Associated Press

SEATTLE — When Rana Nelson of Tacoma had a baby in January, she had no problem getting her insurance company to pay the $5,000 hospital bill.

But when she got an IUD, a birth control device, implanted later, the insurance company demanded she pay the $500 herself.

"It doesn’t make sense," she said.

She and others celebrated Wednesday as state Insurance Commissioner Mike Kreidler signed a rule requiring insurance companies to offer birth control coverage along with their regular prescription drug plans.

"With the signing of this rule, we’re going to end sex discrimination in Washington," Kreidler said. He joked that if men were primarily responsible for birth control, the state would have had the coverage requirement a long time ago.

"It might even have been etched in the state constitution," he quipped.

Nineteen other states have passed laws requiring birth control coverage in some form; Oregon currently is considering such a rule.

The new rule takes effect Jan. 1. It will apply to about 200,000 Washington women covered by state-regulated insurance companies. The rule will give women better access to all kinds of birth control, including emergency "morning-after" pills.

Most people who work for large companies have health insurance that falls under federal regulations, so they won’t be affected by Kreidler’s rule. But there’s change afoot on the federal front, too.

The federal Equal Employment Opportunity Commission ruled last December that excluding birth control coverage is gender discrimination. And U.S. District Judge Robert Lasnik in Seattle ruled in June that it is discriminatory to deny contraceptive coverage while covering other prescription drugs.

Some business groups have complained this required benefit will drive up the cost of health care at a time when businesses can ill afford it.

"They’re going to have to pay more, and that means they may not be able to afford prescription drug coverage (for employees) at all," said Carolyn Logue, state director of the National Federation of Independent Business. She said her members’ health insurance costs increased an average of 20 percent to 50 percent last year.

Kreidler said offering the benefit will cost employers only $17.12 a year.

"When you balance that against the cost of maternity coverage and unintended pregnancy, it doesn’t take a lot of that to balance the cost of birth control coverage," Kreidler said.

But Logue said that most women who plan their pregnancies and need birth control find a way to pay for it, so the new benefit won’t prevent many unwanted pregnancies.

Kreidler stressed this is not a new mandate he’s making up out of thin air — he’s just following state law that bans discrimination on the basis of gender. If businesses are unhappy with the rule, he said, "they need to go to the Legislature and change the law."

Groups such as the National Abortion Rights Action League, Planned Parenthood and the National Organization for Women applauded Kreidler for signing the rule. They worried that earlier drafts included loopholes that would weaken the rule, such as including the term "medically necessary" to define when birth control would be covered.

Kreidler removed that language from the final rule, and revised it in other ways that won wholehearted support from NARAL and the other groups.

"Washington women have needed this coverage for a very long time," said Kate Sadlon, communications director for Washington NARAL. "It’s been a very long fight. The message is, birth control must be considered basic health care for women."

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