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Crossfire

Should Insurance Companies Be Required to Cover the Cost of Contraceptives?

Aired July 20, 2000 - 7:30 p.m. ET

THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.

BILL PRESS, CO-HOST: Tonight, should insurance companies be required to cover the cost of contraceptives?

(BEGIN VIDEO CLIP)

JENNIFER ERIKSON, PLAINTIFF: They'll cover, you know, my pregnancy. They'll cover my abortion. Why -- why can't they cover my pills?

(END VIDEO CLIP)

PRESS: And should employers have to pay into a plan they morally oppose?

ANNOUNCER: Live from Washington, CROSSFIRE. On the left, Bill Press; on the right, Robert Novak. In the crossfire, Helen Alvare, spokesperson for the National Conference of Catholic Bishops, and in New York, Gloria Feldt, president of Planned Parenthood.

PRESS: Good evening. Welcome to CROSSFIRE.

What's good for the gander is good for the goose: That's the contention of Planned Parenthood, which has filed a lawsuit in Washington state against an insurance company that provides coverage for most prescription drugs but not for contraceptives. Plans like that, says Planned Parenthood, discriminate against women, especially since many of those plans, which don't pay for the pill, do pay for a vasectomy and even for Viagra. And a lot of women seem to agree.

(BEGIN VIDEO CLIP)

UNIDENTIFIED FEMALE: They're going to cover Viagra, they should cover birth control, and that's been around a heck of a lot longer than Viagra.

(END VIDEO CLIP)

PRESS: The battle's not limited to Washington state. Thirteen other states already mandate coverage of contraception, and soon so will Washington, D.C. But as requested by the local Catholic bishop, a House committee today said the nation's capital must exempt Catholic-owned businesses and employers from having to pay for contraceptives. And so the debate from coast to coast: Is there one law for Catholics and one law for everybody else? And should women get the same insurance coverage as men? -- Bob.

ROBERT NOVAK, CO-HOST: Gloria Feldt, let me see if I can understand this. Planned Parenthood only got interested in the question of mandating contraceptives when you found out that some insurance plans were providing Viagra. So it's a kind of a little covering thing. You have Viagra to do one thing and you have contraceptives to do the other thing.

Is that -- is that where you're coming from?

GLORIA FELDT, PRESIDENT, PLANNED PARENTHOOD: No, that's absolutely not true. As a matter of fact, we had begun the effort to get contraceptive coverage legislation passed in Congress, the Equity in Prescription Insurance and Contraceptive Coverage Act was first filed in Congress almost four years ago, and in fact, it languished in Congress, and no one paid any affection at all to this very fundamental injustice in the health care system until Viagra came along. And suddenly, it was so obvious what an injustice does exist.

Women spend 68 percent more than men out of pocket on our health care, and contraception isn't all of that, but it's a big piece of it, because so many plans, half of all indemnity plans don't cover prescription contraceptives. And even with HMOs, which tend to cover more preventive services, only 39 percent cover all of the five FDA- approved contraceptive drugs.

NOVAK: Now, the company that you filed suit against in the state of Washington is Bartell Drugs, and to hear Bill Press tell about it they give a lot of prescription services for other things, but not contraceptives. So, that militates -- or that discriminates against women.

But let me quote Jean Bartell-Barber of Bartell Drugs, and she said -- quote -- "We do not" -- "do not" -- "cover prescriptions for Viagra" -- there it is -- "infertility drugs, drugs for weight reduction, immunization agents, drugs for cosmetic purposes, and various other items. If we add something to the plan, we have to take something away from the plan."

So it is a canard to say that this little company, because they don't provide contraceptives, is discriminating against women. Because they don't provide Viagra, they're discriminating against men, too, aren't they?

FELDT: No. If they provide prescription drugs and devices in general and don't -- don't provide for contraceptive prescriptions, then they are discriminating against women, because only women use prescription contraceptives.

