National Women's Law Center

A Platform for Progress

Building a Better Future for Women and Their Families

IMPROVING WOMEN'S HEALTH

Guaranteeing Accessible, Comprehensive Health Coverage

More than 17 million women in the United States do not have any health care coverage. Although men and women face some similar challenges with regard to health insurance, the need for health care is even greater for women than men – women of all ages are nearly 40% more likely than men to take prescription medications on a regular basis and women between 19 and 64 years old have higher rates of disability, more reproductive health care needs, more chronic conditions and more mental health care needs than men. Because of these greater health care needs and women’s lower income, more women than men are “underinsured,” meaning they have health insurance that requires them to spend more than 10% of their income on out-of-pocket costs. Women are also more likely than men to delay or forgo necessary care due to prohibitive costs, which leads to greater health care costs later in life.

To meet the health care needs of women and their families, health reform should ensure that our nation’s health care system meets basic standards and fulfills certain principles: the system should be simple to use and understand; be sufficiently and fairly financed, and leave no one out. The system should guarantee patients a choice of doctors and health care providers, as well as the option of a publicly run health plan. There must be adequate provider reimbursement and steps taken to address provider shortages in both rural and urban areas. Health reform proposals must:

Ensure Equity in Health Care Coverage. Health reform must ensure there are no gaps in access to care, and work to root out disparities in health care access that currently exist. An unacceptable 18% of all women are uninsured, and nearly 23% of Black Non-Hispanic women, 35% of American-Indian/Native Alaskan women and 38% of Hispanic women are without coverage. Reform plans must ensure that care is available for patients who have diverse cultural and linguistic needs. Regardless of age, race, gender, disability, geographic location or employment status, there must be equity in health care access, treatment, research and resources.
Ensure that Health Care is Affordable for All. Health reform should ensure that individuals, as well as businesses and employers, have affordable and more predictable health costs. Currently, more than one in four women report being unable to pay their medical bills. Health insurance premiums should not be based on factors such as gender or health status. Rather, premiums—as well as out-of-pocket health costs like copayments and deductibles—should be based on a family’s ability to pay for health care.
Ensure Comprehensive Benefits. Health reform should ensure comprehensive coverage of health care services that people need both to stay healthy and to be treated when they are ill—regardless of the individual’s stage of life. This includes coverage of preventative services; a full range of reproductive health services including abortion; treatment needed for serious and chronic diseases and conditions; and appropriate end-of-life-care.
Build Accountability Into Any Health Care System. Any plan for health reform should include a “watchdog” role for government to ensure that risk is spread fairly among all health care payers and that health insurance companies do not improperly delay or deny coverage for health care, turn people away, establish or raise rates, or drop coverage based on a person’s health history, age or gender.
Effectively Control Health Care Costs. The current rate of growth in health costs is unsustainable. Between 2000 and 2006, health insurance premiums increased 87% - more than four times as much as wages during that time. Health reform should address the rising cost of insurance premiums, as well as adopt effective cost controls that promote quality, lower administrative costs and provide long-term financial sustainability. Provisions should include use of standard claims forms, secure electronic medical records that adequately protect patient privacy, the use of the public’s purchasing power to instill greater reliance on evidence-based protocols and lower drug and device prices, and better management and treatment of chronic diseases.

Promoting Health

Enactment of comprehensive health reform legislation could meet some of the health care needs addressed by the programs below. But even with the enactment of comprehensive health reform legislation, some programs for research, education and targeted health services for certain populations will be needed to ensure that all women can lead healthy lives.

