Arizona demonstrates why “The Pill isn’t just for family planning!” isn’t enough on its own

A common argument in the debate over contraception coverage is that contraceptives aren’t only used to prevent pregnancy–there are numerous other medical treatments that involve the Pill, from acne treatment up to PCOS and endometriosis. And that’s absolutely true, and a point that needs to be made. But it makes it easy to divide the uses of contraceptives into “legitimate medical condition” and “sluts just want to bone,” hoping that legislators will suck it up and cover the hobags along with the non-slutty, medically needy good girls.

The Arizona legislature, in yet another bid to prove that they’re willing to reach for the stars in the interest of screwing people over, has put paid to that with a bill, currently up for debate, that would allow employers to offer insurance coverage for the good girls but not the hobags–assuming the women in question are willing to put their private medical records up for the judgment of their boss.

Arizona House Bill 2625, authored by Majority Whip Debbie Lesko, R-Glendale, would permit employers to ask their employees for proof of medical prescription if they seek contraceptives for non-reproductive purposes, such as hormone control or acne treatment.

“I believe we live in America. We don’t live in the Soviet Union,” Lesko said. “So, government should not be telling the organizations or mom and pop employers to do something against their moral beliefs.”

Yes, we live in America. The land of freedom. Where employers are free to impose their moral judgments on my health care, and I’m free to submit to an executive upskirt if I want to get my endometriosis treated. Where my personal belief–that I should be able to have sex without making a baby, and that the money withheld from my paycheck each month should go to facilitate that–is superseded by my boss’s, because Jesus. (And, since Arizona is an employ-at-will state, where your boss is free to fire you for being a sinful slattern baby-killer. Yay, freedom!)

First of all: My medical history is my business. Whether I have acne or menstrual cramps or PCOS, it isn’t my employer’s concern–in fact, in the U.S., my employer isn’t allowed to stick his head in my medical (lady)business by requiring me to release medical information, beyond my ability to perform the functions of my job.

Second of all: My sexual activities also are my business. Inquiring at work about my sexual activities unequivocally constitutes sexual harassment, making it a condition of medical benefits doubly so, and requiring a doctor’s note to make sure I’m actually sick and not just trying to bone without consequences definitely applies.

Third of all: Hiding all that behind a veil of religious freedom is weird and freaky and really, really disturbing. And inappropriate. And unacceptable.

AZ HB 2625 requires, in subsection Y of section 20-1057.08, that if an insurance contract covers prescription drugs, that coverage must include any prescribed contraceptives; and that if a contract covers outpatient health care services, that coverage must include any outpatient contraceptive services. Subsection B comes behind it to flush it directly down the toilet.

Subsection B of this section does not exclude coverage for prescription contraceptive methods ordered by a health care provider with prescriptive authority for medical indications other than for contraceptive, abortifacient, abortion or sterilization purposes. A health care services organization, employer, sponsor, issuer or other entity offering the plan may state religious beliefs in its affidavit that require the enrollee first pay for the prescription and then submit a claim to the health care services organization along with evidence that the prescription is not in whole or in part for a purpose covered by the objection. A health care services organization may charge an administrative fee for handling claims under this subsection. [emphasis mine]

So here are your steps:

1. Pay for the full price of your prescription out of pocket.
2. Reveal your private medical history to your employer in the hope–not the guarantee, mind you–that said employer will find your use of contraceptives acceptable.
3. Eat the administrative fee for submitting your claim.
4. Cross your fingers. And your legs.

(h/t Jezebel)

34 comments for “Arizona demonstrates why “The Pill isn’t just for family planning!” isn’t enough on its own

  1. Emolee
    March 14, 2012 at 1:33 pm

    Disgusting and so infuriating. (I feel like I keep saying that about things I read…. I wonder why…)

    I think all people should be able to get hormonal birth control through their insurance- no matter why they need it- as long as a doctor writes a prescription for it. And I think that contraception itself is a legitimate medical concern, as well as a basic human right for people who can become pregnant. I hate the idea of getting into a game about the “good” and the “bad” reasons to use birth control, or a dichotomy of “sluts” vs. “people with lady problems.”

