On September 5, 2001, Washington Insurance Commissioner Mike Kreidler (b. 1943) signs a state administrative regulation requiring insurers to cover contraceptives in prescription-drug plans in health-insurance policies issued for policyholders in the state. The rule follows a federal court decision in Seattle three months earlier ordering Seattle-based Bartell Drug Company to provide contraceptive coverage in its self-insured health care plan.
A Hot-Button Issue
Health-insurance coverage for contraceptives became a hot-button issue during the 1990s. Many insurers didn't cover contraception, and the same was true for many employers with self-insured plans. Still, as the year 2000 dawned, the tide was turning. Some companies had voluntarily provided birth-control coverage, healthcare plans for federal employees now had such coverage, and 11 states had laws mandating that private insurers cover contraceptive drugs in their prescription-drug plans. Washington wasn't one of them, although bills to require this coverage had twice been introduced in the state legislature by the summer of 2000. Opposition from insurers, conservatives, and the Catholic Church prevented the bills from being passed.
But change was just around the corner. Jennifer Erickson, a supervising pharmacist at Bartell Drugs' Bellevue store, had written the company's human resources department in 1999 and asked that Bartell Drugs cover contraceptives in its self-insured health plan. Bartell's eventually declined. Encouraged by Planned Parenthood, Erickson filed a complaint with the Equal Employment Opportunity Commission in December 1999. That was followed in July 2000 by a class-action lawsuit filed against Bartell Drugs in federal court in Seattle by lawyers for Planned Parenthood; the suit was brought in Erickson's name as the lead plaintiff in the case. The complaint alleged that Bartell's prescription benefit plan for non-union employees violated Title VII of the 1964 Civil Rights Act and the 1978 Pregnancy Discrimination Act by providing less-complete prescription coverage to its female employees than to its male employees. (Union employees, as part of their contract with Bartell Drugs, received contraceptive coverage.)
The president of Planned Parenthood of Western Washington told The Seattle Times that the organization had approached fifty companies in the state to ask that they add contraceptive coverage to their insurance plans, and that all had declined. (According to Planned Parenthood, only about half of U.S. employers covered contraceptives at the time.) She added that Planned Parenthood decided to name Bartell Drugs in its lawsuit because Bartell's was considered to be a good employer and a progressive company. Bartell Drugs also may have been considered an attractive target because approximately two-thirds of its employees were women. The case was the first federal lawsuit brought to attempt to force a self-insured healthcare plan to cover contraceptives, and the case received widespread media coverage both locally and nationally.
Equally Comprehensive Coverage
There was no jury trial; the case was decided by District Judge Robert S. Lasnik (b. 1951). On June 12, 2001, Lasnik ruled in favor of Erickson and Planned Parenthood, writing in his decision:
"Title VII requires employers to recognize the differences between the sexes and provide equally comprehensive coverage, even if that means providing additional benefits to cover women-only expenses ... Although the [Bartell] plan covers almost all drugs and devices used by men, the exclusion of prescription contraceptives creates a gaping hole in the coverage offered to female employees, leaving a fundamental and immediate health care need uncovered" ("Judge: Add Birth Control ...").
Because Bartell Drugs was self-insured, the ruling did not apply to insurers doing business in Washington. That quickly changed. The next month two groups -- the American Civil Liberties Union of Washington and the Washington chapter of the National Abortion Reproductive Rights Action League -- filed a class-action lawsuit in King County Superior Court against Regence Blue Shield for its failure to provide full coverage for contraceptives in its health policies. Before that case was decided, state Insurance Commissioner Mike Kreidler signed a new administrative regulation requiring insurers to cover birth control in prescription-drug plans in policies issued for Washington policyholders, saying he was doing so in order to comply with the state's anti-discrimination laws. Kreidler signed the new regulation on September 5, 2001, and it became effective on January 1, 2002.
Not Entirely Settled
But the issue was not entirely settled. By mid-2013, 28 states required insurers that covered prescription drugs to provide coverage for all FDA-approved contraceptives. Further, the federal Patient Protection and Affordable Care Act of 2010, better known as "Obamacare" after President Barack Obama (b. 1961), who championed the act, required new private health plans written on or after August 1, 2012, to cover contraceptives without charging a co-pay to patients.
However, there were exceptions to the federal law, such as for certain existing health plans and for some religious institutions. Dozens of lawsuits were filed by institutions seeking to be exempted from having to comply with the act, raising the possibility that the matter would ultimately end up being resolved by the United States Supreme Court.