Increase Funding for Research and Programs that Help Prevent and Treat Health Risks for Women and Their Families. Congress should provide additional funding for:
- Research on key women’s health issues, including cardiovascular disease, stroke, lung cancer, breast cancer, diabetes, HIV/AIDS, arthritis, violence against women, sexually transmitted diseases, depression and eating disorders
- The Pregnant and Postpartum Women and Their Infants Program, which provides comprehensive, family-based treatment for substance abusing mothers and their children
- WISEWOMAN (Well-Integrated Screening and Evaluation for Women Across the Nation), which provides heart-disease screenings, interventions and important health information to low-income women
- Part D of the Ryan White CARE Act, which provides coordinated, family-centered healthcare and support services to women, children, youth and families living with HIV/AIDS
- The Gynecologic Cancer Education and Awareness Act (Johanna’s Law), which provides information to women and the medical community regarding the signs and symptoms of gynecologic cancers to improve early detection rates
Strengthen and Protect Offices on Women’s Health. Offices of Women's Health are located in agencies across the U.S. Department of Health and Human Services (DHHS) to serve as the government's champion and focal point for women's health issues. These offices ensure that women’s health needs are at the center of our nation’s health care agenda. Unfortunately, few of these offices are permanently authorized in federal law, and many lack the formal authority to do their important work most effectively. Congress should enact the Women’s Health Office Act, which provides permanent authorization for offices and positions of women's health in each of the federal health agencies.

Promoting Reproductive Health and Rights

Women’s ability to make important life decisions about whether and when to have children without government interference is critical to all Americans. With the weakening of Roe v. Wade, individual states – or Congress – could even more severely limit access to abortion. If Roe were overturned, abortion could be banned. Additionally, opponents of birth control continue to block legislation that would make contraception more available and affordable for the millions of women who need it. Women, especially young women, need comprehensive information about, and access to, contraception in order to make good decisions for their health and lives. Comprehensive health care reform could remedy a number of problems that the specific proposals listed below address. However, whether through a comprehensive approach or addressed individually, women’s reproductive health care needs are an essential part of women’s general health care.

Protect a Woman’s Right to Decide to Have an Abortion. With the current makeup of the Supreme Court, Roe v. Wade is in jeopardy of being further limited, or even overturned. At least 30 states are poised to make abortion illegal within a year if the Supreme Court reverses Roe v. Wade. Congress should enact the Freedom of Choice Act, which would prevent states or the federal government from interfering with a woman’s right to choose to bear a child, terminate her pregnancy prior to viability, or terminate her pregnancy after viability when the termination is necessary to protect her life or health. Congress should also eliminate prohibitions throughout the federal government on the use of public funds to provide abortion services.
Ensure Equal Access to Abortion Services for All Women. Congress should prevent discrimination against women in federally funded health care programs, including women on Medicaid, women in the military, federal employees and others, by removing restrictions that deny them the same coverage for abortion services that women in most private health insurance plans receive.
Expand Availability of Birth Control. Congress should enact measures that prevent unintended pregnancies by improving women’s access to preventive health care:
- Increase Funding for Title X. Invest more funds in the nation’s family planning program, which helps millions of low-income women prepare for and safely space their pregnancies through access to low-cost birth control.
- Ensure that Women can Purchase Affordable Birth Control. Enact the Prevention Through Affordable Access Act to restore affordable birth control for clinics that make birth control available to low-income women and women in college, and the Access to Birth Control Act, to protect women’s access to birth control at the pharmacy.
- Increase Information on and Access to Emergency Contraception. Create a public education initiative to provide women and health care providers with information about emergency contraception; require hospitals receiving federal funds to offer and provide emergency contraception to rape survivors upon request along with medically, factually accurate and unbiased information about emergency contraception; and urge the FDA to rescind its arbitrary and unjustified age and access restrictions on the non-prescription sale of emergency contraception, which contradict even the FDA’s own expert scientific panel.
- Expand Family Planning Services under Medicaid. Allow states to expand access to family planning services under Medicaid to any woman in the state who would be Medicaid-eligible for prenatal and labor and delivery care.
Invest in Comprehensive Sex Education. Teens need medically accurate information about contraception in order to make healthy, responsible decisions. Congress should create a federal program dedicated to providing comprehensive sex education – which includes information about contraception, abstinence, and how to avoid sexually transmitted diseases such as HIV and AIDS – to young people and require the provision of medically accurate information concerning the use of contraceptives in any federally funded sex education program.
End Federal Funding for Abstinence-Only Programs. Since 1996, the federal government has spent over $1.3 billion on programs that teach teens abstinence-only-until-marriage, despite mounting evidence of their inefficacy. Congress should end funding for Community Based Abstinence Education (CBAE) programs and the Title V Abstinence Education program, which provide misleading and inaccurate information to teens, promote gender stereotypes, and undermine young women’s confidence in contraception when they do become sexually active.

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