    However, I must admit that I do get especially outraged at the idea that a woman could be denied coverage for a drug that she needs for a very serious, painful, debilitating, possibly fatal condition (such as ovarian cysts) simply because said medication ALSO prevents pregnancy. This is some serious misogyny. Imagine a drug that treated heart problems, for example, but that also made men temporarily infertile…. creating hoops and barriers to get this drug would never fly.

  2. Ryan
    March 14, 2012 at 1:46 pm

    So Majority Whip Debbie Lesko, as a Christian Scientist, I can refuse to provide my employees with access to any healthcare, right? Like if my employee catches cancer, that’s just God’s will and they should be cool with dying, as I would find it immoral to cover their treatment.

    Oh… that’s taking this ridiculous misapplication of a perfectly simple constitutional protection too far? Good to know.

  3. March 14, 2012 at 1:55 pm

    (1) Single payer. The unique US system where healthcare is primarily tied to employment is a terrible idea, and as the far right attempts to use employers’ payments as a weapon of social engineering, we should be talking about moving past it.

    (2) Could they possibly make it more clear that this is neither about funding nor religious freedom, but rather recreating a world in which women cannot use medical technology to decouple sexual activity from pregnancy and infection?

    (3) They’ll pay an electoral price for this. Jonathan Chait, who I don’t always like, recently wrote that the conservatives realize that the demongraphics are against them and that this cycle is their last chance to rule as a coalition between social conservatives and the very wealthy. They are determined to gamble on one last throw and try to entrench far-right principles in legislation and jurisprudence. They’re in the process of losing, and by making their agenda so plain and so repellent, they’re setting up for so much of it to be rolled back. (I suspect that the coming coalition will allow the very wealthy to retain their influence, at the expense of any real fixes for gross distributional injustice, sadly.)

  4. March 14, 2012 at 1:56 pm

    demongraphics. I’d say that’s a band name, but it’s probably already a graphics company.

  5. EG
    March 14, 2012 at 1:57 pm

    I think that Jewish business owners should be able to deny coverage for any medical or hospital fees incurred by their employees due to food poisoning that could reasonably be suspected to have come from eating pork or shellfish. It’s religious freedom.

  6. Emolee
    March 14, 2012 at 2:12 pm

    as a Christian Scientist, I can refuse to provide my employees with access to any healthcare, right? Like if my employee catches cancer, that’s just God’s will and they should be cool with dying, as I would find it immoral to cover their treatment.

    Ryan, I agree with the larger point you are making, but your use of Christian Science as an example is misplaced. Many Christian Scientists do not use medicine, but many do use medicine, some fully and some to varying degrees. There is no church doctrine forbidding the use of medical care (and there are definitely church doctines forbidding a lot of other things, like alcohol and hypnosis, for example).

    Moreover, Christian Scientists do not attempt to deny medical care from people who are not Christian Scientists. The Christian Scientists we hear about in the news, who let their kids die without medical care, do exist (and this is a tragedy), but these are people who have taken the religion to a place that almost all Christian Scientists would vehemently disagree with.

    Also, even Christian Scientists who would never use medicine would NEVER say that illness was God’s will. The religion actually preaches the opposite- I won’t go deeply into the theology here- but a very watered-down version of it is that people are created in God’s image, and therefore spiritually perfect, and any material illness that appears is a deception. Instead of worshipping Jesus as God or God’s son (liek most Christian denominations), the idea is that all people are all as capable as Jesus to heal the sick through the power of God.

    Sorry for the huge derail- but after a certain number of factually inaccurate posts about Christian Science, I feel I have to say something- not to defend the religion (of which I am not a member)but to correct the inaccuracies.

