A proposed state bill that would require Colorado insurance companies to cover maternity care has a new addition: The bill would also require insurance companies to cover birth control.
K. Jerry Frangas, D-Denver, the representative co-sponsoring the bill called the birth control portion of the bill a “no-brainer.”
“My understanding is that some insurance companies cover Viagra. If we’re going to cover reproductive issues or issues related to one gender, we should cover reproductive issues related to both genders,” he said. “It’s an issue of discrimination.”
The market solution
According to the Colorado Division of Insurance, Colorado has no law that mandates insurance companies to cover birth control.
“We do not have a law in Co that addresses [birth control], said Cameron Lewis, spokeswoman for the Colorado Division of Insurance. “There have been some actions taken in other states where if you offer something for one sex you have to offer a comparable thing for another. So fo example you couldn’t offer Viagra for a man unless you offered birth control for a woman…But in Co we do not have a law or mandate that addresses that.”
For example, according to a representative at ehealthinsurance.com, in every other state in the Union where United Health Care offers insurance, their plans would cover an Intra-Uterine Device (IUD) insertion, he said. But not in Colorado. Here, he explained, a woman would have to pay for the IUD out-of-pocket, with no amount of that payment going toward her deductible.
Colorado insurance companies are also not required to offer plans that cover standard maternity costs on the individual market. Employer-sponsored health care plans in Colorado, and all states, provide maternity, per the terms of the Pregnancy Discrimination Act.
According to insurance agents in the state, companies simply don’t offer maternity coverage because they’re not required to. Women can purchase maternity riders on some plans, but that process is riddled with hitches. (See here for The Colorado Independent’s investigation of the maternity rider market.)
Mounting lawmaker support
Frangas said he initiated the maternity bill after years of complaints from constituents who were entrepreneurs, or otherwise without employer-sponsored coverage.
“There are a lot of people in northwest Denver that are on individual insurance plans, so through the years, I’ve gotten a number of people complaining about this particular issue,” he said. “And it didn’t seem like it was going to resolve itself, and the insurance companies weren’t going to do anything, so I decided I was going to carry it.”
Frangas’s bill has passed through the Interim Health Care Committee and the Legislative Council. He expects it to be heard in the House sometime in January.
Frangas acknowledged that the bill will likely draw fire from the insurance industry. He expects the industry lobby to argue that covering birth control and maternity will drive up premium costs.
We always pay
“The one thing I think they’re not really seeing or acknowledging is that no matter what, if somebody doesn’t have maternity care, we ultimately pay for it,” said Frangas.
Frangas pointed out that a baby who doesn’t have good prenatal care can wind up in a neonatal intensive care unit and cost an insurance company up to $500,000. Equally, mothers who don’t have maternity insurance, and can’t pay their medical bills, contribute to hospitals’ un-reimbursed costs. Those costs are passed on to health insurance companies, and ultimately to health insurance consumers.
“Then you look at the birth control issue. You can go on endlessly [about costs] there,” he said.
“We always pay for it,” he said. “So any argument that this will raise your rates is invalid.”
Chaer Robert, a board member at the Women’s Lobby of Colorado, said she’s hoping there will be a fiscal note in the bill suggesting that it will cut state Medicaid costs.
According to Robert, over one-third of the babies born in Colorado are born on state-sponsored health insurance. In part, she said, that’s because the state is less stingy about assistance if a woman is pregnant. But she also wondered if women are going on state assistance because they have no other options.
“A certain percent of folks maybe would have maternity coverage if they could really get it at any realistic level,” she said.
This post has been updated to more accurately describe Colorado’s current laws about covering birth control.