Firms Must Pay for Birth Control, Michigan Civil Rights Commission Rules
    By Kim Kozlowski
    The Detroit News

    Monday 21 August 2006

    Small businesses that offer comprehensive prescription coverage but fail to cover birth control are violating the state's civil rights act and could be forced to change their policies under a ruling Monday by the Michigan Civil Rights Commission.

    The commission agreed that those employers are discriminating against women by failing to pay for birth control, which studies show most women will use in their lifetimes and costs employers about $1.43 a month per employee.

    The ruling paves the way for employees who work in businesses with less than 15 employees to challenge them to cover conception if they cover other prescription drugs. If they refuse, the employee could file a sex discrimination complaint with the Michigan Department of Civil Rights to force a change. A small business owner could appeal that decision to a circuit court.

    Many health advocates are hailing the decision, calling birth control a critical component of women's health care that reduces unwanted pregnancies and manage other gynecological-related syndromes.

    "Contraception is basic health care," said Sarah Scranton, executive director of Planned Parenthood affiliates of Michigan. "Over 85 percent of women will use it at some point in their life."

    But the Michigan Catholic Conference - the major opponent, since the church is opposed to the use of birth control - testified in May that a sex discrimination ruling would trump religious freedoms.

    "Religious freedom is a key principle and a key civil right," said Paul Long, vice president of public policy. "We express deep concern this was a violation of one right to the exclusion of another."

    The commission exempted faith-based organizations in its ruling, provided that the organization's primary purpose is to serve members of its faith. If the organization serves the general public it is not exempt.

    Federal law currently requires all businesses with more than 15 employees that offer health insurance to cover contraceptions. In Michigan, 60 percent of employers have less than 15 employees.

    At least 24 states have passed laws mandating that employers cover contraception when other prescription drugs are covered, according to the Alan Guttmacher Institute. Similar bills have been introduced several times in the Michigan Legislature but have gone nowhere, which is why the American Civil Liberties Union of Michigan and several other organizations asked the Civil Rights commission to make a ruling on the issue.

    Contraception is a medical necessity for three decades of a woman's lifespan, according to the American College of Obstetricians and Gynecologists. When a health care plan excludes contraception coverage, women must bear the costs out of their pocket.

    Women also can be at risk for an unwanted pregnancy, which can lead to poor health for the infant, such as low birth weight or neural tube defects as a result of a mother unknowingly delaying prenatal care or continuing to engage in risky behavior such as smoking and drinking.

    Nearly 41 percent of all pregnancies in Michigan were unintended in 2001, according to the Michigan Department of Community Health.

    Unwanted pregnancies carried to term are generally is covered by employers or Medicaid, the public health insurance for the poor, and cost about $10,000.

    Taking steps to make small businesses pay for contraception can reduce employers' cost of unwanted pregnancies, which is why the state has been working with parents to talk to their children about sex and recently began providing birth control to low-income women.

    Meanwhile, health officials say that oral contraceptives are also used to manage many other ailments such as regulating women's menstrual cycles, and lessening the pain of other gynecological problems, such as severe cramping and endometriosis.

    "It frequently is used by physicians for the treatment of many things beyond contraception," said Richard Smith, an OB/GYN at Henry Ford Hospitals who prescribes oral contraceptives daily to his patients for issues outside of birth control. "In the contemporary care of women it is used commonly by physicians."