  7. Ryan
    March 14, 2012 at 2:28 pm


    I know I was being unfair to Christian Science’s mainstream, and I recognize I could’ve used any number of religions to make the same point (and more humorously, like EG’s shellfish), but I wanted to push reductio ad absurdum angle.

    I meant no offense, and apologize to anyone who takes any. In any event, I usually reserve my intolerance for Southern Baptists.

  8. March 14, 2012 at 2:29 pm

    “I believe we live in America. We don’t live in the Soviet Union,” Lesko said. “So, government should not be telling the organizations or mom and pop employers to do something against their moral beliefs.”

    Employers – excuse me, Job Creators imposing their beliefs upon their employees, however, is perfectly OK. It’s not as if the employee pays a premium for their insurance coverage or anything, right? It’s Obama personally taking hard-earned dollars from the pockets of Job Creators and handing it to welfare queens sluts who can’t keep their legs closed.

    Someone needs to add a poison-pill amendment allowing employers to deny coverage for anti-cholesterol medications and cardiovascular procedures if the employee engages in dietary practices the employer finds morally objectionable. Why should the Anti-Sex League get all the belief-imposing fun?

  9. Emolee
    March 14, 2012 at 2:33 pm

    @ Ryan- yup, I get it, and I did not take offense at all. I just wanted to get the facts straight, this being just one of my pet-peeve common misconceptions out there.

  10. IrishUp
    March 14, 2012 at 2:58 pm

    auditorydamage –
    Alas, employers are *already* sliding down that slope, such as increasing premiums for employees who fail to meet certain BMI criteria or who do not take weight-loss measures (side-eyes Whole Foods).

  11. law talking girl
    March 14, 2012 at 3:22 pm

    Why don’t we just solve this problem by making hormonal birth control available over the counter? As I understand it, the pill is extremely safe, warnings to women over 35 and smokers notwithstanding, and there is no medical reason for the average woman to see a physician or have a pelvic exam prior to taking the pill. It is probably safer than Tylenol. The generic formulations of the pill would be very inexpensive. There might still be a problem with pharmacies lobbying for laws allowing them to refuse to sell the pill though.

  12. Katya
    March 14, 2012 at 3:43 pm

    Why don’t we just solve this problem by making hormonal birth control available over the counter?

    While I agree that the pill is generally safe, there are a couple of problems with making it available over the counter that would need to be addressed. First, there are different formulations of the pill, which carry different risks and benefits. Second, the pill does carry risks of serious side effects, and is even contraindicated for women with certain medical conditions or family histories. Third, the pill is typically taken for an extended period of time, unlike most other OTC medications (with the exception of aspirin taken daily for heart health reasons), and unlike the morning-after pill. Fourth, the pill is not the ideal form of BC for all women. For all those reasons, I think that having a conversation with a medical professional regarding the reasons for taking BC and the form of BC to use is helpful.

    I’m not saying there’s nothing to the idea, but I think that there would need to be some system in place to protect women’s health and assist them in properly choosing the right form of BC for them.

  13. Emolee
    March 14, 2012 at 4:31 pm

    @Irish Up- exactly. Adding more measures that deny bodily autonomy and make the employer the health police is not the answer. Whole foods policy is terrible and discriminatory and should be stopped.

    However I do get the frustration over only this specific medication being targeted because omg women might have sex without having babies. The more I think about ryan’s example of an employer denying all healthcare- as much as I agree with him that that would be absurd, I am incensed that it is viewed by so many as not absurd if it is “only” women’s reproductive healthcare that is denied.

  14. Alix
    March 14, 2012 at 4:38 pm

    But…isn’t this why we had to go through the whole HIPAA implementation mess? So that our medical records could be PRIVATE?

    This bill sounds like a HIPAA violation waiting to happen. Employers aren’t supposed to be able to see your medical stuff, aren’t supposed to ask for it or be able to review it.

  15. EG
    March 14, 2012 at 4:42 pm

    Adding more measures that deny bodily autonomy and make the employer the health police is not the answer.