You know, birth control is basic health care for women. It's not -- it's not a lifestyle choice. It's not a, you know, it's not a frivolity. It is a basic part of health care for women: 90 percent of American couples use birth control to plan and space their families. And we all know, and the reason why the general public supports contraceptive coverage and insurance so profoundly is that we all understand that prevention helps to prevent unintended pregnancies, contraception helps to prevent unintended pregnancies. That helps to reduce the number of abortions. It improves women's health. It improve child health. It has many benefits both healthwise. And also, it's an economic benefit to the insurance company.

PRESS: Let's -- let's welcome Helen Alvare into this debate. Good evening.

HELEN ALVARE, SPOKESPERSON, NATIONAL CONFERENCE OF CATHOLIC BISHOPS: Thank you.

PRESS: let me ask you -- first of all, there's at least a couple of levels we're talking about tonight, just the plain insurance level and then the level dealing with the religion -- religious aspect of it. Let's deal if we can, first, with the insurance side of it.

So I want to ask you, as a woman and not as a spokesperson for the Catholic bishops, if I as a man can walk into some insurance company and get covered for a vasectomy or if I can walk in and get coverage for Viagra, why shouldn't you as a woman be able to get coverage for the pill? Isn't that pure discrimination?

ALVARE: Well, on the Viagra claim, since Viagra actually answers a medical problem, I don't think Viagra can be part of the argument that discrimination is involved. Frankly, I'm surprised that insurance companies cover vasectomies at all.

We would still take the position that that doesn't make contraception anymore health care than it was before. Contraception is a choice that somebody may make, but it doesn't answer a particular health care need.

And if a woman wants it and wants to file a discrimination claim that's one thing, but that's not a problem that I would say: I would say the insurance company would be better off covering neither vasectomies nor contraception.

PRESS: But wait a minute. First of all -- again, I want to come back to this basic thing. If there's no protection and if someone of these two partners gets pregnant, I'm not going to get pregnant. It's the woman that's going to get pregnant. All the more reason -- shouldn't the woman, and not the man, get coverage? Because she's the one who has going to pay all the cost of that.

ALVARE: It's still not answering a disease. Contraception does not answer a disease. It's not health care like other things we think of as health care.

It's true that if the woman gets pregnant, she bears the great burden. I -- I've been pregnant many times. I can attest to that. But it doesn't make contraception itself health care.

PRESS: Well, you see I think you're touching on the central fallacy maybe in this entire argument, and I wanted to quote a doctor that I saw just -- this is not a new issues. It's been around for a while.

But back in 1998, if -- Kate, can you tell if we could use that float right now? About -- this is what the doctor said, just basically, I think, what you said about a medical -- whether or not it's a medical condition.

One second. Let's listen up.

(BEGIN VIDEO CLIP)

LUELLA KLEIN, EMORY UNIVERSITY: I think that's a gender bias. I think that women bear the reproductive burden. They do most the child rearing. And I think it's only fair that health insurance coverage ought to cover reproductive health care. And it certainly...

(END VIDEO CLIP)

PRESS: Well, she made a good point, not the point I thought that we were going to make there, which is prevention. I mean, contraception does prevent a pregnancy, hopefully.

ALVARE: (UNINTELLIGIBLE) not a disease.

PRESS: I mean, the idea that -- but the idea that prevention is not part of health care is just ludicrous. Whether it's cancer or whether it's a common cold, shouldn't health plans cover prevention as well?

ALVARE: Using the word "prevention" is a nice device, but pregnancy is not a disease.

PRESS: I didn't say it's a disease.

ALVARE: Well, but you -- you equated it with cancer.

PRESS: It's a health condition. It's part of a health plan, isn't it?

ALVARE: Sure is, but it's not a disease, which is the difference.

NOVAK: All right, Gloria Feldt, this -- I'm just fascinated by -- I've always been fascinated by Planned Parenthood.

FELDT: Well, thank you. I appreciate that.

NOVAK: You're welcome. This little -- this little lawsuit just intrigues me. Do you know somebody by the name of Chris Carbanot (ph)?

