WA Official: Contraceptive Coverage Rule Stands Despite Court Decision

August 8, 2003 (PLANSPONSOR.com) - Washington State Supreme Court justices may not have been able to find legal authority in state law for forcing health plans to cover contraceptives, but that apparently hasn't swayed state insurance commissioner Mike Kreidler.

>Kreidler said the administrative rule he issued last year requiring such coverage still stands with the additional support of a federal judge’s decision that for health plans to deny contraceptive coverage would violate federal civil rights laws, according to a report in the Managed Care Weekly Digest. So, for now, contraceptives will continue to be covered by virtually all health plans that cover prescription drugs in general, Kreidler said.

>The rule requires contraceptive coverage by the insurers regulated by the state if the plan offers comprehensive drug coverage in general. Kreidler said he believes virtually all drug coverage plans now include contraceptives. “The vast majority of those plans do have contraceptive coverage, but many of them had it before,” the insurance official said. “Those who have continued not to do so are clearly sticking their necks out.”

>The July 17 ruling from the state of Washington high court that state law has no contraceptive coverage requirements came on a state law question referred to the justices by a federal judge as part of the lawsuit that Shulamit Glaubach and Dawn Merydith brought against Regence BlueShield for historically failing to provide such coverage (See  WA Court: No State Obligation to Cover All Contraceptives ). Attorneys for the two women argued that not doing so amounted to exclusion for women of childbearing age.

>A federal judge and the US Equal Opportunity Commission have both ruled that denying contraceptive coverage in such plans is illegal. That has prompted Regence BlueShield and other companies to include contraceptive coverage in their health plans.

>With the Regence case still pending in US District Court, the justices’ decision means the women’s lawyers will have to reshape their lawsuit to rely on broader anti-discrimination protections in law and the state and federal constitutions, said Steve Berman, one of the attorneys, according to the Managed Care Weekly Digest report.

>Kreidler’s rule and the federal decisions that ensure contraceptive coverage only solved part of the problem, Berman said. “We’re also seeking damages for the tens of thousands of women who have had to pay for their own contraceptive devices when it should have been paid by their insurance company,” he said.

For his part, the state official is claiming that the state high court decision validates his rule, and called the plaintiffs’ bid to seek damages for Regence’s past policies “a stretch.”