Montana’s Birth Control Coverage Ban Ruled Unconstitutional

By Beacon Staff

HELENA – A Montana judge has struck down the state’s ban on prescription birth control coverage for teenage girls enrolled in its low-income health insurance program.

Healthy Montana Kids, the insurance program for families with incomes up to 250 percent of the federal poverty level, had covered prescription contraceptives for uses such as preventing acne or easing cramps, but it would not cover contraceptives to prevent pregnancy.

District Judge Jim Reynolds of Helena ruled Friday that those regulations violate the Montana Constitution’s privacy and equal protection clauses, and he prohibited the state from enforcing them.

A minor’s choice regarding procreation is constitutionally protected, whether that choice is to prevent, obtain, maintain or terminate a pregnancy, Reynolds wrote in his decision.

If the state provides coverage for one choice, it must provide coverage for all options neutrally, he ruled.

In addition, the fact that the program allows contraceptive coverage to prevent acne but not to prevent pregnancy illustrates an unconstitutional intrusion “into the most intimate of doctor-patient relationships” — whether a person desires to become pregnant or avoid pregnancy, he wrote.

“In this scheme, if you want to control acne, your birth control is covered; if you want to avoid pregnancy and control your procreative autonomy, your birth control is not covered. This turns the idea of the fundamental right of privacy on its head,” Reynolds wrote.

There is no reason to require an impoverished minor, who has the same constitutional rights as an adult, to say why she is seeking or using birth control unless it is for her protection, the judge wrote.

But the contraception coverage ban isn’t meant to protect the teen and it even appears to go against the state’s interest stated in another law of preventing teenage pregnancies, Reynolds wrote.

Attorneys for the state Department of Justice had argued in defending the law that the regulations don’t deny anyone birth control, but the state should not have to pay for it.

Department of Justice spokesman John Doran said he had no comment on the decision. The state has 60 days to decide whether to appeal the decision, he said.

Department of Public Health and Human Services Jon Ebelt did not immediately return a call for comment.

Montana had been one of only four states in the nation that prohibited birth control coverage through federally funded Children’s Health Insurance Programs. The others are North Dakota, Pennsylvania, and Texas, according to Planned Parenthood of Montana, which brought the lawsuit against the state.

Planned Parenthood had been using federal Title X funds to subsidize birth control for teens in the Healthy Montana Kids program at a cost of about $10,000 per year. Now that money can go to patients who are not enrolled in an insurance program and have no other avenue to obtain contraceptives, said Planned Parenthood spokeswoman Lindsay Love.

“It frees up more resources for people who aren’t covered,” she said.

Montana’s Children’s Health Insurance Program includes about 2,000 girls and young women ages 15 to 19, according to Planned Parenthood. Last year, the organization estimated about 450 teens were in need of contraception coverage, and Love said she estimates that number will grow.