Neither type of reproductive health care is widely available as an essential benefit in Colorado, so in most cases women must pay out of pocket for contraception and buy separate riders for maternity care. Women can
purchase maternity riders on some plans, but that process is riddled
with hitches. (See here for The Colorado Independent’s investigation of the maternity rider market.)
K. Jerry Frangas, D-Denver, the representative co-sponsoring the
bill called the birth control portion of the bill a “no-brainer.”
Frangas went on to say:
My understanding is that some insurance companies cover Viagra. If
we’re going to cover reproductive issues or issues related to one
gender, we should cover reproductive issues related to both genders. It’s an issue of discrimination.
Colorado Independent notes that:
According to the Guttmacher Institute, Colorado has a very narrow
contraceptive mandate: on the small group and individual markets,
insurance companies are required to cover birth control pills (but no
other forms of birth control)–but only if the plan includes
For example, according to a representative at ehealthinsurance.com, in every other state in the Union where United Health Care
offers insurance, their plans would cover an Intra-Uterine Device (IUD)
insertion, he said.
But not in Colorado. Here, he explained, a woman
would have to pay for the IUD out-of-pocket, with no amount of that
payment going toward her deductible.
Colorado insurance companies are also not required to offer plans
that cover standard maternity costs on the individual market.
Employer-sponsored health care plans in Colorado, and all states,
provide maternity, per the terms of the Pregnancy Discrimination Act.
According to insurance agents in the state, companies simply don’t
offer maternity coverage because they’re not required to.
Frangas initiated the maternity bill after years of
complaints from constituents who were entrepreneurs, or otherwise
without employer-sponsored coverage.
“There are a lot of people in northwest Denver that are on
individual insurance plans, so through the years, I’ve gotten a number
of people complaining about this particular issue,” he said. “And it
didn’t seem like it was going to resolve itself, and the insurance
companies weren’t going to do anything, so I decided I was going to
Debate on the bill is expected to begin in January.
Frangas acknowledged that the bill will likely draw fire
from the insurance industry. He expects the industry lobby to argue
that covering birth control and maternity will drive up premium costs.
But, he notes:
“The one thing I think they’re not really seeing or acknowledging is
that no matter what, if somebody doesn’t have maternity care, we
ultimately pay for it,” said Frangas.
Frangas pointed out that a baby who doesn’t have good prenatal care
can wind up in a neonatal intensive care unit and cost an insurance
company up to $500,000. Mothers who don’t have maternity
insurance, and can’t pay their medical bills, contribute to hospitals’
un-reimbursed costs. Those costs are passed on to health insurance
companies, and ultimately to health insurance consumers.
“Then you look at the birth control issue. You can go on endlessly [about costs] there,” he said.
“We always pay for it,” he said. “So any argument that this will raise your rates is invalid.”
Chaer Robert, a board member at the Women’s Lobby of Colorado, said
she’s hoping there will be a fiscal note in the bill suggesting that it
will cut state Medicaid costs.
According to Robert, over one-third of the babies born in Colorado
are born on state-sponsored health insurance. In part, she said, that’s
because the state is less stingy about assistance if a woman is
pregnant. But she also wondered if women are going on state assistance
because they have no other options.
“A certain percent of folks maybe would have maternity coverage if they could really get it at any realistic level,” she said.