Reform. It’s Good for Your Health.

Posted by Leni Preston, Maryland Women's Coalition for Health Care Reform

This article is cross-posted with Mom's Rising and National Council for La Raza

It’s National Minority Health Month and the Maryland Women’s Coalition for Health Care Reform (Coalition) is working from the principle: Reform. It’s Good for Your Health to advance the mission of health equity in Maryland.  Through the successful implementation of the Patient Protection and Affordable Care Act (ACA) and other state-based initiatives we recognize a unique, once in a generation opportunity to transform the health care landscape and to ensure that everyone has access to the full range of health care services they need to live healthy and productive lives.  We also know that unless we address the existing gender, racial and ethnic disparities we will not have lived up to the promise of reform.

In Maryland we are fortunate that Governor O’Malley has made the ACA’s full implementation a high priority.   His Administration has used this opportunity to give stakeholders a real and meaningful role in the process and to emphasize the goal of achieving health equity.  The Coalition has been involved in drafting legislation for Maryland’s Health Benefit Exchange Act of 2012 (SB238/HB443), which sets out the basic principle of health equity, and another law that established Health Enterprise Zones (SB234/HB439) for the purpose of reducing health disparities.  The Coalition has partnered with Maryland’s Department of Health and Mental Hygiene to implement the State Health Improvement Process (SHIP).  This establishes 39 measurable objectives to improve health outcomes, 24 of which directly address disparities.  The Coalition is engaging with groups on the local level through health improvement coalitions to support the SHIP’s goals.

We are also kicking off two exciting initiatives.  The first is the publication of a white paper, Health Equity: Maryland’s Call to Action.   In this we will highlight the challenges and opportunities to achieve health equity through health care reform and provide recommendations on how to achieve these.   This will be released in September 2012 at a forum – Health Care. Women of Color Get It.   This will bring together those working in areas that include health policy, public health, consumer advocacy, and minority health and disparities to engage in discussions throughout which will be interwoven the thread of achieving health equity in our state.   At the same time, we want to empower women of color to raise their own voices to achieve our shared goals of high-quality, affordable, comprehensive and accessible health care for all.

Leni Preston, Chair
Maryland Women’s Coalition for Health Care Reform
leni@mdchcr.org

5 Ways Health Reform Supports Women

Posted by Erin Armstrong, Law Students for Reproductive Justice Fellow at the National Health Law Program

This article is cross-posted from Mom's Rising.

On March 23, 2010, the Affordable Care Act (ACA) was signed into law.  Two years later, we are days away from oral arguments in the case before the U.S. Supreme Court that will decide its fate.  These two occasions have prompted us at the National Health Law Program (NHeLP) to pause and take stock of all that the ACA has done, or will soon do, to improve the health and well-being of low-income and underserved individuals.

In honor of the ACA’s second birthday, and acknowledging all that is at stake in the Supreme Court, NHeLP is pleased to present our “Top 5” list of the ways the ACA addresses women’s health needs.  In truth, it was difficult to whittle the list down to only five.  But here are our personal favorites:

1) Medicaid expansion.  Medicaid already does so much for women.  In fact, women make up three-quarters of the current adult Medicaid population.  However, only women who are pregnant, parenting or living with a disability have historically qualified for enrollment.  The ACA changes that by expanding eligibility in 2014 to all individuals with incomes below 138 percent of the federal poverty level. For the first time, low-income women who do not meet previous eligibility criteria – 55% of currently uninsured women – will qualify for Medicaid coverage.  On top of that, the ACA ensures that the new Medicaid enrollees will receive family planning benefits with the freedom to choose a provider and without cost-sharing.  These are major wins for uninsured low-income women, easily earning the Medicaid expansion the number one spot in our Top 5.

2) Access to preventive care.  The ACA requires all new insurance plans to cover certain preventive health care services without cost-sharing.  This is particularly important for women who, when compared to men, have more preventive health needs, lower incomes, and are more likely to forgo necessary preventive care due to cost.  The list of required benefits includes critical women’s health services such as:  mammograms; screenings for cancer, gestational diabetes, domestic violence, HIV and sexually transmitted diseases; lactation and breastfeeding support and equipment; well-woman visits; and all FDA-approved contraceptive options, ensuring that each woman can obtain the method that is most appropriate for her life and medical condition. Those opposed to contraception are attempting to undermine these guarantees with a broad exemption that would allow any employer to refuse to provide coverage of any health service for any reason.  NHeLP and others are fighting to protect these Top 5-worthy women’s preventive health care gains against attacks on quality health care coverage.

