don't throw a tantrum when others don't want to subsidize that decision for you.

It occurs to me that the insurance company/employer also has a countervailing right to freedom of association. And there is no real requirement for them to offer jobs or health insurance to begin with.

It also occurs to me that a government big enough to mandate the inclusion of birth control in drug formularies as a result of political pressure is a government big enough to forcibly exclude it via political pressure, as well.

Women are better off letting the free market function, and seeking employment elsewhere where they can get a better deal, perhaps through a cooperative buy agreement.

But Birth control? It's not even insurable.

"insurance does no good for high-frequency, low-cost events such as a decision to take a birth control pill. Insurance is for low-frequency, high-cost events, such as a dread disease or traumatic injury."

like viagra and rogaine right? id at least read the article before commenting, jason

"Insurance does no good for high-frequency, low-cost events such as a decision to take a birth control pill. Insurance is for low-frequency, high-cost events, such as a dread disease or traumatic injury."

what about the decision to take daily doses of medication that regulates, for instance, blood pressure? a whole lotta insurance companies subsidize the cost of those puppies.

and,
"Women are better off letting the free market function, and seeking employment elsewhere where they can get a better deal, perhaps through a cooperative buy agreement."
great idea but unrealistic as an actual option for all the women living in this country.

hmm, i'm getting a troll vibe!

i know, doublefantasy, and it's TWICE now i've seen those sentences started with "women should" or "women are" and it's just like i can't even help it, i start typing right at them even though i know i shouldn't bite.

yeah, i was pretty tempted, too-- and i did respond to a comment on a different thread! it's not even worth the energy, though.

Well, you haven't bothered to respond to the the freedom of association point.

It's much easier for the intellectually slovenly to cry "troll, troll!" rather than deal rationally with the counter arguments. But that might be a bit much to ask around here.

>>

Not relevant. The fact that the insurance company in question chooses to cover these drugs or treatments has no bearing whatsoever on whether they should be required, by force of law, to cover others against their will and business judgement. See the Freedom of Association point earlier.

>>

Seems like sound policy to me. It's obviously cheaper to prevent a heart attack than to treat it once it occurs. That reason alone is sufficient for the insurance company to cover BP meds, and has no bearing on birth control whatsoever.

It may also be sound business policy to cover BP rather than pay for medical care surrounding pregnancy and/or childbirth (after which point, the parents would need to pay premiums to cover the child).

However, this is a decision the insurance company can weigh far more efficiently than a judge. Judges are judges, not actuaries.

If the insurance companies violate no law in writing policies, then the judges will butt out, as it should be.

"great idea but unrealistic as an actual option for all the women living in this country."

I don't buy that. ALL women don't have to do it, for example. Only the ones who want other people to subsidize their birth control.

I suspect, though, it's easier to come up with the $50-70 per month it costs.

'Round here, we call it a "cable bill."

>>>it's TWICE now i've seen those sentences started with "women should" or "women are" and it's just like i can't even help it, i start typing right at them even though i know i shouldn't bite.

This was in response to my assertion that women are better off using the free market and letting it function.

But obviously, I'm correct here. After all, using the courts as a remedy to common sense didn't work out all to well, did it?

Q.E.D.

Ok, don't know what happened. The first quote was the snippet "like viagra and rogaine, right?"

The second was "what about the decision to take daily doses of medication that regulates, for instance, blood pressure? a whole lotta insurance companies subsidize the cost of those puppies."

For some reason they were omitted from the text above.

Jason's got a point. If you take out insurance against your house burning down you're insuring against something you don't want to take place happening. Most medical insurance is like that. You're insuring against a cost forced upon you by something you don't want to happen - that includes Viagra, it's inflicted upon you, these guys don't choose impotence.

Contraception just isn't insurable. It's not triggered by an event you don't want to happen, and it doesn't fit into the idea of compensation for an event taking place.

This is essentially a campaign for getting people who don't use contraception to subsidise contraception costs. I can see why contraception users want that, but I can't think of a good justification for why other people should subsidise my sex life.

