Contraceptive Equity

What is Contraceptive Equity?

The Equal Employment Opportunity Commission (EEOC) issued a decision in late 2000, which could potentially affect thousands of AFSCME members and their families whose health plans currently exclude contraceptive coverage. The EEOC stated that employers may not discriminate against women in their health insurance plans by denying benefits for prescription contraceptives if they provide benefits for drugs, devices and services used to prevent other medical conditions. This decision was reinforced by a decision in the US District court of Western Washington, Erickson v. The Bartell Company, in June 2001 and continues to be supported by court decisions.

What types of prescription contraceptives should be covered?

All types of reversible prescription contraceptives available in the United States should be covered, including birth control pills, IUD's, diaphragms, implants, and injections.

Birth control pills should be covered regardless of whether they are prescribed for birth control purposes or for other medical conditions, such as irregular menstrual periods or menstrual cramps.

How must employers cover prescription contraceptives?

According to this EEOC decision:

• Employers must cover the expenses of prescription contraceptives to the same extent, and on the same terms, that they cover other drugs, devices and preventive care. Comparable drugs, devices and services can include: vaccinations; drugs to prevent the development of other medical conditions, such as those to lower blood pressure or cholesterol; weight loss drugs; preventive physical examinations, including lab services and routine pap smears; and preventive dental care. 
• Employers must offer the same coverage for contraception-related outpatient services (such as insertion of devices) as are offered for other outpatient services. 
• When a woman visits her doctor to obtain a prescription for contraceptives, she must be given the same coverage for the office visit as she would have had if she consulted the doctor for other preventive or health maintenance services. 
• However, if an employer limits coverage of comparable drugs or services (e.g. by imposing maximum payable benefits) those limits may also be applied to contraception. 
• Employers must offer the above coverage in all of their health plans that offer comparable preventive drugs, devices and services.
  
  

Why is it illegal for employers to deny prescription contraceptive coverage?

This decision was issued in response to complaints filed with the EEOC by two women who claimed that their employers discriminated against them by not providing health insurance coverage for prescription contraceptives.

The EEOC held that these plans discriminated on the basis of sex and pregnancy, in violation of Title VII of the Civil Rights Act of 1964, as amended by the Pregnancy Discrimination Act. 

Courts continue to support contraceptive equity. In 2005, a federal court in Nebraska issued a decision in the Union Pacific Railroad Employment Practices Litigation that found refusal to cover contraception in health benefits was discriminatory against women. Presiding Judge Lauri Smith Camp stated in her decision, "Union Pacific's policy of excluding prescription contraceptives and services from its [health benefit] Plans violates Title VII as amended by the [Pregnancy Discrimination Act] because it treats medical care women need to prevent pregnancy less favorably than it treats medical care needed to prevent other medical conditions that are no greater threat to employees' health than is pregnancy."

In addition, 26 states have laws, rules or regulations regarding contraceptive coverage. However, laws vary from state to state and may not apply to all businesses within a given state. Many states have included "conscience clauses" within their laws, which allow businesses to refuse contraception coverage based on religious views, even if the employee does not hold the same view. Furthermore, states laws apply only to those insurance plans that are regulated by state law. Self-insured employer health benefit plans are not mandated by state laws, regulations or rules. However, self-insured employer health plans are covered by federal law, which means that they are subject to Title VII discrimination laws.

What the union can do

• Find out whether prescription contraceptives are covered by your employers' health plans. 
• If not, take action! Assert your right to contraceptive equity. Let your employer know that if they don't offer full coverage, they're vulnerable to a lawsuit. 
• Know the facts about the low cost of coverage. One study found that the cost of adding contraceptive coverage to health plans is estimated to cost less than $2 per month, per enrollee. The U.S. Office of Personnel Management reported that the federal government added contraceptive coverage at no increased cost.
  
  

The AFSCME Education & Leadership Training Department has prepared sample letters for your council or local to request coverage information from your employer and to assert your right to contraceptive equity. For these letters or additional information, contact:

AFSCME Education & Leadership Training Department

1625 L Street, NW
Washington, DC 20036
202-429-1250
Fax: 202-429-5088
Contact us

Last updated 6/2006