[Congressional Record Volume 151, Number 76 (Thursday, June 9, 2005)]
[Senate]
[Pages S6316-S6318]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Ms. SNOWE (for himself, Mr. Reid, Mr. Warner, Mr. Leahy, Mr. 
        Chafee, Mrs. Murray, Mr. Kennedy, Mr. Akaka, Mr. Durbin, Ms. 
        Cantwell, and Mr. Lautenberg):
  S. 1214. A bill to require equitable coverage of prescription 
contraceptive drugs and devices, and contraceptive services under 
health plans; to the Committee on Health, Education, Labor, and 
Pensions.
  Ms. SNOWE. Mr. President, this year well over 6 million pregnancies 
will occur in America. The challenge of raising healthy children and 
preparing them for a changing world is a staggering one indeed. This is 
even more so when so frequently both parents are working. So it is 
tragic that half of all pregnancies today are unplanned. In too many 
cases, this means that the necessary financial, emotional and other 
resources for parenting are simply not present. I think we certainly 
share a broad consensus that every child should be wanted, and that 
parents should have the resources to ensure their child's health and 
success.
  This week we have commemorated the 40th anniversary of a landmark 
Supreme Court decision, that of Griswold v. Connecticut, in which the 
right of married couples to contraceptives and family planning 
counseling was recognized. Yet less than a decade ago, when we examined 
the state of contraceptive coverage by insurance plans, it certainly 
was discouraging. While many health plans included coverage for 
prescription drugs, nearly half did not cover even oral contraceptives. 
Needless to say, many other contraceptive options for women, such as 
the diaphragm, implants, and injectable methods were covered even less 
frequently. This is disturbing, as contraception is so vital to a 
woman's health. Most women will spend just a few years attempting to 
conceive, with the average woman desiring two children. That

[[Page S6317]]

leaves about 30 years in which women need access to safe, affordable 
contraceptives.
  The benefits of contraception should be obvious. The maternal death 
rate in the U.S. is only one third what it was back in 1965 before 
Griswold. The same is true for infant survival. Family planning 
preserves a woman's health, and allows couples to ensure that they have 
the means to give every child the attention, support, and resources 
they need.
  So today I am joining again with Senator Reid to introduce 
legislation to ensure broader access to contraception--to ensure that 
the promise of Griswold v. Connecticut is fully realized. I thank him 
for his ongoing leadership on this issue. We both agree that 
contraception coverage is essential to reducing unwanted pregnancies 
and to ensuring that every couple can employ family planning. The 
Equity in Prescription Insurance and Contraceptive Coverage Act, which 
we again introduce today, will assure that for those plans which 
provide prescription drug coverage, contraceptive coverage is not 
excluded. It further ensures that contraceptive services are provided 
equitably with other outpatient services.
  Such coverage is just what the Institute of Medicine called for back 
in 1995, when the Institute reported that a lack of coverage was a 
major contributor to unwanted pregnancy. Expanding the proportion of 
health plans which cover contraception is one of the Surgeon General's 
objectives for the Healthy People 2010 plan. We can certainly achieve 
that objective and ensure that in 2010, unwanted pregnancies are 
exceedingly rare.
  Some may argue that such a mandate creates yet more costs for 
providers, but the evidence fails to support that notion. We have seen 
that for every dollar in public funds which is invested in family 
planning, three dollars is saved in Medicaid costs for pregnancy-
related health care and medical care for newborns. Indeed after we 
acted in 1998 to assure coverage to women in the Federal Employees 
Health Benefits Program, the Office of Personnel Management concluded 
in 2001 that there was no cost increase due to coverage.
  Many health providers have come to the same conclusion. I note that 
approximately 90 percent of plans now cover the leading methods of 
reversible contraception. So we have come a long way.
  There should be no mistake--this issue boils down the principles of 
basic fairness--fairness for half this Nation's population, fairness in 
how we view and treat a woman's reproductive health versus every other 
kind of health care need that can be addressed with prescription drugs. 
The facts are not in dispute B the lack of equitable coverage of 
prescription contraceptives has a very real impact on the lives of 
America's women and, therefore, our society as a whole. This is not 
overstatement, this is reality.
  All we are saying is that if an employer provides insurance coverage 
for all other prescription drugs, they must also provide coverage for 
FDA-approved prescription contraceptives--it is that simple, it is that 
fair, and it builds on existing law and jurisprudence.
  The approach we are taking today has already been endorsed by a total 
of 29 States--including my home State of Maine--that have passed 
similar laws since 1998. This is real progress but this piecemeal 
approach to fairness leaves many American women at the mercy of 
geography when it comes to the coverage they deserve.
  But fairness is not the only issue. We believe that EPICC not only 
makes sense in terms of the cost of contraceptives for women, but also 
as a means bridging the pro-choice pro-life chasm by helping prevent 
unintended pregnancies and thereby also preventing abortions. The fact 
of the matter is, we know that there are over three million unintended 
pregnancies every year in the United States. We also know that almost 
half of those pregnancies result from women who do not use 
contraceptives. Most of the other half involved inconsistent or 
incorrect use of contraceptives--and in many of these cases, the women 
would benefit from counseling or provision of a contraceptive which is 
more appropriate to their circumstances.
  Surveys consistently demonstrate that almost nine out of ten 
Americans support contraception access and over 75 percent support laws 
requiring health insurance plans to cover methods of contraception such 
as birth control pills.
  The question before us is, if EPICC-style coverage is good enough for 
9 million Federal employees and their dependents, if it is good enough 
for every Member of Congress and every Senator, why is not it good 
enough for the American people?
  Women should have control over their reproductive health. It is the 
best interests of their overall health, their children and their future 
children's health--and when we have fewer unintended pregnancies, we 
will reduce the number of abortions. We need to finally fix this 
inequity in prescription drug coverage and make certain that all 
American women have access to this most basic health need. I thank all 
of those who have supported us in this effort, and call upon each of my 
colleagues to join us to ensure that more couples have access to family 
planning to reduce unwanted pregnancies, and to assure the health and 
security of American families.
  Mr. REID. Mr. President, this week marks the fortieth anniversary of 
the U.S. Supreme Court decision in Griswold v. Connecticut that struck 
down a Connecticut law that had made the use of birth control by 
married couples illegal. This decision laid the groundwork for 
widespread access to birth control for all American women.
  In the 40 years since this landmark decision, increased access to 
birth control has contributed to a dramatic improvement in maternal and 
infant health and has drastically reduced the infant death rate in our 
country.
  In spite of these advances, we still have a long way to go. The 
United States has among the highest rates of unintended pregnancies of 
all industrialized nations. Half of all pregnancies in the United 
States are unintended, and nearly half of those end in abortion.
  Making contraception more accessible and affordable is one crucial 
step toward reducing unintended pregnancies, reducing abortions and 
improving women's health.
  We cannot allow the pendulum to swing backwards. That is why Senator 
Snowe and I are reintroducing the Equity in Prescription and 
Contraception Coverage Act of 2005, EPICC. Over the last 8 years, 
Senator Snowe and I have joined together to advance this important 
legislation.
  The EPICC legislation is also a critical component of the Prevention 
First Act, S. 20. This legislation includes a number of provisions that 
will improve women's health, reduce the rate of unintended pregnancy 
and reduce abortions.
  The legislation we are introducing today proves we can find not only 
common ground, but also a commonsense solution to these important 
challenges.
  By making sure women can afford their prescription contraceptives, 
our bill will help to reduce the staggering rates of unintended 
pregnancy in the United States, and reduce abortions.
  It is a national tragedy that half of all pregnancies nationwide are 
unintended, and that half of those will end in abortions. It is a 
tragedy, but it doesn't have to be. If we work together, we can prevent 
these unintended pregnancies and abortions.
  One of the most important steps we can take to prevent unintended 
pregnancies, and to reduce abortions, is to make sure American women 
have access to affordable, effective contraception.
  There are a number of safe and effective contraceptives available by 
prescription. Used properly, they greatly reduce the rate of unintended 
pregnancies.
  However, many women simply can't afford these prescriptions, and 
their insurance doesn't pay for them, even though it covers other 
prescriptions.
  This is not fair. We know women on average earn less than men, yet 
they must pay far more than men for health-related expenses.
  According to the Women's Research and Education Institute, women of 
reproductive age pay 68 percent more in out-of-pocket medical expenses 
than men, largely due to their reproductive health-care needs.
  Because many women can't afford the prescription contraceptives they 
would like to use, many do without

