Kristin Conzet surprised fellow legislators with her yes vote on HB1156 last week, a bill that would have required insurance companies to cover birth control devices and prescriptions for South Dakota women.

"I was the unexpected dark horse on this one," said Conzet, R-Rapid City. "Nobody anticipated my vote."

The bill was defeated 39-29 in the House Health and Human Resources committee, but Conzet said she believes the topic will surface again this session.

Insurance companies in South Dakota are not required to cover birth control devices or prescriptions for women. Yet, men's reproductive needs, including such interventions as Viagra and vasectomies, are generally covered, said Jonie Cutler, R-Sioux Falls, the prime sponsor of the bill.

Twenty-seven states, including Iowa and Montana, have enacted laws mandating that birth control coverage be extended to women as well as men. Cutler said HB1156 was modeled after Iowa's law.

A similar bill failed last year in the South Dakota Legislature, but Cutler believe it's a fight worth continuing. "We have to keep addressing this. People are skittish about talking about it ... but we have to do it because there is no equity," she said. "There is an inequity in the system."

Opponents of the bill argue that mandating coverage is not the role of government and would increase prices.

Rep. Phil Jensen, R-Rapid City, voted no in committee on the bill. "I was conflicted. What I found was that these insurance (companies), they all don't mandate birth control for men," he said.

Jensen said he would prefer to eliminate all mandates and instead require insurance companies to offer cafeteria-style plans to consumers.

"I see this contraceptive bill as one more mandate. I think we're heading in the wrong direction," he said.

Rob Schweers with Blue Cross/Blue Shield said his company opposes mandates in general, partially because it affects premiums, but "more because it takes away some of the flexibility that employers have to create a benefit design that's both right for employees and affordable."

Nathan Peterson of the Campaign for Healthy Families said states like Iowa report only a 1 percent increase in insurance premiums after such legislation, which calculates to a 34 cent a month increase for the consumers.

"We think that it is an important consumer guarantee," he said. "It is a very basic portion of health care that women and families should have access to birth control."

Peterson said it's important that such legislation would not cover abortive medications.

Cutler said arguments against the bill tended to center around a fear of increased costs and religious objections.

But Cutler argues that prenatal care and delivery costs, especially with high-risk pregnancies, cost insurance companies far more than birth control coverage. "Unplanned pregnancies are a lot more expensive than contraceptives are," Cutler said.

As for religion, Cutler said companies that object based on religious affiliation make up just 5 percent of the market share. Other states have found a way to comply with the law while still catering to those businesses.

"They do business in Iowa. They seem to find their way to providing a rider or something," she said.

Cutler said she believes it's important that legislators consider the needs and wants of the entire population of the state.

"When you provide a product such as insurance ... then I believe it's a policymaker's responsibility to take into consideration the overriding and overarching benefits of the public and not allow one religious viewpoint to counter what is a necessary and needed change in policy for 80,000 South Dakota women," Cutler said.

Jensen said he will work with Randy Moses, state deputy insurance commissioner, on legislation to enact a cafeteria-style plan that would eliminate the issue.

Conzet admits that, at first, she was uncomfortable with the bill because it included a mandate to a business. During the days between the bill's introduction and the vote, she researched the issue and talked to legislators and constituents who support it.

"I sat and really thought about it for an entire week," she said. "It pushed me out of my comfort zone."

Conzet said women and men from her district contacted her about the issue, concerned about the lack of coverage.

"It was a very emotionally charged bill," she said. "Emotions get involved and people need to revert to what they know and what they're comfortable with."

In the end, Conzet said she had to look at the bill from the perspective of the 80,000 women in South Dakota whom it affects. And that's why she voted yes.

"I started to think this isn't about me, this is about the people who have contacted me," she said.

Contact Lynn Taylor Rick at lynn.taylorrick@rapidcityjournal.com or 394-8414.