3) The end of discriminatory insurance practices that harm women.  Several provisions in the ACA work together to prevent harmful insurance practices. No longer will insurers be permitted to deny women coverage based on “preexisting conditions” such as pregnancy, cesarean sections or domestic violence.  The ACA requires insurers to sell insurance to any woman no matter her medical history, current condition or health factors.  No longer will insurers in the individual and small group markets be permitted to charge women higher premiums than their male counterparts; this practice of “gender-rating” is prohibited for new plans beginning in 2014.  And for the first time, the ACA prohibits sex-based discrimination by all health programs and insurers that receive federal funding (or are administered by an executive agency like the federal Department of Health and Human Services).  We celebrate these important ACA victories for women and only wish they had happened sooner.

4) A new option for state family planning coverage.  The ACA also created the new Family Planning State Option which allows states to expand access to family planning services and supplies by electing to cover a new Medicaid eligibility category for individuals who need family planning services, but who do not qualify for full-scope Medicaid.  Before the ACA, states had to request permission from the Federal government through a “waiver” to provide this kind of coverage.  Waivers must be budget neutral, are temporary and allow states to limit enrollment or services to stay within specified caps on spending.  In contrast, the new Family Planning State Option allows states to incorporate this coverage into their permanent state Medicaid program and creates an entitlement (without enrollment caps) for all those who qualify, including men.  Better family planning coverage leads to better overall health outcomes for women and children and improves women’s educational and economic opportunities. Thank you, ACA, for creating another pathway to family planning access for these populations.

5) Required coverage of maternity care.  Not surprisingly, pregnancy is one of the most common and significant medical events experienced by women. And yet, according to a report by the National Women’s Law Center, a staggering 87 percent (!) of individual insurance plans do not cover maternity care.  The ACA requires that all new plans in the individual and small group markets, as well as new Medicaid and state “Basic Health” plans, cover maternity care as a part of the Essential Health Benefits package.  Under this change, millions of women will have access to affordable coverage for the services they need to stay healthy during pregnancy and safely give birth to healthier babies.  This incredible victory is more than deserving of the final spot in our Top 5.

On behalf of all of us here at NHeLP, for all of these and other important health care gains, we wish you a happy second birthday, dear ACA!  Here’s hoping that the Supreme Court allows us to celebrate many more.

Read more: http://www.momsrising.org/blog/5-ways-health-reform-supports-women/#ixzz1paRvx9r9

Be Sure to Thank the ACA on National Women & Girls HIV/AIDS Awareness Day!

Posted by Cindy Pearson, Co-Founder Raising Women's Voices for the Health Care We Need

This week, people throughout the country will focus on the serious threat to the health of women and girls posed by the HIV/AIDS epidemic. March 10 is National Women and Girls HIV/AIDS Awareness Day, and on that day national and local organizations working on women’s health and HIV/AIDS will hold community observances and educational events to raise awareness and catalyze action.  I encourage you to find out about an event near you and be a part of it.

More than 290,000 women in the U.S. are living with HIV and the proportion of women infected with HIV keeps rising - in 1985, women made up just 8 percent of all new U.S. HIV infections, but by 2009, women comprised 25 percent of new infections.  The growing impact of the disease is even more alarming for women of color.  Compared to white women, black women are 23 times more likely, and Latinas are 5 times more likely, to contract HIV.  
   
But despite the frightening trends of the epidemic, this year there has also been important progress made for women and girls that we can celebrate. Thanks to the Affordable Care Act (ACA), more women will be able to get the HIV testing they need without any extra charges or co-pays.  We know that about one in five people infected with HIV in the U.S. do not know they have it.  Without this information, people don’t get the treatment that can help them stay healthy, and many new infections are caused because people are unaware of their status.  We also know that co-pays for health services, even small charges, are a significant barrier to care.  In 2009, more than half of women delayed or avoided preventive care because of its cost.  Starting in August 2012, insurers will be required to cover HIV testing and other essential preventive services for women, without additional cost sharing, allowing more women to get tested.  

The ACA will also ensure that women and children living with HIV are able to get and keep affordable health insurance that makes it possible for them to get the treatment they need.  Currently, only 17 percent of those living with HIV have private insurance, and nearly 30 percent have no coverage at all.  The ACA has created a new insurance coverage option for HIV+ people by making it possible for people with pre-existing conditions, like HIV, to get insurance through Pre-Existing Condition Insurance Plans. In 2014, it will make it illegal for insurers to deny a person coverage because of a pre-existing condition, and this protection is already in place for children, meaning insurers cannot deny coverage based on a pre-existing condition for anyone 18 years old or younger.  And importantly for women facing the high cost of lifelong treatment for HIV, the ACA has eliminated lifetime limits on coverage, so insurers can no longer drop people with high health care costs after they hit a certain cap in dollars they spend on health services.  

