I 
109TH CONGRESS 
1ST SESSION H. R. 4651 
To require equitable coverage of prescription contraceptive drugs and devices, 
and contraceptive services under health plans. 
IN THE HOUSE OF REPRESENTATIVES 
DECEMBER 22, 2005 
Mrs. LOWEY introduced the following bill; which was referred to the Com-
mittee on Energy and Commerce, and in addition to the Committee on 
Education and the Workforce, for a period to be subsequently determined 
by the Speaker, in each case for consideration of such provisions as fall 
within the jurisdiction of the committee concerned 
A BILL 
To require equitable coverage of prescription contraceptive 
drugs and devices, and contraceptive services under 
health plans. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Equity in Prescription 
Insurance and Contraceptive Coverage Act of 2005’’. 
SEC. 2. FINDINGS. 
Congress finds that—
(1) each year, 3,000,000 pregnancies, or one 
half of all pregnancies, in this country are unin-
tended; 
(2) contraceptives and contraceptive services 
are part of basic health care, allowing families to 
both adequately space desired pregnancies and avoid 
unintended pregnancy, and should be provided under 
the same terms and conditions as other basic health 
care; 
(3) studies show that contraceptives are cost ef-
fective: it is estimated that for every $1 of public 
funds invested in family planning, $3 is saved in 
medicaid costs from pregnancy-related healthcare 
and medical care for newborns; 
(4) by reducing rates of unintended pregnancy, 
contraceptives help reduce the need for abortion; 
(5) unintended pregnancies lead to higher rates 
of infant mortality, low-birth weight, and maternal 
morbidity, and threaten the economic viability of 
families; 
(6) the National Commission to Prevent Infant 
Mortality determined that ‘‘infant mortality could be 
reduced by 10 percent if all women not desiring 
pregnancy used contraception’’;
(7) most women in the United States, including 
three-quarters of women of childbearing age, rely on 
some form of private insurance (through their own 
employer, a family member’s employer, or the indi-
vidual market) to defray their medical expenses; 
(8) the vast majority of private insurers cover 
prescription drugs, but many exclude coverage for 
prescription contraceptives; 
(9) private insurance provides extremely limited 
coverage of contraceptives: half of traditional indem-
nity plans and preferred provider organizations, 20 
percent of point-of-service networks, and 7 percent 
of health maintenance organizations cover no contra-
ceptive methods other than sterilization; 
(10) women of reproductive age spend 68 per-
cent more than men on out-of-pocket health care 
costs, with contraceptives and reproductive health 
care services accounting for much of the difference; 
(11) the lack of contraceptive coverage in health 
insurance places many effective forms of contracep-
tives beyond the financial reach of many women, 
leading to unintended pregnancies; 
(12) the Institute of Medicine Committee on 
Unintended Pregnancy recommended that ‘‘financial 
barriers to contraception be reduced by increasing
the proportion of all health insurance policies that 
cover contraceptive services and supplies’’; 
(13) in 1998, Congress agreed to provide con-
traceptive coverage to the 2,000,000 women of re-
productive age who are participating in the Federal 
Employees Health Benefits Program, the largest 
employer-sponsored health insurance plan in the 
world, and, in 2001, the Office of Personnel Man-
agement reported that it did not raise premiums as 
a result of such coverage because there was ‘‘no cost 
increase due to contraceptive coverage’’; 
(14) eight in 10 privately insured adults sup-
port contraceptive coverage; 
(15) contraceptive coverage saves employers 
money: the Washington Business Group on Health 
estimates that not covering contraceptives in em-
ployee health plans costs employers 15 to 17 percent 
more than providing such coverage; and 
(16) Healthy People 2010, published by the Of-
fice of the Surgeon General, has established a 10- 
year national public health goal to increase the per-
centage of health plans that cover contraceptives.
SEC. 3. AMENDMENTS TO THE EMPLOYEE RETIREMENT IN-
COME SECURITY ACT OF 1974. 
(a) IN GENERAL.—Subpart B of part 7 of subtitle 
B of title I of the Employee Retirement Income Security 
Act of 1974 (29 U.S.C. 1185 et seq.) is amended by add-
ing at the end the following new section: 
‘‘SEC. 714. STANDARDS RELATING TO BENEFITS FOR CON-
TRACEPTIVES. 
‘‘(a) REQUIREMENTS
FOR
COVERAGE.—A group 
health plan, and a health insurance issuer providing health 
insurance coverage in connection with a group health plan, 
may not— 
‘‘(1) exclude or restrict benefits for prescription 
contraceptive drugs or devices approved by the Food 
and Drug Administration, or generic equivalents ap-
proved as substitutable by the Food and Drug Ad-
ministration, if such plan or coverage provides bene-
fits for other outpatient prescription drugs or de-
vices; or 
‘‘(2) exclude or restrict benefits for outpatient 
contraceptive services if such plan or coverage pro-
vides benefits for other outpatient services provided 
by a health care professional (referred to in this sec-
tion as ‘outpatient health care services’).
‘‘(b) PROHIBITIONS.—A group health plan, and a 
health insurance issuer providing health insurance cov-
erage in connection with a group health plan, may not— 
‘‘(1) deny to an individual eligibility, or contin-
ued eligibility, to enroll or to renew coverage under 
the terms of the plan or coverage because of the in-
dividual’s or enrollee’s use or potential use of items 
or services that are covered in accordance with the 
requirements of this section; 
‘‘(2) provide monetary payments or rebates to 
a covered individual to encourage such individual to 
accept less than the minimum protections available 
under this section; 
‘‘(3) penalize or otherwise reduce or limit the 
reimbursement of a health care professional because 
such professional prescribed contraceptive drugs or 
devices, or provided contraceptive services, described 
in subsection (a), in accordance with this section; or 
‘‘(4) provide incentives (monetary or otherwise) 
to a health care professional to induce such profes-
sional to withhold from a covered individual contra-
ceptive drugs or devices, or contraceptive services, 
described in subsection (a). 
‘‘(c) RULES OF CONSTRUCTION.—