Leederick -

Are you even female? Ive take the pill for many reasons besides its main purpose, contraceptives.

I think the fair thing to do, is not cover as a contraceptive. If they dont cover cover condoms as contraceptives, neither should the pill be covered as one either.

But - women should be able to go to the doctor and get a special prescription or referral for medical necessity and then cover it.

Simply as a contraceptive, it doesnt qualify as a coverable offense. I dont remember any insurance plan that Ive had in 10 years, that covered pills, condoms, injections, patch, etc.

But if a medical necessity (for health afflictions) is demonstrated, then why not cover it?

Its as simple as going to the doctor and getting his approval for medical necessity.

i can't believe the turn this has taken. it's called PREVENTATIVE CARE. it's true that in this country we don't have health care, we have sick care. but that's a PROBLEM, not an unchangable fact. and personally, i don't want to live in a world where only middle class people can afford to have sex or where only middle class people can choose how many children they want to have. your medical insurance is meant to cover your medical needs, whether it be a flu or a pregnancy or cancer. vaccines are preventative care as well, something that i want EVERYONE to have access to. why is pregnancy an "event" and consensual sex for non-procreation purposes not?

condoms are a tricky issue because of the fact that they're not a medication. i think that they should be free or at least much cheaper than they are because they're a public health requirement. at the same time, though, it's easier to get condoms for free than pills and unless you have sex several times everyday, condoms are usually much less expensive, as well.

doublefantasy -

Because once reality sets in, you will see that there is no way in hell US insurance companies will cover condoms or pills.

While I would love to write that expense off, and not have to deal with it anymore, I think you will have an easier time claiming medical necessity than preventive care.

Why wouldnt an insurance company simply respond "Abstinence or condoms achieve the same result"?

Its wrong, and I really agree with you DF.

But it will be a cold day in hell before you can pry millions of women's contraceptive costs from these greedy bastards' hands.

my insurance company covers my pills. every insurance i've ever had (three or four by now?) covered pills. i understand that i've been lucky so far, but it's really not the completely rare occurance you're making it out to be.

When I worked at Staples, my pills were covered. When my husband was in the military, my pills were free at the base pharmacy, $5 co-pay for a 3-month supply elsewhere. Now at another company, my pills are still covered. My mom's pills are also covered by her company's insurance plan. So please quit acting like it doesn't happen.

I'm curious as to why you think employees don't have a right to influence what medicines or proceedures are covered when they are paying into a healthcare plan as well?

And something tells me that if there were a pill that was primarily used as a male contraceptive, but also greatly reduced the chances of testicular cancer, there would be a lot less concern for the sacred free market and precious corporate free association.

the idea that a woman can always come up with $50-$70 a month if she chooses to prevent pregnancy hormonally is unrealistic. and to say, ''Round here, we call it a "cable bill.'" is pretty presumptuous, as if so many women are debating whether or not to pay their cable bill or pick up their orthocyclen. no, i don't think every woman should be on birth control, nor do i think it should necessarily be covered by all insurance companies. but i acknowledge that there are women who want to be on birth control and CANNOT afford it--and do not have cable, or you know, enough income to make rent each month--even though birth control has a number of health benefits above and beyond Preventing Unwanted Pregnancies.
Does anyone know if this particular insurance company covers elective abortion? because if "Insurance is for low-frequency, high-cost events, such as a dread disease or traumatic injury," then they certainly ought to.

"This is essentially a campaign for getting people who don't use contraception to subsidise contraception costs. I can see why contraception users want that, but I can't think of a good justification for why other people should subsidise my sex life."

Well said, Leederick.

"i can't believe the turn this has taken. it's called PREVENTATIVE CARE. it's true that in this country we don't have health care, we have sick care. but that's a PROBLEM, not an unchangable fact."

That sure as heck doesn't make any business of the court's.

"your medical insurance is meant to cover your medical needs, whether it be a flu or a pregnancy or cancer."