    I think it would serve the same political purpose as those wonderful amendments some female legislators have attached to forced-ultrasound bills mandating that men seeking Viagra be forced to have EKGs, submit to a prostate exam, and bring in a signed note from a sexual partner attesting to impotence. It would be political theater to make a rhetorical point, because particularly if the amendment clearly allowed for non-Christians to inflict their religious beliefs on others, such amendments would never pass. Hence, you know, we should all keep kosher.

  16. Emolee
    March 14, 2012 at 4:43 pm

    Yes, I think it is a HIPAA violation. But states pass law that violate federal law and then those laws have to be challenged. They may try to get around it by having the employee “consent” by signing a contract, but the bargaining power is so uneven, it doesn’t lol like consent to me.

  17. Emolee
    March 14, 2012 at 4:51 pm

    EG- I see your point, this could highlight the misogyny, but I would prefer they use something other than a law that will further fat shaming such as the original suggestion that they could refuse to cover cholesterol meds if they don’t agree with your eating habits. Since they can’t possibly know what you actually eat, this will turn into a body size thing. The stuff fat people deal with is too real and damaging to be used as a parody. People would likely not get the absurdity and think it would make a nice add on.

  18. Chataya
    March 14, 2012 at 5:08 pm

    As a healthcare worker, I just see “HIPAA VIOLATION” in giant flashing letters while reading this.

    And you can’t sign away your HIPAA rights, so even requiring a contract agreeing to release this information as a matter of employment wouldn’t work.

  19. Jess
    March 14, 2012 at 5:13 pm

    Seriously?! Look, my state rep has informed her staff not to take my calls and blocked my emails. I have been spending waaaay too much on stamps for the letter-writing campaign. I am running out of printer ink due to protest signs. I have fund-raised, occupied, picketed, given out info on social networking sites, escorted at clinics, and showed up at my state capital to try to convince them they are being idiots. I have put my military career on the line, and I am damn surprised I haven’t been arrested yet…and I am not even as involved as a lot of people! But every time we turn around, these sorts of things are popping up like mushrooms! WTF is going on in this country?!?

  20. March 14, 2012 at 5:53 pm

    It’s actually not a HIPAA violation. HIPAA covers the health care institutions that hold your medical information and gives you control over how they disseminate that information. So your doctor, clinic staff, health insurance company, etc., are all restricted as to what they can do with your medical records. It doesn’t apply to your employer, who in this case is the intended recipient of the information, not the holder of the information.

    What’s going on here is that your employer is asking you to provide them with your medical records to justify your claim. If you go to your doctor and specifically request that he or she release records for that purpose, it’s not a violation. (Not a HIPAA violation, anyway. It’s certainly a violation in other senses of the word.) If your boss goes to your doctor and gets the information, that’s a violation, but it’s by your doctor, not your boss. There are cases when employers are free to get involved in health care issues–drug testing, applying for leave under FMLA, workers’ comp claims, special accommodations, things like that. The violation comes in the unauthorized release of information, not in the asking for it (except in cases governed by the ADA, which is a whole other can of worms).

  21. Annabelle
    March 14, 2012 at 6:05 pm

    I am not a lawyer, but judging from the bill’s text, it is the insurance company – not the employer – who could require proof of some non-contraceptive need before covering the prescription. Obviously, this doesn’t make the bill any less heinous, but it does eliminate a number of the privacy-related legal arguments against it.

    I’ve seen “single-payer” trotted out as a solution to this sort of thing in a few different forums, but I’m not sure. It seems to me that in a single-payer system, we would have these same battles, but at the federal level, and potentially as matters of executive branch policy rather than law. Moreover, “progressive” coverage for things like genital reconstructive surgery or facial feminization surgery (available from a steadily growing number of employers’ plans) would disappear completely. Thoughts?

