COLUMBUS, OHIO ? Beth Taggart pays $35 a month out of her own pocket for contraceptives because her insurance does not cover birth control pills. That doesn’t seem quite fair to her, considering the sort of things her health plan does cover.

“When I think that Viagra is covered, and the consequence of Viagra is not covered, it’s hard to believe,” said the 40-year-old former state employee and mother of a baby daughter. “Plus, it’s a health concern, especially for people who just had babies and don’t want to get pregnant again within the first year.”

Lawmakers are listening: The debate over whether health plans should be required to include contraceptive coverage has moved into nearly all state legislatures

This year, at least 19 states, including Ohio, introduced more than 60 bills regarding insurance for birth control pills and devices. Three of those — New York, Arizona and Massachusetts — enacted laws, bringing to 20 the number of states that have passed such measures in the last five years.

Most of the laws require health insurance policies that cover prescription drugs to cover prescription contraceptives, too.

“This momentum underscores that failure to cover contraceptives is illegal sex discrimination, and people now are recognizing that,” said Elizabeth Cavendish, legal director of the National Abortion and Reproductive Rights Action League in Washington.

Pressure for contraception coverage grew sharply in the late 1990s when Viagra went on the market and insurers quickly covered it, but not such things as birth control pills, intrauterine devices or Norplant.

Two years ago, the U.S. Equal Employment Opportunity Commission issued an opinion that said not providing insurance for contraceptives amounts to sex discrimination. And two federal court rulings last year cited the opinion.

Federal legislation to force insurance companies to offer contraception coverage has languished in Congress since 1997. As a result, most of the action is taking place at the state level.

Ohio state Sen. Priscilla Mead, a Republican, introduced a bill last fall that went nowhere.

“Birth control is a basic part of women’s health care that is used during much of a woman’s life. I have spent about four and a half years of my life bearing children and over 30 years of my life trying not to have children,” said Mead, a 58-year-old mother of four.

Women’s groups, gynecologists and obstetricians argue that affordable pregnancy prevention is a medical necessity and that it can ultimately save employers money by reducing the number of unwanted pregnancies.

Opponents of the bills — mainly insurance companies and some employers — say that what to insure is a decision best left to employers. They say that forcing the issue could lead some employers not to offer insurance at all.

“Employers shouldn’t be told what type of coverage they have to purchase,” said Larry Akey, spokesman of the Health Insurance Association of America. “The problem is that when you force an employer to do something, everything comes with a cost. As mandates pile one on top of the other, it pretty much reaches a breaking point.”