No it isn't. Why do you think we have deductibles? Medical insurance is designed to transfer the risk financial risk of catastrophic or near-catastrophic health events from the individual - who cannot bear the risk without incurring financial ruin - to the capital markets, which can, by setting premiums appropriately.

Covering an ordinary flu, when there are no complications involved, is an abuse of insurance - and silliness like trying to cover every concieveable high-frequency, low-cost need to satisfy the whining of people who don't understand insurance is part of the reason premiums are as high as they are.

I much prefer high-deductible health plans. Birth control pills (assuming they're used for birth control and not to treat another illness) is just a ridiculous item to try to insure, and insuring it accomplishes nothing but raising premiums, to include a nice profit margin for the insurance company (the only reason ANY insurance company would want to try to insure something so foolish.)

There is no reasonable risk-transferrence that occurs - only the subsidizing of the choice to use birth control.

Instead, the company should offer a health savings account, and women can pay for their birth control out of that, tax-free.

"Insurance does no good for high-frequency, low-cost events such as a decision to take a birth control pill. Insurance is for low-frequency, high-cost events, such as a dread disease or traumatic injury."

Let me guess, when you have kids you want to pay the full cost for their well-baby checkups and their annual checkups after infancy instead of just paying a copay and having your insurance pay for the rest (as my parents' health insurance paid when I was a child), right?

"but i acknowledge that there are women who want to be on birth control and CANNOT afford it--and do not have cable, or you know, enough income to make rent each month"

Don't forget that for some women, abstinence can be an even more expensive form of birth control - because abstinence is grounds for divorce and they can't afford to have their husbands leave them.

Neither argument has any bearing whatsoever on whether insurance companies ought to be forced by the courts, against their own business judgement, of covering uninsurable events such as birth control.

Well-baby checkups should be covered by insurance companies to the extent that it is cost effective to do so. If it were not cost effective, then those costs should be borne entirely and directly by those who chose to have children.

In which case, those who are on birth control are subsidizing the decision of others to become parents.

If a woman cannot afford to have her husband leave her, that is her own concern, and not the fault of the insurance company or the other policyholders forced to subsidize her.

Don't you understand...the INSURANCE COMPANY doesn't pay for well-baby checkups. POLICY HOLDERS do. The insurance company just mutualizes the cost...and tacks on a few dollars in profit and administration expenses.

Nobody on this earth owes you coverage. Nobody owes you a damn thing. You already lost the court case. Stop whining because of a sense of entitlement, and go kick some girl's butt into making the extra 70 bucks/month if it's a problem. Or GIVE it to her if you think it's that important.

Just don't expect others to subsidize your choices. You're just driving up premiums and making health insurance coverage less affordable for everyone.

Nazrafel et al,

If you subscribe to the feministing newsletter, the articles featured in the newsletter have an email feature.

i for one would much much much much much much rather have my insurance premiums go towards subsidizing "some girl's" ability to get birth control than for some dude to get erections or proceed his his hairline. it would be one thing if this insurance company covered nothing but the urgently life threatening.
the fact that it leaves birth control uncovered, meaning women have to bear the brunt of an inconvenient or IMPOSSIBLE cost to have any of the benefits of birth control, but covers the choice to use Cosmetic Foam that gets your hair back is one of the many reasons that the content of this original post is so damn maddening.

You're insuring against a cost forced upon you by something you don't want to happen - that includes Viagra, it's inflicted upon you, these guys don't choose impotence.

Since when is impotence harmful? Isn't that what religious folk call part of "God's Plan?" While a flaccid penis might be unpleasant, intercourse isn't necessary for a guy to live. The Rogaine coverage also just blows me away...if an insurance plan wants to be ghetto, at least be consistent in what types of meds are not covered.

I think you are missing the point, Jason. You may have your opinions on what insurance should be, but you are very far off the mark as far as what it is now. We've moved beyond the major medical coverage available in my grandparents' day.

