Teachers’ union sues Milwaukee school system for exclusion of erectile dysfunction drugs from health care plan
According to the Associated Press, the Milwaukee Teachers’ Education Association (MTEA) has been waging a two year battle with the Milwaukee school system’s board over the board’s decision to exclude erectile dysfunction (ed) drugs, such as Viagra, Cialis, and Levitra, from the teachers’ health care plan. MTEA contends that the drugs are necessary treatment for “an exclusively gender-related condition.” However, the school board attorneys counter that the drugs were excluded in 2005 to save money, and there is no discrimination because their use is not a medical necessity.
One state legislator is question why MTEA would embroil itself in a dispute over ed drugs when teachers are losing their jobs (referring to a massive layoff of teachers in June). A school board consultant has estimated that reinstating the drug benefit would cost $786,000 per year, which State Rep. Jason Fields argues would be money better spent on saving jobs. MTEA spokeswoman Kris Collett declined comment. However, the union’s attorney, Barbara Quindel, stressed that the case was worth fighting despite the district’s grim finances because erectile dysfunction is associated with heart disease, prostate cancer and other conditions, and the drugs are approved by the Food and Drug Administration and recommended by the American Urological Association. “MTEA believes that men should not be discriminated against in receiving treatment for their medical conditions,” she said.
Health insurer Aetna Inc., which provides one of the district’s two plans, says its standard pharmacy plans exclude Viagra and other “drugs for lifestyle enhancement or performance.” Basic state employee health plans also generally don’t cover those drugs, but more expensive premium plans might, said Dick Cauchi, who tracks health benefits at the National Conference of State Legislatures. Lisa Soronen, National School Boards Association senior staff attorney, also said she had never heard of a similar case or an example of a union negotiating coverage for erectile dysfunction drugs. “If you are getting down to what drugs are covered, you are really getting in the weeds,” she said, explaining most negotiations are over premiums and co-payments.
Although the board agreed to cover the ed drugs after negotiations in 2002, by 2004, the number of claimants receiving prescriptions skyrocketed to more than 1,000 per year, costing the district $207,000. During negotiations in 2005, the board proposed eliminating the benefit and an arbitrator adopted the plan. In 2008, MTEA filed a sex discrimination complaint with the state. In June, the Labor and Industry Review Commission ruled the union couldn’t pursue the case without identifying employees who have been injured by the policy and the complaint was filed after the statute of limitations expired. The union is asking a Milwaukee County Circuit Court judge to overturn that decision and declare that the policy violates the Wisconsin Fair Employment Act.
MTEA’s claim appears to be unique because ed drugs are usually cited as examples of discrimination against female employees. Several lawsuits have claimed that employer health plans discriminate against women when they cover Viagra but not contraceptives or infertility treatment. MTEA, on the other hand, claims men are treated unfairly here. The union’s lawyers have argued that vaginal cream, anti-bacterial medicine and estrogen replacement medication for female sexual dysfunction are covered.
Source: Associated Press, 8/7/10, Ryan J. Foley