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them, and the result, all too often, is unintended pregnancy and 
abortion.
  This isn't an isolated problem. The fact is, a majority of women in 
this country are covered by health insurance plans that do not provide 
coverage for prescription contraceptives
  This is unfair to women. It is bad policy that causes additional 
unintended pregnancies, and adversely affects women's health.
  Senator Snowe and I first introduced our legislation in 1997. Since 
then, the Viagra pill went on the market, and one month later it was 
covered by most insurance policies.
  Birth control pills have been on the market since 1960, and today, 45 
years later, they are covered by only one-third of health insurance 
policies.
  So, today we find ourselves in the inexplicable situation where most 
insurance policies pay for Viagra, but not for prescription 
contraceptives that prevent unintentional pregnancies and abortions.
  This isn't fair, and it isn't even cost-effective, because most 
insurance policies do cover sterilization and abortion procedures. In 
other words, they won't pay for the pills that could prevent an 
abortion, but they will pay for the procedure itself, which is much 
more costly.
  The Federal Employee Health Benefits Program, which has provided 
contraceptive coverage for several years, shows that adding such 
coverage does not make the plan more expensive.
  In December 2000, the U.S. Equal Employment Opportunity Commission, 
EEOC ruled that an employer's failure to include insurance coverage for 
prescription contraceptives, when other prescription drugs and devices 
are covered, constitutes unlawful sex discrimination under Title VII of 
the Civil Rights Act of 1964.
  On June 12, 2001, a Federal district court in Seattle made the same 
finding in the case of Erickson vs. Bartell Drug Company.
  These decisions confirm what we have known all along: contraceptive 
coverage is a matter of equity and fairness for women.
  We are not asking for special treatment of contraceptives, only 
equitable treatment within the context of an existing prescription drug 
benefit.
  This legislation is right because it is fair to women.
  It is right because it is more cost-effective than other services, 
including abortions, sterilizations and tubal ligations, costly 
procedures that most insurance companies routinely cover.
  And it is right because it will prevent unintended pregnancies and 
reduce abortions, goals we all share.
  This is common sense, common-ground legislation, and it is long 
overdue.
                                 ______