  22. law talking girl
    March 14, 2012 at 6:25 pm

    Yes, I am aware of these issues, but I don’t think they are problems. People I believe to be more knowledgeable than me about the medical stuff have suggested that these issues could be easily resolved by requiring consultation with a pharmacist and self-screening by women over 35 who smoke. For example, this guy seems pretty worthy and he thinks the pill should be OTC – Perhaps the pill could be dispensed in 3-6 month supply packages, with appropriate literature, only by a licensed pharmacist, and only after a 5-10 minute interview with the woman. This interview could cover how the pill works, contraindications, and the different formulations of the pill. Or the OTC formulation could be restricted to the low-dose monophasic pills, with the others staying prescription-only.

    Many OTC medications are taken for extended periods of time with no end date (allergy medications, you mentioned aspirin, and I am sure there are more). I am not sure why this is a reason to keep the pill prescription only. Also many OTC medications are contraindicated for some people. People with high blood pressure should not use OTC hemorrhoid creams. Every OTC decongestant I’ve ever taken has told me on the packaging to talk to my doctor before taking it because I have asthma (though if your asthma is well-controlled an OTC decongestant is probably not going to hurt you).

    As I understand it, notwithstanding the increased stroke risk to smokers over 35, birth control is extremely safe, has proven health benefits, and is undoubtedly safer than a lot of OTC medications. One reason we continue to think it is risky is the fact that it is only available by prescription, whereas if it were available OTC people would realize that it is less of a threat to human health than Tylenol, which kills about 458 people per year ( Most Tylenol deaths probably result from unintentional overdose, and OTC birth control would rely on a woman’s ability to correctly identify herself as falling in the population of women who should not take the pill. But I do not see why we could not permit a woman to make that determination herself or with the assistance of a pharmacist.

    Furthermore, while the pill may not be the right birth control for every woman, I think it is perfectly alright for a woman to do her own research and decide which method is right for her and her partner without discussing this beforehand with a medical doctor. Discussion of birth control methods can happen at a woman’s annual exam or if she has a special situation like a history of blood clots, just as people with high blood pressure should talk to their doctors before slathering on the Preparation H. I think the more birth control options and information are freely and cheaply available the better informed women and men will be. One way to further that is to make the pill OTC.

    One caveat to this grand plan is that some people have said that making a drug OTC makes it more expensive. I don’t know how that would work with the pill. Caveat two is that I am a lawyer and I do not even play a doctor on TV, though I once dreamed I went to medical school and I once played “doctor” with a boy who lived on my street growing up. If any doctor or nurse here says I am wrong, then let me know!

  23. Tamara
    March 14, 2012 at 8:30 pm

    I’m not sure what “single payer” technically means but I thought I would give you an idea of how this is done in New Zealand.

    Hospital level care is provided by the state as is primary care for chidren, and the state subsidises other groups as well. Private health insurance is used by people who can afford it to pay for things not covered by the state or to speed up access to certain services that may have long waiting lists. Insurers don’t cover contraception as it is preventative.

    Many medications are subsidised by the state, which has an agency that purchases medications for this purpose. This includes many contraceptives. So, when need I need to get the pill I go to my GP, get a prescription, take it to the pharmacy and get 6 months worth for the grand sum of NZD3.

    This system is pretty great and things like contraceptives are not remotely contentious. We have had controversies about the funding of some drugs but they tend to relate to questions of efficacy versus cost.

  24. Tamara
    March 14, 2012 at 8:32 pm

    I should have said, insurers wouldn’t need to fund contraceptives for other medical uses anyway, since the state pays for that.

  25. SecondJen
    March 14, 2012 at 8:35 pm

    Already boycotting Arizona because of the blatant racism, ideas on how to boycott them more? Also, I’ve been working at the especially draconian [redacted] and thinking it’s totally legal for corporations to dictate how employees behave in certain ways in and out of the workplace (drug tests, dress codes, “codes of conduct”) that it isn’t legal for the U.S. government to dictate. This is extreme evidence of that. “Sorry, we don’t hire whores, so…”

    I’m feeling kind of powerless, not being a legislator or a millionaire. Any ideas about what we can do to fight stuff like this?

