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Radical Trumpcare bill is gaining speed!

We’re back on high alert for the most radical Trumpcare bill yet!
Last week, we warned that Senate Republicans might make one last push to repeal the Affordable Care Act (ACA) and gut Medicaid before they run out of time. This week, we’re moving to red alert in response to reports that Republican leadership is gearing up for a vote the week of September 25, and a possible sham hearing before then.
Now is the time to call, write and rally to urge senators to reject this new threat! Tell them to instead support a bipartisan package to stabilize the insurance markets and fund the cost-sharing reductions that make coverage more affordable for many of us. You can call Congress toll-free at 844-898-1199.

The bill is known as Graham-Cassidy-Heller-Johnson for its sponsors—Senators Lindsey Graham (R-SC), Bill Cassidy (R-LA), Dean Heller (R-NV), and Ron Johnson (R-WI). This legislation is being sold as a “compromise” and “non-partisan” solution, even though no Democrats support it. Not only is Graham-Cassidy not a compromise, it is the most radical proposal yet.  The bill goes far beyond Republicans’ campaign pledge to repeal the ACA, including Medicaid expansion. This measure also attacks long-standing traditional Medicaid.  
Republicans have only two weeks to ram through repeal with just 50 senators, plus the tie-breaker vote from Vice President Mike Pence. That’s because on September 30, when the current fiscal year ends, the special process known as “reconciliation” will turn back into a pumpkin and Republicans will once again need 60 votes to overcome a filibuster on any health care package.
Medicaid and the ACA
What’s at stake for women and families in the Medicaid portion of this latest Trumpcare bill? Traditional Medicaid, enacted in 1965, is sometimes described as “low-income and...” because to qualify, an individual must fit into a second category—such as low-income and pregnant, low-income and disabled, low-income andelderly.  Prior to the ACA, simply living below the poverty line wasn’t enough to qualify for coverage in most states, so millions of low- and middle-income adults had no access to health insurance.
The ACA, enacted in 2010, increased coverage in two ways. First, for those living below 138 percent of the federal poverty level, the ACA expanded Medicaid, giving low-income adults who didn’t otherwise qualify for Medicaid the same guarantee of high quality coverage. The ACA as written made the Medicaid expansion mandatory for all states, but in 2012 the Supreme Court made it optional. Nineteen states have refused to expand, leaving millions of their residents in a coverage gap. The intra-party battle in Congress this year has been heavily influenced by the dispute between the Republican governors who responsibly covered their constituents by expanding Medicaid and those who didn’t and now want to be rewarded by the party for fighting “Obamacare” at the expense of their constituents and state budgets.
The second way the ACA expanded coverage was by helping low- and moderate-income households living over the federal poverty line buy private health insurance in the individual market. The ACA subsidizes both premium expenses and out-of-pocket costs like co-pays and deductibles.
Under current law, everyone who is eligible for Medicaid or for financial help purchasing private coverage is entitled to it. That coverage guarantee means that the programs are flexible enough to respond to economic downturns, natural disasters, rising medical costs, and an aging population. By contrast, Graham-Cassidy would end these guarantees for both Medicaid and the ACA.

