News
Firms must pay for birth control
State rules it's illegal for small companies that offer drug coverage to omit contraceptives.
Small businesses that offer comprehensive prescription coverage but fail to cover birth control are violating the state's civil rights act and could be forced to change their policies under a ruling Monday by the Michigan Civil Rights Commission.
The commission agreed that employers with 15 workers or fewer are discriminating against women by failing to pay for birth control, which studies show most women will use in their lifetimes and costs a company about $1.43 a month for coverage per person.
"Prescription contraception equity is a simple matter of fairness," said Mark Bernstein, chairman of the Michigan Civil Rights Commission. "Only women are affected when an employer fails to include (contraceptives) in their drug plan."
The issue of inequities in coverage has gained attention nationally at a time when some health plans cover the male sexual enhancement drug Viagra, but not contraceptives.
The ruling, thought to be the first declaratory ruling by the commission during its 43-year existence, paves the way for employees who work in businesses with fewer than 15 employees to challenge them to cover contraception in their plans. If the companies refuse, employees could file a sexual discrimination complaint with the Michigan Department of Civil Rights to force a change. A small-business owner could appeal the commission's ruling to a circuit court.
Steven Schneemann of Steven Schneemann Studio of Architecture in Farmington doesn't offer health benefits to his five employees, but he plans to by the end of the year and likely will include contraceptive coverage.
"To me, it's better to have happy employees than to save a couple of dollars here and there," Schneemann said.
Most small businesses don't offer insurance at all, said Jeff Van Winkle, chairman of Michigan Small Business Association's board of directors. For those that do, they likely will look at how much it will cost.
"If they haven't been offering it, they will evaluate whether they will make a change and figure out whether it will cost their employees more," Van Winkle said.
Many health care advocates are hailing the decision, calling birth control a critical component of women's health care that reduces unwanted pregnancies and manages other gynecological-related syndromes.
"Contraception is basic health care," said Sarah Scranton, executive director of Planned Parenthood of Michigan. "Over 85 percent of women will use it at some point in their life."
The commission's ruling included an exemption to faith-based organizations that object to birth control, provided the organization's primary mission is to promote its values to its members.
But the Michigan Catholic Conference said it didn't find the exemption acceptable.
"We find that to be a very narrowly based definition of what a faith-based organization is," said Paul Long, vice president of public policy. "We would express deep disagreement over the ruling's limited vision of the First Amendment's religious freedom rights."
Federal law requires all businesses with more than 15 employees that offer health insurance to cover contraceptives. But in Michigan, 60 percent of employers have fewer than 15 employees.
At least 24 states have laws mandating that employers cover contraception when other prescription drugs are covered, according to the Alan Guttmacher Institute, a reproductive research organization. Similar bills have been introduced several times in the Michigan Legislature but have gone nowhere, which is why the American Civil Liberties Union of Michigan and several other organizations asked the Civil Rights Commission to rule.
Contraception is a medical necessity for three decades of a woman's lifespan, according to the American College of Obstetricians and Gynecologists. When a health care plan excludes contraception coverage, women must bear the costs, which can be hundreds of dollars a year.
Meanwhile, health officials say oral contraceptives are used to manage many other problems such as regulating women's menstrual cycles and lessening the pain of other gynecological problems, such as severe cramping and endometriosis.
"It is frequently used by physicians for the treatment of many things beyond contraception," said Richard Smith, an OB/GYN at Henry Ford Hospitals who prescribes oral contraceptives to his patients for issues outside of birth control.
Diane Madsen, whose daughter needed oral contraceptives to help with pre-endometriosis, called the ruling a victory for women. When she retired and switched insurance carriers, she lost coverage for her daughter -- but the company covered erectile dysfunctional medication for men.
"It seemed like a double standard," she said.