[Congressional Record Volume 143, Number 63 (Wednesday, May 14, 1997)]
[Senate]
[Pages S4487-S4488]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Ms. SNOWE (for herself, Mr. Reid, Mr. Warner, Ms. Mikulski, 
        Mr. Chafee, Mr. Durbin, Ms. Collins, Mrs. Murray, and Mr. 
        Jeffords):
  S. 743. A bill to require equitable coverage of prescription 
contraceptive drugs and devices, and contraceptive services under 
health plans; to the Committee on Finance.


  THE EQUITY IN PRESCRIPTION INSURANCE AND CONTRACEPTIVE COVERAGE ACT

  Ms. SNOWE. Mr. President, nowhere is the middle ground in American 
politics harder to find than in the debate over abortion. It is clear 
that the apparent inability of pro-choice and pro-life members to find 
common ground is one of the most divisive issues we face today. In 
debate after debate, it often appears that there is no middle ground. 
Well, I am extremely pleased that my colleague from Nevada, Senator 
Reid, is joining me today to introduce legislation that will prove this 
statement untrue.
  Too often, pro-choice leaders do too little to convey that they are 
not pro-abortion. Likewise, abortion opponents too often fail to work 
constructively toward reducing the need for abortion. The failure of 
pro-choice and pro-life members to stake out common ground weakens our 
Nation immeasurably.
  Today that's going to change. The cosponsors of this bill come from 
different parties, and have very different views on abortion. Our 
voting records are clear: I am firmly pro-choice; Senators Reid is 
firmly pro-life. Yet, despite these fundamental differences, we agree 
that something can and must be done to reduce the rates of unintended 
pregnancy and abortion in this country. That is why we are joining 
forces and introducing bipartisan, landmark legislation to make 
contraceptives more affordable for Americans. And I am pleased that a 
number of my colleagues, including Senators Warner, Mikulski, Chafee, 
Durbin, Collins, Murray, and Jeffords are joining us as original 
cosponsors.
  The need is clear. This year, there will be 3.6 million unintended 
pregnancies--over 56 percent of all pregnancies in America--and half 
will end in abortion. These are staggering statistics. But what's even 
more staggering is that it doesn't have to be this way. If prescription 
contraceptives were covered like other prescription drugs, a lot more 
Americans could afford to use safe, effective means to prevent 
unintended pregnancies.
  The fact is, under many of today's health insurance plans, a woman 
can afford a prescription to alleviate allergy symptoms but not a 
prescription to prevent an unintended and life-altering pregnancy. It 
is simply not right that while the vast majority of insurers cover 
prescription drugs, half of large group plans exclude coverage of 
prescription contraceptives. And only one-third cover oral 
contraceptives--the most popular form of birth control.
  Is it any wonder that women spend 68 percent more than men in out-of-
pocket health care costs--68 percent. It does not make sense that, at a 
time when we want to reduce unintended pregnancies, so many otherwise 
insured woman can't afford access to the most effective contraceptives 
because of the disparity in coverage.
  The lack of contraceptive coverage in health insurance is not news to 
most women. Countless American women have been shocked to learn that 
their insurance does not cover contraceptives, one of their most basic 
health care needs, even though other prescriptions drugs which are 
equally valuable to their lives are routinely covered. But until today, 
women could do little more than feel silent outrage at a practice that 
disadvantages both their health and their pocketbook.
  Now, the Equity in Prescription Insurance and Contraceptive Coverage 
Act gives voice to that outrage. EPICC sends a message that we can no 
longer tolerate policies that disadvantage women and disadvantage our 
nation. When our bill is passed, women will finally be assured of 
equity in prescription drug coverage and health care services. And 
America's unacceptably high rates of unintended pregnancies and 
abortions will be reduced in the process.
  This EPICC approach is simple. It says that if insurers already cover 
prescription drugs and devices, they must also cover FDA-approved 
prescription contraceptives. And it takes the commonsense approach of 
requiring health plans which already cover basic health care services 
to also cover medical and counseling services to promote the effective 
use of those contraceptives. The bill does not require insurance 
companies to cover prescription drugs--it simply says that if insurers 
cover prescription drugs, they cannot treat prescription contraceptives 
any differently. Similarly, it says that insurers which cover 
outpatient health care services cannot limit or exclude coverage of the 
medical and counseling services necessary for effective contraceptive 
use in order to prevent unintended pregnancies.
  This bill is not only good policy, it also makes good economic sense. 
We know that contraceptives are cost-effective: in the public sector, 
for every