Graham-Cassidy Guts Traditional Medicaid
Graham-Cassidy would replace traditional Medicaid’s 50-year federal-state partnership with a cap-and-slash system designed to cover less and less each year. Under current law, Medicaid automatically adjusts when public health crises like those resulting from Hurricanes Harvey and Irma suddenly drive up per-person costs. But under Graham-Cassidy, once the federal per-person spending cap has been reached, federal funding cuts off. And natural disasters aren’t the only variables sure to raise costs.
The Center on Budget and Policy Priorities (CBPP)  warns that under a per capita cap, “federal funding [in traditional Medicaid] for seniors, people with disabilities and families with children would no longer automatically increase to account for higher costs such as prescription drug price spikes or rising costs resulting from an aging population. States would be responsible for 100 percent of all costs above the cap.”
So how does Graham-Cassidy expect states to cope with these huge cuts? By dropping coverage (like prescription drugs) and dropping people (like pregnant women) that they are currently required to cover.
Graham-Cassidy Repeals the ACA and Replaces It with … Nothing
Starting in 2020, Graham-Cassidy completely eliminates the ACA’s Medicaid expansion and subsidies for purchasing private insurance. As Cassidy himself tweeted, Graham-Cassidy “repeals entire architecture of Obamacare.”
In its place, the bill calculates how much money the federal government would have spent on ACA programs, cuts that by over one-third, and then redistributes the much smaller pot as block grants to the states with few strings attached. While the ACA includes consumer protections that prevent insurance companies from selling worthless “junk” insurance, rescinding coverage the moment someone gets sick, or discriminating against people with pre-existing conditions,Graham-Cassidy gives states free rein to reinstate all of the worst insurance practices of the bad old daysThat means insurance companies could once again charge non-smoking women more than smoking men, treat rape and domestic violence as pre-existing conditions, and reinstate annual and lifetime caps on coverage.
Even worse, there’s no requirement that states actually spend the money on providing coverage to low- and middle-income families. States would be free to spend the money on any purpose tangentially related to health care, and could design programs that discriminate against women, people of color, immigrants, LGBTQ people and other marginalized communities.
Initially, the 19 states that have thus far refused to expand Medicaid—leaving millions of their residents without care—will get an increase in ACA dollars by taking money away from the states that covered their residents. While the bill’s formula for distributing funds is complicated, it can be summed up in under 140 characters, as tweeted by conservative Senator Rand Paul (R-KY): “#GrahamCassidy … redistributes money from dem states to republican states.”
But even many of those Republican states will actually still face deep cuts once the per capita cap on traditional Medicaid is factored in. Analysis by CBPP finds that all but eight states will lose millions to billions of dollars under Graham-Cassidy in the years between 2020 and 2026.
But, no state will benefit for long. That’s because after 2026 under Graham-Cassidy, traditional Medicaid will be reduced by over one-third, while the ACA-turned-block grant funding will disappear altogether to be replaced with… nothing. That’s right, starting in 2027, the bill eliminates every last dollar spent on the ACA.
Finally, the bill once again attacks the ability of women and men to use Medicaid or other forms of government health insurance at Planned Parenthood for services like cancer screenings, STD treatments, family planning services like birth control, and more.

What’s Happens Next?

Senator John McCain (R-AZ), who dramatically voted against an ACA repeal in July out of concern that the bills hadn’t gone through “regular order”—including a bipartisan process of committee consideration—has said that he supports the bill (bill sponsor Graham is his best friend).  But he has hedged about whether he could support it in absence of a committee process. In response, bill co-sponsor Johnson told the press, “I’m chairman of Homeland Security. If either the Finance Committee or HELP committees [with jurisdiction] won’t hold a hearing, I’ll [set up] one this afternoon,” simply to check that box.

Under Senate rules, Graham-Cassidy will need a budget “score” from the Congressional Budget Office (CBO) and a “Byrd bath” from the Senate parliamentarian—the process of determining whether individual provisions qualify under the “Byrd rule,” which limits what can be included in a reconciliation package. Republican leaders are pushing for a partial CBO score by next week, one that shows the fiscal impact but not the number of people harmed by cuts to their care.
Should Republicans secure 50 votes on Graham-Cassidy or any other Trumpcare proposal, they will be able to pick up from where they left off in July, with all debate time expired and only the rapid-fire amendment process known as vote-a-rama left. In other words, some of the most consequential legislation in our nation’s history, affecting one-fifth of our economy, could get a vote after only 5 minutes of debate on the Senate floor.
If we can prevent the Senate from passing repeal legislation before September 30, we will have blocked their ability to pass Republican-only health care legislation for the foreseeable future. But if the Senate passes Graham-Cassidy, the House faces no similar time limit on their ability to pass the bill. They could—and likely would—move to immediately take up the Senate bill and pass it without changes, sending it to Donald Trump for signature. But they could also use the remaining 15 months of this Congress to pressure blue state Republicans to vote for the bill and stymying hope for a bipartisan package.
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This week’s view from Washington, D.C

This week’s newsletter will be shorter than usual as we get ready for our annual convening in Washington, D.C. this week, when Raising Women’s Voices regional coordinators from around the country gather to discuss the months and year ahead. We’re excited to bring together so many different voices and perspectives at a time when the challenges facing us are so many!

But first, a quick update on what is happening in Washington, where conservatives still hope to beat the odds and push through a Trumpcare bill before the clock runs out on September 30 --  even as a bipartisan group of senators is working on a bill to stabilize health insurance markets upended by Trump’s sabotage.

