The Washington affiliates of the American Civil Liberties Union (ACLU) and the National Abortion Rights Action League (NARAL) have filed a lawsuit against Regence BlueShield for failing to provide coverage of prescription contraceptives in the health insurance policies it sells to the ACLU, NARAL, and other small employers in Washington state.

The lawsuit seeks class action status and comes one month after a federal judge ruled that Bartell Drug Co. of Seattle must pay for prescription contraceptives for its female employees, sparking reproductive-rights activists and lawyers to predict a rapid increase in the number of similar lawsuits filed in Washington state and throughout the country.

According to the ACLU, the activist groups filed the lawsuit because both organizations provide their workers with health insurance benefits (including prescription drug coverage), but that Regence BlueShield — the state's largest health insurer — only offers small group plans that either do not cover prescription contraceptives or cover only oral contraceptives. Other prescription contraceptives include diaphragms, intrauterine devices, injectable contraceptives like Depo-Provera, and Mifreprex, also known as "the morning after" or "abortion" pill.

"It is ironic that an organization that fights to protect reproductive freedom is unable to provide basic reproductive health care for its employees," says Karen Cooper, the executive director of NARAL's Washington chapter.

Regence BlueShield was unavailable for comment.

Women need more choice

According to the ACLU, it told Regence BlueShield in 1998 that the two health insurance plans made available to the ACLU were inadequate because one of the policies only covered birth control pills and the other didn't even provide that. ACLU says Regence BlueShield declined to offer complete prescription contraceptive coverage and even declined the organization's request to purchase the additional coverage as a rider.

Both the ACLU and NARAL say that to successfully prevent pregnancy, women must have a choice among several contraception methods. According to the ACLU, for women who cannot safely take birth control pills, health insurance limited to oral prescription contraceptives amounts to no coverage at all. The lawsuit also points out that many women obtain and use prescription contraceptives for regular maintenance of health, such as reducing severe pain during menstruation, rather than just the prevention of pregnancy.

In 1998, Congress ruled that all health insurance plans for federal employees must cover prescription contraceptives. Since then, a body of case law has been mounting that says the omission of contraceptive coverage is unlawful in some cases. On June 12, 2001, United States District Judge Robert S. Lasnik of Seattle ruled that Bartell Drug's exclusion of contraceptives from its health insurance plan constituted discrimination under Title VII, also known as the Pregnancy Discrimination Act (PDA). Enacted in 1978, PDA requires equal treatment of women "affected by pregnancy, childbirth, or related medical conditions" in all aspects of employment, including the receipt of fringe benefits.