[[Page S4488]]

dollar invested in family planning, $4 to $14 is saved in health care 
and related costs. And we also know that by helping families to 
adequately space their pregnancies, contraceptives contribute to 
healthy pregnancies and healthy births, reducing rates of maternal 
complications, and low-birth weight.
  Time and time again Americans have expressed the desire for their 
leaders to come together to work on the problems that face us. This 
bill exemplifies that spirit of cooperation. It crosses some very wide 
gulfs and makes some very meaningful changes in policy that will 
benefit countless Americans.
  As someone who is pro-choice, I firmly believe that abortions should 
be safe, legal, and rare. Through this bill, I invite both my pro-
choice and pro-life colleagues to join with me in emphasizing the rare. 
And I invite all who believe in sound public policy to join our 
alliance. Because we as a nation must be truly committed to reducing 
rates of unintended pregnancy and abortion. We must come together 
despite our differences. We must pass this EPICC bill into law.
  Mr. REID. Mr. President, I am proud to introduce today, with Senator 
Snowe, the Equity in Prescription and Contraception Coverage Act of 
1997. I have said time and time again that if men suffered from the 
same illnesses as women, the biomedical research community would be 
much closer to eliminating diseases that strike women. I believe this 
is a similar type of issue. If men had to pay for contraceptive drugs 
and devices, the insurance industry would cover them.
  The health industry has done a poor job of responding to women's 
health needs. Women spend 68 percent more in out-of-pocket costs for 
health care than men. Reproductive health care services account for 
much of this difference. According to a study done by the Alan 
Guttmacher Institute, 49 percent of all large-group health care plans 
do not routinely cover any contraceptive method at all, and only 15 
percent cover all five of the most common contraceptive methods. Women 
are forced to use disposable income to pay for family planning services 
not covered by their health insurance--the pill--one of the most common 
birth control methods, can cost cover $300 a year. Therefore, women who 
lack disposable income are forced to use less reliable methods of 
contraception and risk an unintended pregnancy.
  The legislation we introduce today would require insurers, HMO's, and 
employee health benefit plans that offer prescription drug benefits to 
cover contraceptive drugs and devices approved by the FDA. Further, it 
would require these insurers to cover outpatient contraceptive services 
if a plan covers other outpatient services. Lastly, it would prohibit 
the imposition of copays and deductibles for prescription 
contraceptives or outpatient services that are greater than those for 
other prescription drugs.
  Each year approximately 3,600,000 pregnancies, or 60 percent of all 
pregnancies, in this country are unintended. Of these unintended 
pregnancies, 44 percent end in abortion. Reliable family planning 
methods must be made available if we wish to reduce this disturbing 
number. Further, a reduction in unintended pregnancies will also lead 
to a reduction in infant mortality, low-birth weight, and maternal 
morbidity. In fact, the National Commission to Prevent Infant Mortality 
determined that ``infant mortality could be reduced by 10 percent if 
all women not desiring pregnancy used contraception.''
  Ironically, abortion is routinely covered by 66 percent of indemnity 
plans, 67 percent of preferred provider organizations, and 70 percent 
of HMO's. Sterilization and tubal ligation are also routinely covered. 
It does not make sense financially for insurance companies to cover 
these more expensive services, rather than contraception. Studies 
indicate that for every dollar of public funds invested in family 
planning, $4 to $14 of public funds is saved in pregnancy and health 
care-related costs. According to one recent study in the American 
Journal of Public Health, by increasing the number of women who use 
oral contraceptives by 15 percent, health plans would accrue enough 
savings in pregnancy care costs to cover oral contraceptives for all 
users under the plan.
  It is vitally important to the health of our country that quality 
contraception is not beyond the financial reach of women. Providing 
access to contraception will bring down the unintended pregnancy rate, 
insure good reproductive health for women, and reduce the number of 
abortions.
  It is a significant step, in my opinion, to have support from both 
pro-life and pro-choice Senators for this bill. Prevention is the 
common ground on which we can all stand. Let's begin to attack the 
problem of unintended pregnancies at its root.
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