S-0847.1  _______________________________________________

 

                         SENATE BILL 5512

          _______________________________________________

 

State of Washington      56th Legislature     1999 Regular Session

 

By Senators Costa, Winsley, Kline, Patterson, Gardner, Prentice, Long, Goings, Snyder, Fraser, Brown, Kohl‑Welles, Jacobsen, Spanel, Fairley, Haugen, Wojahn, Thibaudeau, Loveland, Bauer, Eide, B. Sheldon, McAuliffe, T. Sheldon, Heavey and Shin

 

Read first time 01/26/1999.  Referred to Committee on Health & Long‑Term Care.

Requiring health plans that cover prescription drugs to cover the cost of prescription contraceptives.


    AN ACT Relating to contraceptive health care benefits; adding a new section to chapter 48.43 RCW; and creating a new section.

 

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:

 

    NEW SECTION.  Sec. 1.  The legislature finds that:  (1) Over half of all pregnancies are unintended; (2) by reducing rates of unintended pregnancy, contraceptives help reduce the need for abortion; (3) unintended pregnancies lead to higher rates of infant mortality, low birth weight, and maternal morbidity, and threaten the economic viability of families; (4) contraceptive services are part of basic health care, allowing families to both adequately space desired pregnancies and avoid unintended pregnancy; (5) many health carriers cover prescription drugs and devices but exclude prescription contraceptives and contraceptive devices; (6) women of child-bearing age spend significantly more than men on out-of-pocket health care costs, with contraceptives and reproductive health care services accounting for most of this disparity; (7) lack of contraceptive coverage in health plans places many effective forms of contraceptives beyond the financial reach of many women, leading to unintended pregnancies; and (8) the ability to plan her childbearing is central to a woman's ability to participate on an equal basis in education and employment.

    The legislature intends to reduce the number of unintended pregnancies and ensure access to contraceptive services in health plans that cover prescription drugs and outpatient health services.  The legislature also intends to further the goal of eliminating sex discrimination in health benefits for women.

 

    NEW SECTION.  Sec. 2.  A new section is added to chapter 48.43 RCW to read as follows:

    (1) The definitions in this subsection apply throughout this section unless the context clearly requires otherwise.

    (a) "Prescription contraceptive drugs and devices" includes prescription contraceptive drugs and devices approved by the federal food and drug administration, including oral contraceptives, intrauterine devices (IUDs), injectables, hormonal implants, diaphragms, cervical caps, and emergency contraception.

    (b) "Outpatient contraceptive services" means services necessary for the effective use of contraception, including family planning counseling, exams for inserting, removing, or dispensing prescription contraceptive methods, and laboratory services.

    (2) A health plan issued to individuals or groups shall not exclude or restrict an enrollee's access to:

    (a) Prescription contraceptive drugs and devices approved by the federal food and drug administration if the plan provides benefits for prescription drugs; or

    (b) Outpatient contraceptive services, if the plan provides benefits for outpatient health services.

    (3) Except as provided in subsection (4) of this section, a health carrier shall not create or impose disincentives for utilization of the benefits required by subsection (2) of this section.

    (4) Nothing in this section shall be construed as:

    (a) Preventing a health carrier from imposing deductibles, coinsurance, other cost-sharing requirements, or other limitations in relation to providing prescription contraceptive drugs and devices, or outpatient contraceptive services, provided that the deductible, coinsurance, other cost-sharing requirement, or other limitation is not greater than or different from the deductible, coinsurance, other cost-sharing requirement, or other limitation for other prescription drugs, devices, or outpatient health care services covered under the plan; or

    (b) Requiring a health plan to cover experimental or investigative

prescription contraceptive drugs and devices, or outpatient contraceptive services, except to the extent that the plan provides coverage for other experimental or investigative prescription drugs, devices, or outpatient health care services.

    (5) This section applies to health plans issued or renewed on or

after the effective date of this section.

 

    NEW SECTION.  Sec. 3.  If any provision of this act or its application to any person or circumstance is held invalid, the remainder of the act or the application of the provision to other persons or circumstances is not affected.

 


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