Erections Get Insurance; Why Not the Pill?

"It's inappropriate to take cost-effectiveness figures and propagate them to a higher-income, employed population," said Tom Wildsmith, policy research actuary for the Health Insurance Industry of America, a trade association.

Forcing employers and insurers to cover birth control will only exacerbate high health insurance costs, Wildsmith said.

"It's understandable why if you think something is important you would want someone to pay for it for you. But you can add on nice things to the point where insurance is less affordable than it is now," he said.

An estimated half of traditional indemnity plans and preferred provider organizations, 20 percent of point-of-service networks, and 7 percent of health maintenance organizations cover no contraceptive methods other than sterilization.

Some States Allow Religious Exemption

Although women's activists say the best "prescription equity" laws cover the full range of contraceptive needs with no loopholes, 11 states allow an exemption on religious grounds. That's OK, some women's advocates say, as long as the employer or insurer is not just tangentially connected to a religious institution, such as a religiously affiliated hospital.

Women's groups say they're facing less opposition now than when they started pressing the issue years ago. Some companies are even starting to offer contraception coverage on their own, such as the Chrysler Group, the American subsidiary of German automaker DaimlerChrysler AG, which this month expanded its employee benefits package to include coverage for prescription contraceptives.

While some anti-abortion activists may have reservations about the government requiring coverage for contraception and reproductive services, they have not lined up in overwhelming numbers on the contraceptive coverage issue.

However, in some parts of the country, anti-abortion activists are fighting public funding for birth control. In Kentucky, hard-line abortion foes are lobbying a public health board to turn down federal family planning money used to dispense birth control pills to women, saying the contraceptives are the equivalent of an abortion.

Both sides of the abortion debate will be watching that vote when it takes place tonight.

Overall, though, Janet Krepps, staff attorney for the New York-based Center for Reproductive Law and Policy, says attitudes about insurance coverage for birth control are changing.

"As people have become more educated about the issue they've realized that this is basic fairness and health care," she said. Also, predictions about the economic effects of contraceptive coverage just did not bear out, she said.

"There was all of this doom and gloom that [birth control coverage] would cause increases in premiums and costs, but that hasn't been realized," Krepps said.

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