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Fact Sheets The Equity in Prescription Insurance and Contraceptive Coverage Act

More than half of all pregnancies in the United States are unintended, and half of all unintended pregnancies end in abortion. Contraceptives have a proven track record of enhancing the health of women and children, preventing unintended pregnancy, and reducing the need for abortion. However, although contraception is basic health care for women, far too many insurance policies exclude this vital coverage.

In fact, while most employment-related insurance policies in the United States cover prescription drugs in general, the vast majority do not include equitable coverage for prescription contraceptive drugs and devices. Similarly, while most policies cover outpatient medical services in general, they often exclude outpatient contraceptive services from that coverage. This failure is costly, both for insurers who may have to pay for either maternity care or abortion, as well as the families whose physical and financial well-being is threatened by unintended pregnancy and lack of access to equitable coverage for contraceptives.

Senator Olympia Snowe (R-ME) and Representative James Greenwood (R-PA) are sponsoring The Equity in Prescription Insurance and Contraceptive Coverage Act, to provide equity in insurance coverage for contraception. The bill simply seeks to establish parity for contraceptive prescriptions and related medical services within the context of coverage already guaranteed by each insurance plan.

Under this legislation, plans already covering prescription drugs and devices would include equal coverage for prescription contraceptive drugs and devices. Also, plans that include coverage for outpatient medical services would include outpatient contraceptive services in that coverage. The bill defines contraceptive services as "consultations, examinations, procedures, and medical services, provided on an outpatient basis and related to the use of contraceptive methods (including natural family planning) to prevent an unintended pregnancy."

 While plans routinely cover other prescriptions and outpatient medical services, contraceptive coverage is meager or nonexistent in many insurance policies.

Contraception is basic health care for women and a critical contributor to improved maternal and child health.

Insurers have relied on women and their families paying out of pocket for contraceptive services and supplies, forcing financial decisions that may result in the use of less effective or less medically appropriate contraceptive methods.

The correlation is clear. Contraception prevents unintended pregnancy and reduces the need for abortion.

Prepared with the assistance of The Allen Guttmacher Institute 4/97.)

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