Watching Graham-Cassidy bill as a “sleeper” threat

We wrote last week about the Graham-Cassidy bill, which is the last standing threat to repeal of the Affordable Care Act (ACA). The bill would turn the ACA and Medicaid’s guarantee of coverage into state-based block grants that cover millions fewer people, and would eliminate altogether both the Medicaid expansion and the ACA’s subsidies for private insurance after 10 years. The bill is expected to be released later this week after its initial introduction date of Monday was delayed. It is being backed by the White House and the House Freedom Caucus, but faces opposition from at least one Senate conservative after Senator Rand Paul (R-KY) announced this week that it doesn’t go far enough for him.

It’s clear that the bill doesn’t yet have the votes, and a number of Republicans are eager to set aside health care and move onto tax reform. But we will be monitoring it as a sleeper issue right up until 12:01 am October 1, when the current reconciliation process (allowing passage with only 51 votes, instead of the usual 60-vote requirement) loses its privilege on the Senate floor.
Work continues on bipartisan health coverage stabilization package

Meanwhile, there’s quiet optimism about the bipartisan package being crafted by the chairman and ranking member—Senators Lamar Alexander (R-TN) and Patty Murray (D-WA), respectively—of the Senate Health, Education, Labor & Pensions (HELP) Committee, even as a number of sticky issues remain. 

In August, CBO concluded that failure to fund the cost-sharing reduction (CSR) payments that lower out-of-pocket costs for low-income consumers payments “would increase the federal deficit, on net, by $194 billion from 2017 through 2026,” by driving up premiums and automatically increasing federal premium subsidies. A number of insurance companies have warned that they won’t participate in the health care marketplaces at all without a guarantee that the payments will be made. Most importantly, Republican leadership in Congress appears to have accepted that the payments must be made in order to stave off voter outrage.

In the ongoing negotiations, Republicans want to provide only a single year of CSR funding while Democrats argue that true stability demands a multi-year investment. At the same time, Republicans want Democrats to support unwinding key consumer protections in exchange for CSR money.
Senator Murray has been adamant that Democrats “will reject any effort to use this process as a back door to pass parts of Trumpcare that would erode protections for people with preexisting conditions — for example, women seeking maternity care or those with mental illness or substance-use disorders.” It’s likely that Democrats have the upper hand in negotiations. With a sizable block of Republicans in both chambers likely to oppose a deal no matter what, Republican leaders will have to depend on Democratic votes for passage, which should give Democrats significant leverage over the final deal.

Some of our regional coordinators will also be paying visits to their members of Congress while they are in DC this week for the RWV annual convening. We will be eager to hear what they learn.
Watch for next week’s newsletter, which will give highlights of our convening!





Trump is back, and we’re fighting back!

Just back in Washington from his summer vacation, Donald Trump is already busy using the power of the presidency in ways that will harm marginalized people – young immigrants who dream of citizenship and uninsured people who desperately need affordable health coverage.
This week, Trump announced that over the next six months, he will end the Deferred Action for Childhood Arrivals (DACA) program initiated by President Obama. DACA has allowed hundreds of thousands of young immigrants brought to the U.S. as children (often referred to as “Dreamers” for the DREAM Act, which would provide them with a pathway to citizenship) to gain work permits and live their lives free from the threat of deportation.
Unless Congress takes action, the DACA announcement will not only be a looming humanitarian crisis, it will also be a health crisis. Over 90 percent of the Dreamers surveyed in a recent study are currently employed, and hundreds of thousands of them get their health insurance through their employer. So, loss of their work permits will mean loss of their health care.

We express our solidarity with the thousands of activists throughout the country who have mobilized to defend the Dreamers and all of the undocumented people who face harassment and deportation. Raising Women’s Voices staff joined a protest march to Trump Tower in New York City last week, in anticipation of his action on DACA. Some of our signs are shown above. Our resolve for action was perfectly captured by two of our regional coordinators.

