WE WRITE on behalf of the Contraceptive Coverage Committee, an organization of University undergraduate, graduate and professional students, advocating changes in the student health insurance endorsed by the University. We are concerned about the exclusion of prescription contraceptives and emergency contraception from the University's student health insurance policies. The University's failure to provide coverage for these items places economic burdens on female students, increases the risk of unintended pregnancy, and discriminates against women. To treat its students equitably, we believe that the University must change the student insurance plan.
U.Va.'s student health insurance plan covers prescription medications and medical devices, but specifically excludes all prescription contraceptives - birth control pills, Depo-Provera, IUDs, Norplant, diaphragms, cervical caps and emergency contraception. According to QualChoice, the policy only covers oral contraceptives when used for medical purposes. Yet, it is our understanding that the University does not consider the use of prescription contraceptives to avoid unintended pregnancy a medical purpose.
By excluding these reproductive health services from its student health insurance, the University forces women students to bear more out-of-pocket medical costs than male students. The University also places female students at higher risk of unintended pregnancy, with its attendant detrimental effects on academic performance and retention.
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We hope to work with QualChoice and the University to change the student health insurance policy so that women students are treated fairly and equally. The incremental costs of adding comprehensive coverage to a group insurance policy have been shown to be minimal. A 1998 Guttmacher Institute study estimates the average total cost for adding a full range of reversible medical contraceptives for employees and their dependents to health plans that do not currently cover them to be $21.40 per year.
These costs are balanced by savings incurred by avoiding unintended pregnancy. Where the inclusion of reproductive health services is necessary to ensure that women students can participate fully and equally in the life of the University, a minimal increase in cost, if any, would be justified.
Changing the student health insurance policy is also warranted by law. Excluding prescription contraceptives from the insurance plan breaks federal law concerning sex in educational programs or activities receiving federal assistance. The regulations implementing Title IX state: "A recipient shall treat pregnancy, childbirth, false pregnancy, termination of pregnancy and recovery therefrom in the same manner and under the same policies as any other temporary disability with respect to any medical or hospital benefit, service, plan or policy which such recipient administers, operates, offers, or participates in with respect to students admitted to the recipient's educational program or activity."
In interpreting similar language contained in Title VII of the Civil Rights Act of 1964, as amended by the Pregnancy Discrimination Act, requiring equal treatment of women "affected by pregnancy, childbirth or related medical conditions," the Equal Employment Opportunity Commission recently ruled that an employer's failure to provide coverage for prescription contraceptives when it otherwise covered prescription drugs and devices constituted illegal sex discrimination (www.eeoc.gov/docs/decision-contraception.html).
We believe the student health insurance endorsed by the University should, at minimum, provide coverage for all FDA-approved contraceptive drugs and devices, and emergency contraception. The plan should require co-payments and caps on benefits, if any, for reproductive health care that are comparable to the rates provided by other public universities' student health insurance plans.
QualChoice's proposal is unacceptable because it imposes extra costs on two levels: first by increasing all students' total premiums by 2 percent and second, by charging a $18-$20 co-pay for contraceptives.
The equality and well-being of all students at the University are at the forefront of our concern. The University's failure to cover prescriptive contraception and emergency contraception places an unfair burden on female students. As long as the University mandates health insurance it cannot justly ignore the health care needs of one half of the student population.
The Student Health Insurance Committee will convene Tuesday, Feb. 27 at 4:30 in Minor Hall to vote on whether QualChoice should include contraceptive coverage in its future student plan. All students interested in voicing their opinion on this issue are encouraged to attend.
(Valerie Nannery and Susan Burgess are first-year Law students. They are co-founders of the Contraceptive Coverage Committee and co-wrote this column with first-year Law student Lise Adams.)
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