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(U-WIRE) NEW YORK -- A ruling last week by New York's highest court reaffirmed a law mandating that health insurance cover birth control. But in reality, the availability of such coverage remains complex and uneven.
The ruling, made by the Court of Appeals for the State of New York, upheld the Women's Health and Wellness Act, which requires all insurance plans to cover prescription contraceptives in their drug benefit packages, including plans provided by Catholic charities that had argued against the law.
Still, many women can fall through the cracks, including those who don't have health coverage or those who are dependent on their parents' insurance plan and, by extension, their parents' rules.
A Columbia University engineering sophomore who spoke on condition of anonymity said that though she is sexually active, she does not use birth control because she is worried that her parents may notice the charge. She said the consequences if her parents found out would be disastrous.
"I would be a failure child. ... They were already extremely disappointed when they found out I was dating. They'd be ashamed of me as a daughter," she said.
Birth control varies in price. According to Planned Parenthood, the prescription for the pill may be purchased at a drugstore or clinic for about $15 to $35 a month, the patch costs between $30 and $40 a month, the ring is between $30 and $35 a month, and the diaphragm costs between $23 and $92 per purchase.
The prices can add up quickly in the absence of insurance, whether one is a low-income New Yorker or a recently graduated college student who can no longer be covered under her previous insurance plan. According to the New York City Department of Health and Mental Hygiene, 24 percent of residents in Central Harlem and 22 percent of Upper West Side residents do not have a primary care physician.
Women who don't have a primary health care provider often visit Planned Parenthood, the nation's largest provider of contraceptive services.
Samantha Levine, a PPNYC spokeswoman, said that the organization's counselors advise those who come to them with no insurance to obtain public health insurance such as Medicaid or the family planning benefit program.
At Columbia, prescriptions are covered under the Student Medical Insurance Plan and co-payment varies on whether the drug has a generic form or not-meaning birth control, which is sold only by brand name, would fall at $25.
Fewer than half of undergraduates are enrolled in the University plan, according to Shachar Gillat, representative for Health Services at Columbia.
But the department can provide a prescription for students not on their insurance because all full-time students pay the Health Services fee, which covers all visits to Primary Care Medical Services. This means students don't have to deal with their private insurance carriers or worry about their parents finding out.
At Barnard College Student Health Services, on-site clinicians sell all forms of contraception directly to the students at cheaper-than-retail prices.
Many students aren't aware that Health Services at Columbia University can provide a prescription for birth control without insurance. For some, the risk of their parents learning that they're sexually active through an insurance bill makes contraception not worth having at all.
"I don't go to Health Services -- I go to Planned Parenthood. I don't know their procedures or their hours, and I can just pay what I can at Planned Parenthood, so it seems like a better option," said a Columbia College sophomore on condition of anonymity.
If a student makes visits to Columbia's health program under University insurance, privacy concerns can still be avoided. Since the student is the primary insurance policy holder, she therefore has rights to change the address to which bills are sent, for example, from her parent's permanent address to her local Lerner mailbox.
Barnard students also have unlimited access to Health Services at Columbia, including the dispensary that offers discounted contraceptives without regard for health coverage.
"There is no way a parent is going to find out through Health Services that Barnard students are getting contraceptives. No insurance gets activated for anything we do here at Health Services," said Brenda Slade, director of Barnard College Student Health Services,
"College health has always been committed to providing confidential, sensitive care for reproductive issues and concerns," she added. "We're a leader in the field in that regard. We know what a huge issue this is for this age group."
(C) 2006 Columbia Daily Spectator via U-WIRE
