You Were Told What!? A short history on the refusal of insurance plans and pharmacists to fill prescriptions for birth control and emergency contraception

  ,
women have been at the
mercy of insurance carriers
and employers who have
refused to include contraceptive
options as part of their
health plans. Women who
have been prescribed birth control for medicinal
purposes other than contraception have
had to petition their providers to make an
exception. Permission was given grudgingly
after many phone calls and documentation.
In 2001, a University of Illinois employee,
whom we will call Sandra, got fed up
with her insurance provider’s refusal of
coverage of birth control for endometriosis.
Sandra called the Champaign County
Health Care Consumers to see what she
could do. While the doctor and the insurance
provider duked it out, a call went out
to other health care agencies to meet and
discuss what could be done to address the
issue. The Women’s Health Task Force
(WHTF) was formed and this issue was the
first one to be tackled. It is ironic to note
that U of I students had easy access to most
birth control options at McKinley Health
Center through student insurance.
This same problem was being addressed
in several other states with law suits being
filed in Washington state for discrimination
based on gender. Men had no problem getting
Viagra but women could not get birth
control. Title IX was invoked and the first
domino fell, soon followed by others. The
EEOC ruled in the favor of women and
employers began to take notice. WHTF
requested an audience with the Chancellor
to discuss broadening coverage to faculty
and staff for birth control. After several
months, U of I announced that faculty and
staff could pick up birth control at McKinley,
a first step. Meanwhile, efforts were
being spearheaded by Planned Parenthood at
the state level which would require employers
and insurance companies to include birth
control in plans that included pharmacy coverage.
This provision was passed into law
with exceptions for small businesses, businesses
that were self-insured and businesses
that have corporate offices in states where
coverage is not required. Thus the U of I was
required to offer the benefit while Carle
Hospital was not.
The next project of the WHTF was to
spread the word about Emergency Contraception,
a low dosage of regular birth control
that prevents pregnancy when taken
within 120 hours of unprotected sex. Presumably,
pharmacies that carried birth control
would also carry Plan B, a brand of
emergency contraception. Not so! The list
for Champaign County showed that some
pharmacies did not or would not stock Plan
B, and some pharmacists refused to fill a
prescription. Additionally, Catholic Hospitals
would not even give information about
Plan B to victims of sexual assault.
The WHTF spent many hours at rallies,
dispensing information and collecting signatures
for legislators who were discussing
another law to make EC available. Planned
Parenthood worked with the Governor’s
staff to encourage him to pass a rule making
it illegal for a pharmacist to refuse to fill a
prescription for EC or birth control. This
rule became law in January of 2006.
Pharmacists have refused to fill prescriptions,
to refer to pharmacists who will
fill the script and in some cases, have taken
the script and refused to return it to the
patient. They have lectured and shamed
patients coming in for the drug. A recent
decision by Wal-Mart to carry Plan B heralded
the end to a series of requests to stop
their discriminatory behavior. Many smaller
communities only have one pharmacy and it
is often a Wal-Mart which meant that
women had to drive many miles to a
provider who would dispense Plan B.
In Illinois, several pharmacists have
been terminated as a result of their refusal
to fill the prescription. The excuse is their
moral objection to birth control and they
would like to invoke the conscience clause
used by medical providers. Planned Parenthood
and most physicians do not consider
pharmacists health care providers. Several
Right Wing groups have taken this issue as
their “cause celebre” and are suing the State
of Illinois for not allowing pharmacists to
pursue their career with their own moral
interpretation. The governor has recently
submitted a rule that would make a posting
of information on access to birth control
and emergency contraception mandatory.
Citizen input is being solicited by June 5.
When practitioners and professionals
begin to use their own moral compass to
control women’s health care access, women
invariably lose. Planned Parenthood and its
allies are ensuring the future of women’s
health through excellent health care, medically
accurate education and advocacy.