AUGUSTA — A bill that seeks to improve birth control access by allowing patients to fill prescriptions for one year at a time faces strong opposition from Maine’s insurance industry, which worries it might constitute a new mandate.
Lawmakers heard extended testimony Tuesday on L.D. 1237, which would permit women who are prescribed birth control to receive up to one year’s worth of medication before having to revisit their pharmacist.
Currently, Maine’s insurers allow patients to receive a maximum of three months’ of birth control and some require a refill trip every month.
“It’s a burden for many women to come in that often,” said Rep. Joyce McCreight, D-Harpswell, the bill’s sponsor. “The purpose of this bill is to help remove this barrier to consistent contraception.”
OTHER STATES HAVE SIMILAR REQUIREMENTS
Her bill would allow patients to receive a 3-month supply for their first dispensing and then a 12-month supply for a subsequent dispensing of the same contraceptive supply. McCreight said several other states already have similar requirements of their insurers.
She also said a 2011 survey of more than 84,000 women by the University of California at San Francisco found that women who received a year’s supply of birth control were 30 percent less likely to have an unwanted pregnancy and were 46 percent less likely to have an abortion.
The bill was supported by several advocacy organizations, including Planned Parenthood, the Maine Women’s Lobby and the Maine Coalition to End Domestic Violence.
But the bill drew concerns from the insurance industry, mostly because its language seemed to mandate that insurers provide access to a broader range of contraceptives at “no cost-share to members.” Although it was not expressly stated, the bill seemed to apply most to traditional oral contraceptives that can be taken daily. But Katherine Pelletreau, executive director of the Maine Association of Health Plans, said it could apply to other forms of contraceptives that are more costly for insurers.
The four insurers her organizations represents – Aetna, Anthem, Cigna and Harvard Pilgrim – already provide no-cost share coverage for some contraception as outlined under the federal Affordable Care Act.
Pelletreau, however, said L.D. 1237 goes well beyond that and would increase costs by mandating no-cost share coverage for all approved contraception, not just what is spelled out in the ACA. She said that would increase costs to other members.
Allison Hepler, a history professor at the University of Maine-Farmington who testified in support of the bill, said it represented a common-sense approach to public health.
“It not only reduces the chances of unplanned pregnancies, it also provides enormous security for thousands of child-bearing women in rural Maine, some of whom regularly juggle more than one job, child care and live far from a pharmacy,” she said.
Regina Rooney, public awareness coordinator for the Maine Coalition to End Domestic Violence, said many women at risk of domestic or spousal abuse want to keep their birth control a secret. She explained that abusers can use reproductive coercion – essentially forcing their partner to get pregnant and give birth – as a way to control her. She said those women would have a difficult time filling their prescription every month or every three months.
Peter Michaud, representing the Maine Medical Association, said there are no medical reasons why a patient shouldn’t receive their prescription for up to a year.
The debate over L.D. 1237 was at times awkward, featuring many older male lawmakers asking questions about a topic they likely haven’t given much thought. Rep. Gina Melaragno, D-Auburn, made note of that at the close of Tuesday’s hearing when she thanked the many women who testified and shared stories.
The major sticking point for committee members, though, seemed to be whether the bill represented a mandate and would therefore trigger a review by the state’s insurance board. That process could take up to a year.
However, Nicole Clegg with Planned Parenthood said mandated coverage of birth control already exists with no required co-payment. The bill only allows patients to get a longer supply of medication.
Danna Hayes, public policy director for the Maine Women’s Lobby, said even if the bill does mandate no-cost share coverage, that would still cost far less than a pregnancy, which she estimated at about $13,000 for prenatal care, labor and deliver and the first 12 months of infant care.
The bill will now be scheduled for a work session in the Insurance and Financial Services Committee, where it will be debated and perhaps revised before being voted on.
Eric Russell can be contacted at 791-6344 or at: