Viagra is one of the most popular drugs in history, responsible for urologists of the late 1990s having to add night and weekend office hours to keep up with demand for the erectile dysfunction (ED) medication.
Viagra is considered a lifestyle drug except in cases where it is used for life threatening conditions like pulmonary arterial hypertension (for which it is sold under other trade names). Many men would argue that Viagra is life-changing rather than life-enhancing, particularly if they dealt with ED in the days before it was available. At that time, treatments for ED were often painful (involving injections into the penis) or bulky and inconvenient (vacuum pump devices).
Viagra has recently been drawn again into headlines following a ruling by the US Supreme Court concerning requirements for the coverage of contraception for women under the Affordable Care Act (ACA).
What the Ruling Said
Burwell v. Hobby Lobby ruled that “closely held” corporations do not have to adhere to the birth control mandate that’s part of the ACA if it conflicts with the strongly held religious beliefs of those running the corporation. The ruling was 5-4 and was handed down June 30. The majority included justices Kennedy, Roberts, Scalia, Thomas, and Alito, while those in opposition were justices Sotomayor, Kagan, Ginsburg, and Breyer.
The specific types of birth control that Hobby Lobby wanted to opt out of covering included morning after pills Plan B and ella, and copper or hormonal intrauterine devices (IUDs). The company believes that these products can disrupt an existing pregnancy, therefore acting as a form of abortion. However, scientific studies have shown that these products work by delaying ovulation and preventing fertilization. In fact, “morning after” drug ella is approved for sale in Italy, an overwhelmingly Catholic nation, where it would have been deemed illegal if it had been considered to terminate existing pregnancies.
Writing for the majority, Justice Alito said that the requirement that co-challengers Hobby Lobby and Conestoga Wood Specialties provide contraception coverage was a substantial burden on their religious liberty, referring, presumably, to the $475 million in annual fines to which Hobby Lobby would be subject if it didn’t comply. Though Alito didn’t reject the government’s interest in ensuring access to contraception for women, he said that it could be done without violating the corporation’s religious rights.
The concept of corporations having religious rights was seized upon by Justices Ginsburg and Sotomayor, who wrote that the decision marked the first time the court had given religious protections to “the commercial, profit-making world.”
Perceived Inconsistencies in Hobby Lobby’s Policies
It didn’t take long for those not in favor of the Supreme Court’s ruling to start looking at Hobby Lobby’s insurance policies for other coverages that might be considered inconsistent with a conservative Christian viewpoint. Viagra in particular, which is covered under the company’s insurance policy, was brought up for discussion.
Many people who disagreed with the Supreme Court ruling asked, “Why does Hobby Lobby’s insurance cover a product designed to help men enjoy sex, while not covering products (like IUDs) that are designed to help women enjoy sex?
Moreover, it didn’t take long for people to discover that Hobby Lobby’s 401(K) plan includes investments in companies that make some of the very products it doesn’t want to cover in its insurance plan. Employees enrolled in the company’s 401(K) plan have the option to invest retirement dollars, as well as the money Hobby Lobby contributes in matching contributions into at least eight funds that invest in Teva Pharmaceuticals, Bayer, and Pfizer, companies that make contraceptives. Teva, for example, makes Plan B, a morning-after contraception that Hobby Lobby no longer has to cover under its health insurance plan. Forest Laboratories, another company in the portfolio, makes a drug used to induce medical abortions.
Is The Birth Control-Viagra Comparison a False Equivalence?
One question that arises is whether a comparison between birth control and Viagra constitutes a false equivalence. There’s little question that both birth control and Viagra allow people to enjoy sexual activity more – birth control by relieving a fear of unwanted pregnancy and Viagra by relieving ED. But Viagra doesn’t address conception directly, except by giving men the ability to participate in sexual activity that could, of course, lead to pregnancy.
Catholic leaders say that it is a case of false equivalence, telling NPR that the Catholic Church encourages procreation, and Viagra (and other ED medications) can help with that. Therefore it’s OK for a religiously conservative corporation to deny birth control coverage while allowing coverage for Viagra. Catholic leaders do draw the line at vasectomy, however, a male birth control procedure that is still covered under Hobby Lobby’s policy.
Some people say that Viagra is being dragged into an argument where it doesn’t belong, while others say that insurance coverage for Viagra but not for certain types of birth control shows a double standard that men are expected to engage in sex recreationally, but women are not. While many people have pointed out this discrepancy, there are no signs that insurance coverage for Viagra will be affected due to the Hobby Lobby court case.
Should Men Expect Further Scrutiny of Insurance Coverage of Viagra?
While Viagra has been brought up as a talking point in the debate over what should and should not be required coverage under the ACA, there’s little reason to believe that much will change with respect to insurance coverage of Viagra and other drugs like it.
Some plans cover Viagra and some do not. The likelihood of ED medications gaining broader coverage under health insurance plans will probably have more to do with cost, particularly once generic competitors are allowed onto the US market, which won’t happen until late 2017. If your insurance covers Viagra, that will probably not change as a result of the recent Supreme Court ruling.
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