摘要：The Equity in Prescription Insurance and Contraceptive Coverage Act, introduced in Congress in 1997 and still unpassed, seeks to redress health insurers’ failure to pay for birth control as they pay for other prescription drugs, most paradoxically Viagra. In 1936 the International Workers Order (IWO), a fraternal society, became the first insurer to include contraception in its benefits package. A forerunner in the movement for prepaid medical care, the IWO offered its members primary care and contraceptive services for annual flat fees. Founded at a time when the legal status of contraception was in flux, the IWO’s Birth Control Center was the only such clinic to operate on an insurance system. Recent state laws and judicial actions have revived the IWO’s groundbreaking view of contraception as a basic preventive service deserving of insurance coverage. “TODAY WE FIND OURSELVES in the inexplicable situation where most insurance policies pay for Viagra but not for prescription contraceptives that prevent unintentional pregnancies and abortions.” 1 So argued Senator Harry Reid (D, Nev) in 2005 as cosponsor of EPICC, the Equity in Prescription Insurance and Contraceptive Coverage Act, which was first introduced in 1997 and remains unpassed. Insurers have evaded covering the cost of contraception by defining it as a “lifestyle” item rather than a “medical necessity.” That claim seemed particularly specious once insurers jumped to cover the impotence drug Viagra, with nearly half of Viagra prescriptions being subsidized by insurance less than 2 months after the drug’s release on the market in 1998. 2 Since then, while attempts at federal legislation went nowhere, uproar over this sexually absurd disparity spawned a patchwork of state laws and legal decisions mandating contraceptive equity. But even before Viagra tipped the scales, one forward-looking insurer recognized the virtue of contraceptive coverage and voluntarily added birth control services to its benefits package—in 1936. This is the story of the International Workers Order (IWO), a fraternal society that, at the inception of health insurance and in the infancy of the birth control movement, forged the first connection between the two.