FELDT: I'm sorry. Chris Carbanot?

NOVAK: Do you somebody names Chris Carbanot?

FELDT: Chris Sharbanot (ph)? The CEO...

NOVAK: Sharbanot, yes.

FELDT: Yes. Chris Sharbanot is the CEO of our affiliate in western Washington.

NOVAK: Exactly. And she said this. I assume she has some good sense or she wouldn't have that high of a position in your organization. But she said the reason they went after this little drug company is that it is a good employer and a progressive company that sells morning-after pills. Morning-after pills while some companies won't put it on their drugstores. But they went after them to show that even a good employer is not prevented from being sued by Planned Parenthood if they don't provide contraceptives. Nobody is protected.

Is that -- isn't that the essence of what she said?

FELDT: Well, many people have asked me, "why now?" I mean, why are we just now doing this? I mean, this is really a landmark lawsuit, and it's on behalf of all women of reproductive age in America and it is...

NOVAK: You didn't answer my question.

FELDT: ... it is so...

NOVAK: Why did you go after this company?

FELDT: I mean, it is so obviously needed.

NOVAK: Why did you go -- this is a good company. Why did you go after it?

FELDT: If I could finish my sentence, it will explain why we're suing this particular company. Sometimes I think there are injustices in society that are so pervasive and have been around so long that we don't even notice them, and frankly, I think the lack of coverage for contraceptives in insurance plans is a very good example of that.

We sued this particular company because a plaintiff came forward to us who works for this company. She is a pharmacist who works for this company, and she's a young woman. She's 29 years old. She's married. She plans to have children someday, but she's not ready yet. And she was dismayed to find that her own company didn't cover contraceptives.

And when she as a pharmacist would be dispensing, filling prescriptions from her clients, and she would see that these women...

NOVAK: All right. All right, Ms. Feldt.

FELDT: ... would be dismayed that they -- their insurance plans didn't cover contraceptives either.

NOVAK: That -- that is not the...

FELDT: She really put herself forward, and I think she's very... NOVAK: That is -- pardon me if I...

FELDT: ... courageous woman and kind of a hero to young women in this country.

NOVAK: Yes, but that is -- that is not what your president out there gave.

Now, I just want -- I don't know if you're...

FELDT: I think I've lost you.

NOVAK: I don't know if you're interested at all in uninsured people.

FELDT: I believe I've lost the sound.

PRESS: All right. Let's -- let's jump in here just a second and we'll get that checked.

NOVAK: Why not go to break? They said just go to break.

PRESS: OK.

NOVAK: OK. You want to be part of CROSSFIRE? Well, chat with tonight's guests right after the show at cnn.com/crossfire. And we'll be back to talk about the contraceptive fight: D.C. City Council versus Congress.

(COMMERCIAL BREAK)

NOVAK: Welcome back to CROSSFIRE.

Is it OK for health insurers to deny contraceptives on moral or religious grounds? The Washington, D.C. City Council said no in a bill that passed last week. But today, a congressional committee voted to bar the enforcement of the city council's mandate: in effect, approving a so-called "conscience clause" against contraceptives.

Debating this issue in New York, Gloria Feldt, president of Planned Parenthood, and here in Washington, Helen Alvare, spokesperson for the National Conference of Catholic Bishops.

PRESS: Ms. Alvare, one more question on the insurance side, if we can, before we move into the church's position and the D.C. City Council.

I don't -- I simply don't understand this insurance company position, particularly when -- even when you look at the economics of it -- I'd just like to show, for example, what the costs are. Women's health care costs, according -- these come from Planned Parenthood, by the way.

A pregnancy full term: $10, 000. Abortion: $450. Birth control pills an entire: $300. You know, a pill costs a buck a piece. Viagra costs $10 a pill. Just from a pure economic point of view, doesn't it make more sense for the insurance companies to cover the pill rather than some of these other procedures?

ALVARE: Clearly insurance companies feel that that's not true.

PRESS: I'm asking you.