“We will continue to speak out and to organize and to fight any policy or any decision that will undermine our health, dignity and rights,” said Cristina Aguilar, Executive Director of the Colorado Organization for Latina Opportunity and Reproductive Rights (COLOR). “Immigrants are here to stay. A strong, vocal, organized Latinx community is here to stay in this fight. We are not going anywhere.”
California Latinas for Reproductive Justice (CLRJ) released this statement: “Today CLRJ continues to stand strong and follow the lead of immigrant youth, who consistently put their lives on the line, to fight for all immigrants - queer, black, trans, low-income, and other immigrants who are deemed “unworthy” by U.S. immigration policies. Let us be clear, a person’s worth is not determined by their economic contribution, their age at entry, or any other category that defines their status. We will fight for immigration reform that fulfills our dream to be with our families, for the 800,000 DACA recipients and for ALL 11 million undocumented people. We will accept nothing less.”

 Meanwhile, Trump is sabotaging our health coverage
As part of its wholesale attempt at sabotage of the ACA, Trump’s Department of Health and Human Services (HHS) announced late last week that it would only spend $10 million on nationwide advertising of the 2018 open enrollment period—down from $100 million the year before. In addition, HHS would cut the amount spent on in-person outreach through the federal navigator program by 41 percent. As Vox reported, “Those in-person outreach efforts also ensure that vulnerable populations, like those that don’t speak English or lack internet access, can still enroll. Instead of making Obamacare more robust and inclusive, they’re setting the law up to fail.”
Trump’s demand that Senate Republicans hold another Trumpcare vote was given extra urgency after the Senate parliamentarian ruled on Friday that the special expedited process (known as budget reconciliation) that Senate Republicans had hoped to use to repeal the ACA with just 51 votes would die with the end of the current fiscal year on September 30. Senators Lindsey Graham (R-SC) and Bill Cassidy (R-LA) have been pushing a radical proposal that would turn the ACA and Medicaid’s guarantee of coverage into state-based block grants providing less than two-thirds of the current federal commitment to health care funding. The bill would completely eliminate both the Medicaid expansion and the ACA subsidies for private insurance after ten years.
While the crowded Senate to-do list makes action before September 30 difficult, a short-term deal announced on Tuesday between the White House and congressional Democrats to raise the debt limit and make a down payment on disaster relief funding could open the door for Republicans to make one last Trumpcare push. This time, they have locked up the vote of Graham friend Senator John McCain (R-AZ), who told reporters this week that despite his impassioned pleas for a return to “regular order” process of bipartisan committee hearings and careful deliberation, he would still vote for the proposal, even if leadership rushed it through.

Should Republicans secure 51 votes on Graham-Cassidy or any other Trumpcare proposal, they will be able to pick up from where they left off in July, with all debate time expired and the rapid-fire vote-a-rama on amendments under way. In other words, some of the most consequential legislation in our nation’s history could get a vote with no committee consideration and only 5 minutes of debate on the Senate floor.
Fortunately, there was also a hint of positive news this week as the Senate Health, Education, Labor & Pensions (HELP) Committee began its first round of bipartisan hearings over the next ten days to help craft a bipartisan deal to stabilize health insurance marketplaces before September 27, when insurance companies must sign final contracts. Republicans had hoped to avoid giving insurance experts a chance to publicly unwind their most dishonest talking points by ramming a Trumpcare package through Congress without hearings, but this week state insurance commissioners were finally given the chance to knock down falsehoods and to urge Congress to fund the cost-sharing reduction (CSR) payments that Trump has repeatedly threatened to withhold. For example, Theresa Miller, Pennsylvania’s insurance commissioner, testified that “the narrative that Obamacare is imploding is just false,” while Mike Kreidler, Washington State’s commissioner, compared not permanently funding CSR payments to yelling ‘fire’ in a crowded theater.

We’ve been keeping the pressure on Congress
While members of Congress were in their home districts for the recess, some of our regional coordinators and national allies participated in visibility events and district meetings to send a message that our health coverage must be preserved.

The Save My Care Drive for Our Lives bus hit the road again, touring the country to highlight the stories of people whose lives on are the line if the ACA is repealed. Among some of its final stops were in Charleston, West Virginia, and in West Orange, New Jersey. RWV regional coordinators WV FREE and New Jersey Citizen Action (NJCA) both showed up to welcome the bus to their state, and to highlight the impact ACA repeal would have on local women and families. 