  26. Emolee
    March 14, 2012 at 10:15 pm

    Making it OTC could make it more expensive to the consumer because most insurance doesn’t pay for any OTC drugs even if they are expensive and the doctor writes a prescription.

  27. Angie unduplicated
    March 15, 2012 at 8:05 am

    It’ss ever so obvious that Arizona is becoming a social laboratory for stupidity.
    The bosses are already sneaky and hostile, and this strikes me as a last, desperate bid to keep the best-educated wage-gapped workforce in the world oppressed and humbled. Prior to last year’s reports that childless single urban females out-earned their male counterparts, nobody gave a hoot about ridding the world of contraception. Suddenly, it’s a priority with the neocons. The fact that childless single urban females don’t want to be free hostage housekeepers is an additional factor here. One child per woman would make a nifty excuse for crooks to keep the wage differential in place, and underpaid women with children have been known to marry or cohabit to keep the bills under control.
    This may sound like paranoia to the urban and educated, but down here in Deliverance country, single men still talk of “trapping a bitch” and employers want the same fate for quality underpaid workers of both sexes. Never underestimate the enemy.

  28. JinianVictoria
    March 15, 2012 at 4:04 pm

    What really tears it for me is that the author of the bill was a female!. 1984 has arrived…big brother can now determine if you are a worthy candidate for treatment..never mind the fact that not getting the prescription might mean your death If your boss decides you are not a good enough employee, or not acting approiately at any time according to his./ her standards…its sorry toots your out of luck. I hope the women in Arizona hound this woman all the way to her grave and definitely out of office at the very least

  29. Iam138
    March 15, 2012 at 5:38 pm

    I don’t know if anyone posted this (too many comments to scroll through), but I think this would probably violate HIPAA. Employers aren’t supposed to be able to ask too many questions about an employee’s health.

  30. Arkady
    March 15, 2012 at 5:48 pm

    Ugh, while I am one of those ‘good girls’ {spit} who only uses the Pill for medical reasons (asexual with probable endometriosis) this crap is just creepy. Seriously, being obliged to give intimate medical details to your employers? Who not only could deprive you of something so basic as the Pill, but could also decide to fire you if they think your ‘medical issues’ could cause you to take time sick off work? My problems are under control and haven’t missed a day of school/work in years, but am well aware it could change or I may someday have to come off the Pill and go back to the megacramps with projectile vomiting…

    So glad to live in a (currently!) sane country, the UK even waives the standard prescription charge for hormonal contraception.

  31. Natalie
    March 16, 2012 at 10:15 am

    As fair as the OTC thing goes, I don’t necessarily believe that would be the greatest idea because a pharmacist does not know your family history or your risk for adverse reactions. If the pill were to be OTC, yes more women would have access, but more women would be using (for lack of a better word) the wrong type of pill. Because there is progestrone only pills vs. combination pills vs. the mini pill a pharamcist isn’t necessarily going to have the best knowledge base to accurately prescribe. Also if say your mother or aunt had a bad reaction to a certain type of pill, your pharamacist probably doesn’t know that, and wouldn’t be able to guide you away from that kind.

  32. EG
    March 16, 2012 at 10:42 am

    Also if say your mother or aunt had a bad reaction to a certain type of pill, your pharamacist probably doesn’t know that, and wouldn’t be able to guide you away from that kind.

    To be fair, neither would your doctor know to do that unless you volunteered the info.

  33. March 18, 2012 at 6:47 pm

    actually, we already lost the fight 4 privacy on the job back in the 80’s when the legislature gave bosses the right 2 force U 2 piss in a jar—not that workers have ever really had rights in this country—in america, the only ppl w/ rights R those who own property—if U rent from them, work 4 them, etc, U essentially ARE their property along w/ all the nonliving stuff like land and machinery—like the first nations ppl R fond of saying—america was the land of the free and the home of the brave–then the white man showed up

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