ALVARE: Well, I agree with the companies. The large majority of them are not presently covering it, and in the words of the head of the Department of Commerce -- or the U.S. Chamber of Commerce today, she said, "You know, we've looked at insurance companies plans on this, and the ones that don't cover it, well, they tend to cover things that are medically necessary and therefore they don't cover contraception." That's why it makes sense.

PRESS: Now, speaking of a -- in your position, a spokesperson for the National Conference of Catholic Bishops, I understand -- don't agree with -- the church's position on contraception, against it. But I understand it and I accept it.

My question is, however, why should the bishop of Washington, D.C. be able to dictate to the Washington City Council what they write in a bill? Isn't that a clear violation of separation of church and state?

ALVARE: The violation has occurred, but the council has done it. They are telling the bishops conference to take our property, our money, our insurance company costs, our prescription coverage costs, and spend it for something that we believe is deeply violative of our faith and not just for contraception, but drugs that Planned Parenthood own manuals will tell you destroy a human embryo after it's created. That's abortion.

That is a tremendous violation of the church's right.

PRESS: What -- no, they're saying that. What they're saying is health care includes the pregnancy and it includes prevention of pregnancy, it includes contraception. And that's what the city council said. That's what the state says.

Again, how does a church have a right to dictate to the city? I mean,, does there have to be a bishop's informata (pnh) from now on, on everything the City Council does?

ALVARE: I think it's really clear here and you'll see that, because every single member of Congress, Republican and Democrat, on the Appropriations Committee today that overrode the City Council said the same thing. The City Council cannot tell the church in its parishes, in Mother Teresa's house, in the Daughters of Charity or elsewhere that they have to take their money and pay for things like abortion and contraception.

NOVAK: Gloria Feldt, as I understand it, the Catholic Church is not saying that the D.C. Council, whether it's -- this is a wise or an unwise step, cannot mandate contraceptives. It just says that people of the Catholic faith or any faith for reasons of conscience can opt themselves out. And I just want to quote to you what the auxiliary bishop of Washington, William E. Lori, said.

He said -- quote -- "The D.C. City Council is forcing Catholic institutions" -- Catholic institutions -- "to pay for what is contrary to church teaching." End quote. Can't you understand that?

FELDT: If I may ask, I think the real issue, the real question is, whose conscience counts? What about the conscience of the individual who feels that it's very important to plan and space having children until you're ready to take care of them.

And you know, if you want to be in the health care business and you want to be a large provider in the health care business, then you need to understand that you need to serve everybody.

I think it's as I simple as that. No one says anyone must use contraception, not by any means. That is strictly up to the individual.

But people should have that option, and birth control is basic health care: 90 percent of the couples in this country use it, and plan and space their children. That's what the prevents the need for abortion.

And I think the majority of people -- we know that 78 percent of people who have health insurance today say that they would be delighted to pay additional premiums in order to have their insurance cover it. So...

NOVAK: But Mrs. Feldt, I don't -- I don't know if you're quite familiar with what was going on when the District of Columbia City Council...

FELDT: Yes, I am familiar with it. Yes, I am.

NOVAK: ... passed this. And I watched the -- the scenes in the City Council. It was one of the ugliest scenes I ever saw, where a City Council member talked about deferring to the Catholic Church, deferring to Rome, talked about the pope running things. It was blatant intolerance, and Representative Tom Davis, the subcommittee chairman of the District of Columbia, Republican of Virginia, who is not a conservative and he is not a Catholic said -- quote -- "It's one thing when you talk about religion imposing itself on the state. Here you have the state imposing itself on religion. That is unfortunate in a city that has long been a symbol of tolerance."

Why -- I can't understand it. If you're going -- if you're getting what you want, why can't you let these Catholic institutions opt out?

ALVARE: Might I jump in here?

(CROSSTALK)

NOVAK: I want to ask -- I want to get her to answer. FELDT: If I may, if I may, covering contraception is simply giving people the option. It's not forcing anyone to do anything.