WV FREE staff Chela Barajas, Julie Warden and Amanda Schwartz (pictured above from left to right) were at the August 24 Drive for Our Lives bus tour stop in Charleston, WV
At the September 1 bus stop in West Orange, New Jersey, NJCA and partners Health Professionals & Allied Employees (HPAE), Blue WaveNJ, NJ Assemblywoman Mila Jasey (D Essex/Morris), local host Pastor Miquel Hernandez and 50 community members, pictured below, welcomed the tour’s crew and speaker Ilyse Hogue, President of NARAL. The rally called on Republicans to recognize health care as a human right.  NJCA Health Care Program Director Maura Collinsgru issued a call to action urging people to continue the fight to save the ACA and join with NJCA in promoting the upcoming open enrollment saying, “boosting enrollment is the best defense we have against repeal.”  See a video of the event, including Maura’s full speech here

Meanwhile, RWV’s Memphis-based regional coordinator,SisterReach, took advantage of the August recess by meeting with some of their members of Congress in-district. As part of their Reproductive Justice Week of Action (August 22-24), SisterReach hosted a legislative day of action where they met withCongressman David Kustoff’s (R-TN 8) staff about the importance of fixing, rather than dismantling the ACA. SisterReach also held a policy briefing -- Our Bodies, Our Lives, Our Voices: The State of Black Women and Reproductive Justice Policy -- with Congressman Steve Cohen (D-TN 9), where they applauded his efforts defending the ACA.  London Lamar, SisterReach’s Policy Associate, is shown on the right in the photo.



Advancing reproductive and racial justice in conservative states

See what RWV coordinators in conservative states have been doing!

With images of white supremacists marching in Charlottesville fresh in our minds, Raising Women’s Voices is more committed than ever to fighting for reproductive and racial justice. Our founding mission states that we want to raise the voices of those who are often marginalized and left out of health care policymaking, including women and LGBTQ people of color, immigrants and our families. One of the ways we are pursuing that mission is through funding and supporting groups in conservative states that are working for reproductive and racial justice. This week, we are proud to share some of what they have been doing this year!

The Afiya Center, the Raising Women’s Voices regional coordinator in Dallas, TX, has been working hard to promote reproductive justice in a state with a hostile political climate.

One of the legislative priorities championed by the Afiya Center took an important step forward late last month. On July 31, the Texas House of Representatives passed HB 11: The Texas Moms Matter Act, a piece of legislation to address the maternal mortality crisis in Texas. Afiya Center Executive Director Marsha Jones, third from left in photo, celebrated House passage of HB 11 with the bill's sponsor, Representative Shawn Thierry (D-Houston), second from right, and legislators and advocates.

The Texas Moms Matter Act will create a Maternal Mortality and Morbidity Task Force within the Department of State Health Services to review cases of pregnancy-related deaths and trends in severe maternal morbidity, which has disproportionately affected Black women. The Afiya Center hosted a press conference addressing the maternal mortality crisis in Texas, encouraged supporters to attend hearings and drove out calls to state representatives and senators demanding they support The Texas Moms Matter Act.

Earlier this year, the center hosted a #TXBlackWomenRiseUp Advocacy Weekend attended by women of color advocates and allies, as well as supportive state legislators. The weekend included a rally with abortion provider and activist Dr. Willie Parker and other reproductive justice leaders, a screening of the documentary film TRAPPED and an advocacy training before hill visits the next day to the state capitol building in Austin. Advocates distributed information on the ACA and Medicaid, and other laws that would impact Black women, maternal health, women with HIV and LGBTQ individuals.

With so much at stake for states, governors and state legislators have played an outsized role this year in the national fight over the future of the ACA and Medicaid. The Afiya Center also took their message directly to Congress, meeting with the offices of Representatives Eddie Bernice Johnson and Marc Veasey and Senators Ted Cruz and John Cornyn, and attending Representative Joe Barton’s town hall in Mansville, TX, speaking up in defense of the ACA and Medicaid. 

Meanwhile, SisterReach, the RWV regional coordinator in Memphis, TN, has laid the groundwork for a model of intersectional partnerships, taking a regional approach to building reproductive justice (RJ) power in the South. Earlier this year, they initiated a cross-state coalition, the Deep South Regional Round Table, to build RJ power across Tennessee, Mississippi, Arkansas, Kentucky and Alabama, with a focus on priorities such as opposing religious exemptions that allow health providers and employers to deny care and coverage, criminal justice, and reproductive and healthcare justice.

