Bill would require contraceptive insurance coverage

The Banking, Commerce and Insurance Committee heard testimony March 1 on a bill that would require an individual or group health insurance plan or self-funded employee benefit plan to include coverage for certain contraceptives.

LB20, introduced by Sen. Carol Blood of Bellevue, would require public and private insurers not preempted by federal law to cover the expense of a self-administered hormonal contraceptive approved by the Federal Drug Administration.

The bill also would require coverage of up to a three-month supply of a qualifying contraceptive on the first prescription and up to 12 months on the second and subsequence prescriptions. The state Department of Health and Human Services would be required to ensure that a prescription for a one-time, 12-month supply of a covered contraceptive be provided as prescribed to Medicaid recipients.

Blood said LB20 would expand access to contraceptives, particularly for women in rural Nebraska, by reducing the number of pharmacy or doctor visits required. She added that expanded access to contraceptives would decrease the number of unplanned pregnancies and abortions.

“This bill does not mandate a provider to prescribe 12 months at a time,” she said. “It only requires that insurance covers the full supply of the prescription to be provided to the patient at one time, for up to 12 months.”

Tiffany Joekel of the Women’s Fund of Omaha testified in support of the bill. Oral contraception requires constant and regular administration to be effective, she said, and missing just one pill can lead to an unplanned pregnancy. Reducing the number of trips to the pharmacy would help women maintain a regular schedule, Joekel said.

Meg Mikolajczyk of Planned Parenthood North Central States also spoke in support. She said that approximately one in three patients will not fill a prescription for oral contraceptives unless they receive a 12-month supply.

“When you have an unintended pregnancy it leads to increased costs to insurers, including Medicaid,” Mikolajczyk said.

Also speaking in support was Karen Bell-Dancy, executive director of the YWCA of Lincoln. The bill would help reduce the burden on women in rural Nebraska, she said, particularly those who lack reliable transportation.

“There are only 30 states that cover prescription contraceptives through insurance. It is now time for Nebraska to join these states,” Bell-Dancy said.

Robert Bell, testifying on behalf of the Nebraska Insurance Federation, spoke in opposition to LB20. He said the bill would increase insurance premiums and reduce an insurance company’s flexibility by requiring that the same coverage be offered to all customers.

Eric Dunning, testifying on behalf of Blue Cross Blue Shield of Nebraska, also opposed LB20. He said Blue Cross Blue Shield supports the goal of expanding access to birth control but said the bill could lead to wasted medication if a patient changes contraceptive brands for medical reasons mid-prescription.

“We see significant issues with disposal of unused prescriptions as is,” Dunning said. “A requirement that birth control pills be issued for a one-year minimum will only make that issue worse.”

Also in opposition was Marion Miner of the Nebraska Catholic Conference. Miner said the bill would force employers who may have religious objections to pay for employee birth control and he disputed the assertion that greater access to birth control would reduce unintended pregnancies.

The committee took no immediate action on LB20.