Coverage for Contraceptives Pushed

SACRAMENTO — Saying contraceptives are the only drugs routinely excluded from insurance coverage, a state lawmaker from Sherman Oaks is pushing legislation that would require prescription insurance policies to pay for five contraceptive drugs and devices.

Contraceptives are the most widely used drugs by women in their child-bearing years, and insurance companies should pay for them just as they routinely cover every other class of FDA-approved medications, Assemblyman Bob Hertzberg said Wednesday.

If the Democrat succeeds, California would become the first state to mandate coverage from private insurance companies for contraception.

His bill is backed by a long list of women’s groups, medical groups and Planned Parenthood. “The foundation of the argument is women’s rights,” Hertzberg said.

Hertzberg said California women on public assistance, including Medi-Cal, are covered for contraception.

“Look who doesn’t get it--the working women,” he said.

The five contraceptives that would be covered if the legislation passes are birth control pills, intrauterine devices, Depo-Provera injections, diaphragms and Norplant.

The bill, which has been approved by the Assembly, cleared a key hurdle Wednesday by passing the state Senate Insurance Committee, despite an outcry from insurance carriers and an insurance reform group about the cost.

“We would quarrel with the assertion that mandated benefits don’t add to the cost of insurance,” said Leslie S. Spahnn, speaking for Californians for Affordable Health Reform.

Hertzberg rejected their argument, saying the insurance industry’s own figures estimate the cost at $16 a year per policyholder.

“Clearly, this is more cost-effective than having women pay several thousand dollars a year for a policy that doesn’t cover the medication they need most frequently,” Hertzberg said.

Insurance does routinely cover more expensive alternatives, including sterilization and abortion, as well as childbirth-related expenses. It would save money to provide contraception to prevent unwanted pregnancies, Hertzberg said.

Hertzberg was not, however, able to persuade committee members to include individual health plans in the mandate. But the committee did agree that individual plans would have to offer coverage for contraception as an option.

The last time a similar bill was passed by the Legislature in 1995, the $16-a-month figure was not available, Hertzberg said.

Gov. Pete Wilson vetoed that bill, based on its unknown potential cost to small business owners. The veto outraged Wilson’s critics, who called him a hypocrite for portraying himself as a champion of women’s rights to reproductive freedom.

Since then, Hertzberg said, the governor put a requirement for contraceptive coverage in his Health Insurance Plan of California, which offers small business owners comprehensive health care plan packages.

So, Hertzberg said, he is hopeful that Wilson will not veto his measure if it wins Senate approval.

A spokesman for Wilson did not return a phone call seeking comment on the governor’s current stance on the issue.