To deny birth control coverage is to deny women basic preventative care. Birth control pills have medical uses well beyond pregnancy prevention. But considering pregnancy has consequences ranging from 9 months of regular medical care followed by a 3-day hospital stay to serious long-term physical and mental problems, insurance companies are putting womens' health in serious jeopardy. This becomes a matter for the courts when when an insurance company agrees to provide necessary preventative reproductive (and unnecessary quality of life) care to men. Believe it or not, some of us actually believe that equal protection should trump business interests.

Of course, as I mentioned before, if testicles were on the line, there would likely be much less concern for corporations and a little more for protecting the health of the insured.

http://www.shrm.org/trends/visions/1issue2005/Visions0105.pdf

Jason, businesses do have a stake in providing preventative care. My husband's insurance just started a program that basically gives us a partial refund for joining Weight Watchers, to prevent diabetes. How is preventing unplanned pregnancy any different? What about covered pills to reduce cholesterol buildup to PREVENT heart attacks? In either case, the employer will likely find that preventative care is more cost effective than the loss of productivity resulting from one-time, major health events, including pregnancy, or from longterm illness, or childrearing.

I know, I don't mean that having children is a disease, just that a parent is likely to have child-work conflicts. Also, men are increasingly taking time off to help with pregnancy, birthing and childcare. If it's really about a business's bottom line, then they should worry more about keeping employees happy and healthy.

insurance is best purchased (by either a company or individual) for low possibility, high cost events like severe illness or accident.

It seems to me that there are good reasons for distributing the cost of birth control over the entire population rather than on women who choose to use it. But private insurance is clearly the wrong way to do this. If insurers know that they have to provide the pill and that a high % of customers will use the pill insurance rates will go up considerably since the likelihood of pay outs is high and this cost cannot be distributed over many non-pill using customers. (remember also that a company factors in healthcare costs when determining employees' salaries. So the more comprehensive your healthcare plan, the lower your direct monetary income.)

The better solution would be for the government to provide some sort of program for reduced cost contraceptives. Of course, given current politics, the chance that the federal government will provide contraception is about nill.

"insurance is best purchased (by either a company or individual) for low possibility, high cost events like severe illness or accident."

That would be more relevant in this case if the insurer actually did limit itself to low possibility, high cost events. Now, are impotence, baldness, and healthy young children "low possibility, high cost" events?

insurance is best purchased (by either a company or individual) for low possibility, high cost events like severe illness or accident.

And those of us with chronic, endemic illnesses are supposed to do what, then? Go jump in a lake? Thanks.

As has been pointed out numerous times, that's not how health insurance works in this country, and it's not how this particular insurance plan works either. If routine, maintenance medical care was affordable, and routine treatment of chronic conditions was affordable, you might have a point. But then again, if frogs had wings they wouldn't bump their asses on the ground, as my dad used to say.

You're insuring against a cost forced upon you by something you don't want to happen - that includes Viagra, it's inflicted upon you, these guys don't choose impotence.

Indeed. And women don't want an unplanned pregnancy forced upon them. One could go so far as to say as women don't want fertility forced upon them when they're not ready for it. How is that different?

I'll answer my own question, actually. The difference is in social attitudes toward sexuality. Underlying your points is the assumption that sexual activity is essential for men (so if they're impotent, Viagra is a necessary medical treatment) but optional for women (so, how dare they seek insurance that enables them to have sex without getting pregnant). That is the essence of the sexism of this decision: why should women be expected to just forego all sexual activity, while the conditions that keep men from having sex are treated as emergencies?

None of you have demonstrated why this private matter - between an insurance company, an employer, and employees, is a matter for the courts to involve themselves in.

Obviously, the courts agreed.

Actually, Jason, it has been explained (whether or not you agree), the district court agreed, and one judge in the most recent case agreed. But thanks for the selective reading.

Manda,

What part of "we find for the defendant" do you not understand?

My previous post was admittedly unclear. Let me try again...

The distric court ruled in favror of requiring contraception coverage and one judge on the pannel agreed. So I guess the issue is not as *obvious* as you would like to think.