ALVARE: If I might counter that, giving people the option is what people have now. People go out and they decide they're going to buy contraception or they're not going to buy it. It's perfectly...

FELDT: No, if...

ALVARE: If I might finish my sentence please. What is being done here is to tell the church, you have a deeply held belief about human nature and what is elevating to human people. It is a deeply held religious belief. It is 2,000 years old. You also have a firm teaching against killing. And I'm sorry, you have to pay for it.

That is very different from people's freedom to go out and buy it if they want. It is forcing us to do this.

FELDT: In the very same -- in the very same sense, though, Helen, women are being discriminated against, women who believe deeply that it is the most moral thing they can do to plan and space their childbearing responsibly. And when their health plans do not cover contraception, which is basic health care for women that most of us use at some time during their life, including 85 percent of all Catholics, it is blatant sex discrimination against women.

PRESS: We're almost out of time. I have to ask you this question the church's position on this. I understand the church's adamant position and opposition to abortion. But isn't it a fact that by not allowing birth control you in effect are responsible for a great number of abortions?

You can't have it both ways. If you don't want so many abortions, why don't you recognize and allow people to pay for contraception?

ALVARE: Two points. I'm afraid you can't have it both ways either. You can't, on the one hand, say, as Ms. Feldt does, that 90 percent of people use contraception and we have 1.3 million abortions a year, and an on the other hand, say somehow we're responsible for people not using contraception.

Sadly, most people, including the vast majority of single people who go to Planned Parenthood for abortions -- why? Because their contraception failed -- are using contraception. The rates of use of contraception in the United States and the rates of abortion have gone up together.

PRESS: We're out of time. We have to say thank you...

ALVARE: Thank you.

PRESS: .... to Helen Alvare. Thank you for being here on CROSSFIRE.

FELDT: Thank you. PRESS: Gloria Feldt, thank you very much for joining us from New York. We'll let the two women go. The two men will come back with some closing comments on the pill and Viagra, whatever else.

(COMMERCIAL BREAK)

PRESS: OK. Here's a reminder. You can continue the CROSSFIRE online with tonight's guests, both of them, right after the show at cnn.com/crossfire.

You know, Bob, there are really two issues. I think you're wrong on both.

One is you can't defend covering Viagra and not covering the pill. I mean, it just makes no sense at all.

And secondly, when the City Council -- a bishop tells a city council what to do and Congress starts dancing to the bishop's tune, Bob, you know that's a very, very, slippery slope.

NOVAK: Well, I've got to say it's a conscience clause.

I don't know -- you're such a busy person, Bill, you probably didn't watch the D.C. City Council. That was really the ugly, the anti-pope, anti-Catholic remarks coming out of the members of the City Council.

And I can tell you this right now: The last group in America that people feel safe in being discriminatory against and attacking is the Catholic Church. And it's an absolute outrage, and as a Catholic you ought to be outraged by it.

PRESS: Bob, I'm not defending any of those comments. What -- but I'm also not defending -- I mean, this would not happen in Italy, it wouldn't happen in France, it wouldn't happen in Mexico. It happened in Iran and the United States, where the Congress says, oh, the bishop doesn't like it, therefore, we're going to force it on a city council, Bob. That is outrageous.

NOVAK: Maybe if you're that outraged, you ought to go back to Cuba again. You know, you like -- you like communist Cuba better...

PRESS: I didn't say anything about Cuba. I'm talking about the United States of America, where we have separation of church and state, Bob, and people are free to do whatever they feel they want to do.

NOVAK: How about a little -- a little conscience clause if somebody is -- feels it's against their moral requirements?

PRESS: I think -- Gloria said it correctly. It's everyone's individual conscience to make that decision. You don't dictate it to that state.

NOVAK: But I'm tired of this anti-Catholic bashing, is an outrage. PRESS: Not what it's all about.

From the left, I'm Bill Press. Good night for CROSSFIRE.

NOVAK: From the right, I'm Robert Novak. Join us again next time for another edition of CROSSFIRE.

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