SisterReach was also active in the fight to save the ACA and Medicaid, co-leading the Save My Care Bus Tour’s Memphis stop, and hosting a “Black Folks on the Hill” day at the Tennessee state capitol in Nashville.  SisterReach provided training, exposure to legislative committee and caucus meetings, and helped their participants meet legislators and staff in six offices. The photo shows SisterReach CEO & Founder Cherisse Scott, staff and volunteers posing with State Representative G.A. Hardaway Sr. during Black Folks on the Hill Day.

In Louisiana, Women With A Vision, one of two RWV coordinators based in New Orleans, held RJ roundtables in New Orleans, Baton Rouge and Lafayette to discuss health issues important to Black women, including ACA and Medicaid expansion. Then they took those messages to the state capitol, bringing low income Black women and LGBTQ individuals from across the state to Baton Rouge for an advocacy day focused on Black women’s issues. “Our Voice Our Time:  Black Women’s Advocacy Day” was attended by over 50 women, who met with state legislators and their staff to discuss the impact of Medicaid expansion on women in Louisiana. WWAV trained the participants on how to advocate for health care, ACA and Medicaid, and provided swag bags with educational information related to policy advocacy as well as t-shirts, fans and pens. Shown below are “Our Voice Our Time” attendees posing in their pink WWAV shirts at the state capitol in Baton Rouge.

WWAV also participated in RWV’s #IfILoseCoverage social media campaign, asking women across the state to describe the effect ACA repeal would have on their lives. They gathered stories highlighting women’s fears about losing their choice of when to reproduce, not being able to receive their medication, decrease in standard of life, fear of losing preventive health services and not being able to manage chronic illnesses. 

On the other side of the country in Phoenix, AZ, RWV regional coordinator Trans Queer Pueblo convened an organizing institute in May, during which supporters, board members and staffers discussed “know your rights” training, health justice, and economic justice. A second convening is planned to train new members in leadership development and enhance their ability to activate communities. TQP uses promotora leaders, or community health educators, to speak with LGBTQ people and migrants about the importance of health care.  With the support of RWV, TQP brought on board three promotoras this year in time for TQP’s first organizing institute to learn effective organizing. 

The promotoras are tasked with outreach to the immigrant community to encourage use of the LGBT-friendly primary care clinic, Clínica Liberación, which Trans Queer Pueblo created.  Trans Queer Pueblo continues to grow support for their clinic and organization through hosting monthly activities like volleyball and sex-ed trivia with Planned Parenthood and healing circles.

This year, TQP also joined Joti-PolitcAZ, a coalition tracking state legislation affecting health and other issues impacting the LGBTQ community. TQP put together an advocacy workshop for their membership, hosted small community gatherings and fought back against Donald Trump’s tweets to block trans military servicemembers from serving. They made news in Phoenix during the annual Pride Parade when they temporarily shut down the parade to highlight the ways in which the movement has failed to ensure the rights of trans and queer migrants, bringing the issue national attention.  Shown in photo are Trans Queer Pueblo leaders Cyntia Domenzain Mejía and Karyna R Jaramillo protesting at the Phoenix Pride.


While fighting ACA repeal, we’ve been busy protecting our health in the states

For months, we’ve been highlighting Raising Women’s Voices work opposing efforts by Congress and the White House to repeal or replace the Affordable Care Act (ACA). Now that we have a brief pause in the action, after the Senate repeal/replace efforts failed spectacularly, we want to share with you some of the amazing work our Raising Women’s Voices regional coordinators have been doing to protect the health of diverse women, LGBTQ people and our families at the state level.

Oregon passes Reproductive Health Equity Act and Cover All Kids Act

Our Raising Women’s Voices regional coordinator based in Portland, OR, the Oregon Foundation for Reproductive Health, celebrated a major reproductive health win with the successful passage of the Reproductive Health Equity Act. This comprehensive piece of legislation will ensure access to reproductive health care for everyone in Oregon, regardless of income, type of insurance, citizenship status or gender identity. The bill will provide the full scope of reproductive health care, including contraception and abortion, with no cost-sharing. Notably, it will extend post-partum care to about 48,000 Oregonians of reproductive age, including undocumented immigrants, who have coverage for labor and delivery that drops immediately after birth.

The Reproductive Health Equity Act was part of a larger policy agenda of Fair Shot for All, an initiative with the goal of achieving greater health equity in Oregon. Just last week, the Cover All Kids act (SB 558), another Fair Shot legislative priority, was signed into law. With its passage, Oregon became the seventh state in the country to extend health coverage to all children, regardless of their immigration status. 

