Contraception Coverage: Employers May Exclude Contraception Coverage from Their Health Insurance Plans - Standridge V. Union Pacific Railroad Company1

By Pugh, Chad | American Journal of Law & Medicine, April 1, 2007 | Go to article overview

Contraception Coverage: Employers May Exclude Contraception Coverage from Their Health Insurance Plans - Standridge V. Union Pacific Railroad Company1


Pugh, Chad, American Journal of Law & Medicine


Contraception Coverage: Employers May Exclude Contraception Coverage from their Health Insurance Plans - Standridge v. Union Pacific Railroad Company1 - The Court of Appeals for the Eighth Circuit recently held that the Pregnancy Discrimination Act of 1978 ("PDA") does not require employers to cover contraception as part of their health insurance plans.2 The court further held that employers do not violate Title VII of the Civil Rights Act of 1964 ("Title VII"), as amended by the PDA, by excluding contraception from their health insurance plans.3

Union Pacific Railroad Company ("Union Pacific") provided health care benefits to its employees through several different health plans.4 These plans provided coverage for services such as routine doctor visits, tetanus shots, and drug and alcohol treatments.5 The plans excluded, for both males and females, prescription and non-prescription contraception unless the contraception was medically necessary for a non-contraceptive purpose, such as treating skin problems.6 Two of Union Pacific's female employees, Brandi Standridge and Kenya Phillips, brought suit against Union Pacific for sexual discrimination under Title VII.7 Specifically, Standridge and Phillips alleged that Union Pacific discriminated against its female employees by failing to cover prescription contraception.8

Title VII provides, in pertinent part, that "[i]t shall be an unlawful employment practice for an employer ... to discriminate against any individual with respect to his compensation, terms, conditions, or privileges of employment, because of such individual's . . . sex."9 After the Supreme Court held that denial of pregnancy benefits did not violate Title VII in General Electric Company v. Gilbert, 10 Congress enacted the PDA.11 The PDA provides:

The terms "because of sex" or "on the basis of sex" include, but are not limited to, because of or on the basis of pregnancy, childbirth, or related medical conditions; and women affected by pregnancy, childbirth, or related medical conditions shall be treated the same for all employment-related purposes, including receipt of benefits under fringe benefit programs, as other persons not so affected but similar in their ability or inability to work ... .12

The district court interpreted the PDA broadly, holding that it requires employer health plans to "treat the risk of pregnancy no less favorably than the Plans treat other similar health risks."13 Applying this interpretation, the district court found that Union Pacific violated Title VII, as amended by the PDA, because "it treats medical care women need to prevent pregnancy less favorably than it treats medical care needed to prevent other medical conditions that are no greater threat to employee's health than is pregnancy."14

On appeal, the Court of Appeals for the Eighth Circuit reversed.15 In reaching its decision, the court relied extensively on its holding in Krauel v. Iowa Methodist Medical Center,16 where the court held that the "PDA does not extend to infertility treatment."17 In Krauel, the court distinguished infertility from pregnancy and childbirth because "infertility prevents conception, while pregnancy, childbirth and medical conditions related to them can occur only after conception."18 Applying Krauel, the court held that the PDA does not apply to contraception "because, like infertility treatments, contraception is a treatment that is only indicated prior to pregnancy."19 In addition, the court stated that contraception and infertility are similar in that they are gender-neutral terms because they apply equally to both men and women.20 Consequently, the court found that Union Pacific's policy of denying coverage for contraception did not violate Title VII, as amended by the PDA.21

The court also considered whether, under a general Title VII analysis, Union Pacific's coverage plan discriminated on the basis of sex.22 Under a claim of disparate treatment, Standridge and Phillips had to establish that Union Pacific's plan treated its female employees less favorably than it treated its similarly situated male employees. …

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