So as you join with others on March 10 to recognize the terrible impact, of HIV/AIDS in the lives of women and girls, I hope you’ll also take a minute to say thank you Affordable Care Act for upholding your promise to provide more women with the health care we need.

I Heart the Affordable Care Act!

Written by: Sarah Murphy, intern at the National Women’s Health Network

My love affair with the Affordable Care Act (ACA) began almost two years ago, when it was signed into law and began fulfilling its promises to provide women with the quality affordable care we need to stay healthy. In particular, the ACA is doing great things to prevent chronic illnesses such as heart disease, which is responsible for one in four female deaths in America.

In honor of American Heart Month this February, I am professing my heart to the Affordable Care Act for helping ALL women’s hearts stay healthy!

How is the ACA doing this? For starters, the ACA has already starting requiring insurance companies to provide coverage of important preventive services without additional cost-sharing.  In the past, many women have delayed or avoided preventive care (more than half of all women) because of its cost – truly heartbreaking.  Research shows that coverage of essential preventive services like blood pressure and cholesterol screenings, diet counseling, obesity screening and tobacco cessation programs can decrease a woman’s risk of developing heart disease, thereby contributing to lower rates of heart disease which keeps more women healthy. 

In addition, the ACA provides for a special Prevention and Public Health Fund to help women lead healthy lives and develop healthy habits early on, which in turn will serve to prevent chronic illnesses such as heart disease further down the road. Money from this fund would have been spent on projects such as the “Putting Prevention to Work” initiative, which supports interventions regarding tobacco use, obesity prevention, improved nutrition, and increased physical activity.  Unfortunately, just this week, Congress cut the Fund by $5 billion, diverting the money for other initiatives and putting the long-term future of this provision of the law in question.

For women who already suffer from heart disease, the ACA promises to make sure that they can access and afford the care that they need. Beginning in 2014, insurance companies will not be able to deny coverage to women with pre-existing conditions, like heart disease, and until then the ACA provides women who have been denied coverage by the insurance industry the option of Pre-Existing Condition Insurance Plans that offer insurance coverage for those with pre-existing conditions.

My love of the Affordable Care Act will continue long into the future, as we see more and more health care benefits for women.  So, from my heart and millions of others, thank you ACA for upholding your promise to provide us with the health care we need to stay healthy!

For more important information on women and heart disease, please visit WomenHeart, the National Coalition for Women with Heart Disease.

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Hey Congress - We expect women to be treated equally!

President Obama stood strong on contraceptive coverage despite intense pressure from the U.S. Conference of Catholic Bishops (USCCB), but last week the struggle continued as conservative members of Congress rushed to the aid of the Bishops. 

The latest assault on women and contraceptive coverage came last week as the House Committee on Oversight and Government Reform held a hearing entitled “Lines Crossed: Separation of Church and State.  Has the Obama Administration Trampled on Freedom of Religion and Freedom of Conscience?"  The committee chairman, Darrell Issa (R-CA), allowed Republicans to submit eight witnesses (all of whom were men), and denied the Democratic witness, Sandra Fluke, the right to testify as a representative of the millions of women seeking access to safe and affordable coverage for basic preventive health care, stating that she is “not an appropriate witness.” 
 
Ms. Fluke, a student at Catholic-affiliated Georgetown Law School, was asked about her university’s freedom of religious conscience.  She responded, “We can only answer that we expected women to be treated equally, to have their medical needs met.”  Sandra, we couldn’t agree more because we know that a woman’s conscience matters the most in matters relating to her health and life! 

House member Rosa DeLauro, D-CT, had the right question about the hearing: "What I want to know is, where are the women?  I look at this panel, and I don't see one single individual representing the tens of millions of women across the country who want and need insurance coverage for basic preventive health care services, including family planning. Where are the women?"
 
In his turn in the spotlight at the House hearing, Bishop William Lori of Connecticut went so far as to suggest that requiring Catholic-affiliated institutions to cover contraception for their employees was like forcing a kosher deli to serve ham sandwiches.  Really? Basic preventive health care is the same as a ham sandwich? Funny how that food theme keeps cropping up.  The general counsel for the Bishops last week complained that while the USCCB is exempt from having to cover contraception for its employees, “if I quit this job and opened a Taco Bell, I’d be covered by the mandate.”
 
