HELENA – A Helena district judge has declared unconstitutional the state’s ban on prescription birth control coverage for teenage girls covered under the state’s health insurance program for low-income people.
District Judge James Reynolds concluded that the state contraceptive ban for teenage girls in the Healthy Montana Kids Program “violates the right of privacy and the rights of persons not adults set forth in the Montana Constitution.”
The Healthy Montana Kids program, formerly known as the Children’s Health Insurance Program, insures children with family incomes up 250 percent of the federal poverty level.
“The state has failed to provide a compelling state reason for this exclusion and has failed to show how this exclusion enhances the rights of persons not adults,” Reynolds said. “Rather, as the court determined and as the state itself declared: reducing teenage pregnancy (is) a compelling state interest.”
He issued his ruling in the longstanding lawsuit filed by Planned Parenthood against the state in June 2009. The group sued after failing for a decade to get the Legislature to remove the state ban.
Reynolds said teenage girls insured by Healthy Montana Kids can obtain contraceptives for other purposes, such as acne or difficult menstrual cycles.
“Only if the minor seeks contraceptive medication for its designed purpose, preventing conception, will HMK (Healthy Montana Kids) not provide coverage for the medication,” the judge wrote.
That in turn forces Healthy Montana Kids to inquire into what Reynolds called “the most intimate of doctor-patient relationships about the most fundamental personal autonomy decision – whether a person desires to become pregnant or avoid pregnancy.”
“In this scheme, if you want to control your acne, your birth control is covered; if you want to avoid pregnancy and control your procreative autonomy, your birth control is not covered,” the judge said. “This turns the idea of the fundamental right of privacy on its head.”
Reynolds went on to say: “The point is this: because HMK provides payment for medical services associated with procreative autonomy, the individual privacy guaranteed in Montana’s constitution applies and the right operates to prohibit precisely the inquiry made by the contraception exclusion – unless the state can provide a narrowly tailored, compelling state interest judging this infringement.”
When Planned Parenthood challenged the law, it said Montana had been one of only four states that prohibited birth control coverage in its Children’s Health Insurance Program.
On Wednesday, Stacy James, CEO of Planned Parenthood of Montana, applauded Reynolds’ decision:
“The court sent a resounding message today,” she said. “The state of Montana should protect the privacy of all its citizens equally and ensure equal access to health care for everyone, regardless of age.”
Planned Parenthood said because of the ruling, many more young women will be able to gain access to affordable birth control to prevent teen pregnancy.
Anna Whiting Sorrell, director of the state Department of Public Health and Human Services, which runs the program, said, “State law had prohibited the state from providing birth control coverage. Judge Reynolds’ decision clarifies what benefits are covered, and DPHHS will comply with the law.”
The state has 60 days to decide whether to appeal the decision to the Montana Supreme Court.
“Montana’s taken a leap forward,” said former state. Sen. John Brueggeman, R-Polson, who in 1999 had tried to remove the ban as a means to reduce abortions. “If your interests are in reducing unwanted pregnancies and reducing abortions and reducing the cycle of poverty that often begins with an unwanted pregnancy, this is an important step.”
Critical of the decision was Jeff Laszloffy of Laurel, president and CEO of the Montana Family Foundation, a group that promotes conservative social values and one that has lobbied for keeping the contraception ban in place.
“Judge Reynolds takes the right of privacy too far,” Laszloffy said. “The state does have a compelling interest in enhancing the protection of minors. The Legislature felt that we should not be encouraging risky out-of-wedlock sex between 13- and 14-year old children.”
Planned Parenthood said the Healthy Montana Kids Program insures more than 18,000 people, including nearly 2,000 who are women aged 15-19.