RWV coordinators push for contraceptive coverage protections, expansion

RWV Regional coordinators have been joining with allies in more progressive states to advocate for policies that would secure the ACA’s contraceptive coverage protections and even improve on them. Both Washington and Colorado approved legislation that will improve access to contraception by allowing for the dispensing of 12 months of contraception at one time. Colorado Organization for Latina Opportunity and Reproductive Rights (COLOR), RWV’s Denver-based RC, and Northwest Health Law advocates (NoHLA), our Seattle-based regional coordinator, played critical roles in the successful passage of these bills. COLOR was present as Governor John Hickenlooper (shown at right) signed HB 1186 into law at the state Capitol.

Twelve-month dispensing policies align with recommendations from the Centers for Disease Control and Prevention, which state that providers can promote the consistent use of contraception by providing or prescribing multiple cycles of contraceptives at a time. A 2011 study found that dispensing a one-year supply of contraceptives (as opposed to a three- or one-month supply) is associated with a 30% reduction in the likelihood of an unplanned pregnancy.

RWV regional coordinators in a handful of states -- including CT, MA, MN, NM and NY -- worked to build support for contraceptive equity bills that would codify the ACA’s contraceptive coverage requirements into state law, thereby ensuring that women have access to the full range of FDA-approved contraceptive options with no cost sharing.  Bills to accomplish that goal were enacted last year in Illinois and Maryland with the support of our regional coordinators.  While none of the proposed bills in other states were enacted this year, our regional coordinators reported they made good progress in communicating the need for these policies and are looking forward to 2018 state legislative sessions to renew their efforts.

New York protects reproductive health coverage through regulatory action

In New York, the Cuomo Administration responded to requests from Raising Women’s Voices-NY and other  women’s advocacy groups for state-level action to protect New York’s women from attacks on reproductive health coverage by Congress and the Trump administration. The governor issued regulations to expand contraceptive coverage protections in the state. These regulations, which are less comprehensive than the proposed Comprehensive Contraceptive Coverage Act, which RWV-NY continues to support, were finalized in June. They require coverage without co-pays for one type of contraception in each of the 18 FDA-approved categories (the federal ACA standard), and allow for the dispensing of 12 months of contraception after an initial three-month allotment (June 28, 2017 Register: Page 13, Notice of Adoption).

In addition, the Cuomo Administration finalized another regulation that requires private insurance coverage for medically necessary abortions without cost sharing (June 21, 2017 Register: Page 18, Notice of Adoption). While the draft regulation included an overly broad religious exemption – which would have followed the disturbing national trend of allowing employers to use their personal religion to discriminate against employees – the finalized regulation includes a much narrower religious exemption. The change came in response to hundreds of comments that individuals and organizations like RWV-NY submitted in support of the proposed regulations, and urging the Administration to narrow the scope of the overly broad religious exemption.

More recently, the Cuomo Administration proposed a rule that would require insurance carriers offering health plans in New York’s individual and small group market to cover the ACA’s 10 Essential Health Benefits, which include vital services for women, such as maternity care. The emergency/proposed rule also includes a non-discrimination provision, which includes discrimination based on race, color, creed, national origin, sex (including sex stereotyping and gender identity), age, marital status, disability and preexisting conditions. RWV-NY has joined other members of the Health Care for All NY coalition in praising these proposed measures, but urging the addition of sexual orientation to the non-discrimination policy.

Preserving funding for Planned Parenthood at the state level

Since many of the GOP’s proposed ACA repeal bills included provisions that would defund Planned Parenthood, our coordinator in Maryland, Consumer Health First, worked to successfully advocate for the passage of HB 1083 – Family Planning Services – Continuity of Care. Maryland is the only state in the country to proactively address the threat to women’s health in the event that the federal government revokes funding under Title X, the national family planning program. The bill directs $2.7 million in state funding to establish a Family Planning Program at the Department of Health and Mental Hygiene. This ensures that patients can continue to access these providers, including Planned Parenthood.

RWV will continue to fight for our health at the state level!

Given the continued federal threats to our health, it is critical that states serve as leaders in ensuring access to reproductive health care. RWV and our regional coordinators will continue to work to protect women, LGBTQ people and our families from harmful federal policies that threaten our well-being.