So the Bishops’ friends in Congress have introduced four bills that would allow any employer – including Taco Bells or kosher delis -- to deny employees coverage of any health care service based on religious or moral objections.  All four of the bills (S. 1467 Blunt/H.R. 1179 Fortenberry, S. 2043 Rubio/H.R. 3897 Chabot, S. 2092 Rubio-Manchin, and H.R. 3982 Luetkemeyer) nullify the contraceptive coverage rule issued under the authority of the Affordable Care Act’s  preventive care requirement. Each of the four bills has additional objectionable elements:

• S. 1467 and H.R. 3982 allow plans to refuse coverage for any essential health benefit, which would include maternity care, HIV/AIDS treatment, mammograms or cancer screenings;
• S. 1467, H.R. 3982 and S. 2092 allow employers to refuse coverage on a broad definition of “moral” grounds, not just religious grounds;
• S. 1467 and S. 2092 provides those individuals or entities a private right of action to protect violation of their rights of conscience in stripping away basic health care for women;
• H.R. 3982 would block the HHS regulation on preventive services from going into effect at all.

These outrageous proposals undermine the fundamental goal of the ACA -- to help more people be able to afford the services they need to stay healthy.  We need to tell Congress that women, regardless of where we work, should have health care insurance that covers the services we need.  

What difference does a co-pay make? Plenty!

What difference does a co-pay make?  Plenty!

I’m 57.  It’s been a long time since I’ve used contraception.   When I did use it, back in the last century, pills and other kinds of contraceptives were all very affordable.  If you picked up your pills at the drugs store and paid out-of-pocket – which is what you had to do back then since no insurance plans covered contraceptives – you might pay $5/month for a cycle of pills.  And if you were young or poor or both, it wasn’t hard to find a clinic that offered pills for $1/month.  Even though the minimum wage was only $3.35, pretty much everyone could afford to use contraception when they wanted. 

What’s it like now?  In a word – bad.  Most contraceptives are so expensive that I honestly don’t know a single person who tries to pay the full cost of a prescription contraceptive out-of-pocket.  It’s true that women with insurance are now much more likely to have coverage for contraceptives than back in the old days.  But sadly, as coverage has expanded, co-payments have gone up.  Way up.

My 21-year old daughter and her friends are facing co-payments that are so high, there’s almost no way these young adults can earn enough to pay for contraception … assuming that they’re also paying for rent, food, transportation and all the other costs faced by young adults.  Yes, it’s true that the minimum wage has more than doubled since the last time I was a regular contraceptive user.  But what’s happened to costs?  Have they doubled, too?  Hardly!  My daughter’s friends are being charged $40/month co-payments when they buy their pills at the drugstore.   Even student health centers, traditionally a go-to place for low-cost prescriptions, are charging $20/month co-payments.   And don’t even get me started about the cost of IUDs!  Would you believe $800 for the device itself, not including the practitioner’s fee?

I’m angry at pharmaceutical companies for charging such outrageous prices.  And as a leader of a consumer advocacy group, I can promise you that we’ll keep putting pressure on these companies.  But in the meantime, we need to rally round the administration’s new rules that require insurance companies to cover contraception without any additional fees like co-payments or deductibles.   It’s the best chance we have, right now, to make sure that costly co-pays don’t stand between a woman and the contraception she needs. 

Part of the #HERvotes blog carnival.

Our voices were heard!

After reviewing more than 200,000 comments from the public – many of them from RWV supporters like you!-- HHS Secretary Kathleen Sebelius announced earlier today that almost all employers will have to include coverage for women’s preventive health services, including contraceptive services, starting in August 2012.  The administration, which had faced criticism from religiously affiliated organizations that do not currently cover contraception, announced that it will allow those organizations an additional year, until August 2013, to come into compliance.   This new rule requires insurers to offer policies that cover important preventive services with no extra fees, such as co-pays and deductibles. 

This is a huge and important victory for women.  The US Conference of Catholic Bishops and a few other religious leaders were lobbying the administration to create a broader exemption, allowing them to continue to deny women who work for a wide range of organizations affiliated with religious institutions coverage for comprehensive reproductive health services.  But thanks to you, HHS heard from more than just conservative religious leaders.  Women like you spoke out and told them just how important these services are to our health. 

Raising Women’s Voices for the Health Care We Need told HHS that we believe that women deserve full coverage of all their health needs, regardless of where they work, and HHS listened.  The administration’s decision maintains the narrow exemption for churches and religious organizations that serve primarily members of their own faith, rather than broadening the exemption as the bishops had urged.  It affirms the rights of the vast majority of women to make their own decisions about their health, while giving religiously affiliated organizations that currently don’t provide contraceptive coverage an extra year to comply with the requirement.

The preventive health services to be covered with no extra fees include comprehensive contraceptive care, screening and counseling for intimate partner violence, screening for gestational diabetes, breastfeeding counseling and equipment, screening for sexually transmitted infections (STIs) and a well-woman preventive care visits once a year. The requirement that all FDA approved methods of contraception be covered includes both long-acting methods such as the IUD and emergency contraception (EC).

You can read the formal announcement, here.

And you can send a new thank you to HHS by clicking here!