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Wait, There Wasn’t a Law Against That Already? Section 1557: a Title IX for Health Care

Strong federal protections against sex discrimination exist in the workplace and in schools, and have existed, for sixty and forty years, respectively. Of course, there’s a lot of work to do to enforce those protections and build on them. In health care, no such broad antidiscrimination law existed.

You may need to re-read that. People generally do a double-take when they hear there has been no big prohibition against sex discrimination in health care until just 3 years ago. “Did I really read that right??” You did.

We needed a Title IX, the federal law that prohibits sex-based discrimination in education program, for health care. Finally, now, we got one!

Section 1557 of the Affordable Care Act (Obamacare) adds this important protection against sex discrimination in health care. But, that’s not all.

For one, Section 1557 expands existing protections against discrimination in the health care area based on race, color, national origin, disability, and age. Specifically, the law protects individuals from discrimination based on race, color, national origin, sex, age, disability, gender identity, and sex stereotypes in:

  • the health programs or activities of recipients of federal financial assistance, like all operations of a hospital or the health plans of entities that receive federal grants;
  • federally-administered programs, such as Medicare or the Federal Employee Health Benefit Plan; or
  • any entity established under Title I of the ACA, including the health insurance exchanges being established in the states—the places people will go to compare their options for and purchase health insurance

Or, put more simply: the law’s reach is broad and impacts virtually all aspects of health care. Read more »

There Should Be A Law Against That. . . And Now, There Is! Federal Law (Finally!) Prohibits Sex Discrimination in Health Care

Did you know that until 2010, no federal law provided protection against sex discrimination in health care? What?!

Section 1557 is an antidiscrimination provision in the Affordable Care Act (Obamacare) that includes the first federal protection against sex discrimination in health care. For those familiar with Title IX, the federal law that prohibits sex discrimination in education programs, Section 1557 is like a Title IX for health care.  

And, today, the NWLC filed the first set of complaints under Section 1557 addressing a major issue for young women – the fact that they often don’t get maternity coverage if they are on their parents’ health insurance plan. NWLC filed complaints with the Office for Civil Rights (OCR) at the Department of Health and Human Services (HHS) against five institutions whose health plans do not provide pregnancy benefits to the dependent children of employees. Because the institutions receive federal funds, they cannot discriminate against any individual participating in any of their health programs, including their employee health plans. Read more »

A Vacation Education on the Welfare Debate

Ah, August. Congress is out, traffic is a (relative) breeze, and I’m feeling refreshed after a relaxing family vacation that involved lots of lazy beach time and zero talk of what was happening back at the office.

…Well, maybe not zero. One thing I’ve found about devoting your career to really interesting women’s issues is that it’s not unusual for conversations with friends and family to wind up delving into those very same issues. Especially if, say, I’m in a house with 20 or so family members from across the country who want to know more about what’s going on in Washington.  

My family is full of bright, interesting people who are pretty on top of current events and have a range of perspectives on the issues. Previous gatherings have involved talk of taxes, health care policy, climate change, and the need to reform agricultural practices. This year, the subject of welfare came up – and so did some misinformation about a recent proposal from the Obama administration to allow states to waive certain work participation requirements under the federal welfare program (known as Temporary Assistance for Needy Families, or TANF). Read more »

Mixed Signals on Child Care and Early Education

Child care and early education issues are gaining increased attention at the federal and state level. Earlier this week, the U.S. Department of Education and Department of Health and Human Services announced that of the $550 million appropriated for the Race to the Top education grant competition in 2012, $133 million will be used for a second round of Early Learning Challenge grants to help states strengthen their early care and education systems. (Five states that just missed out on the first round of funding will be eligible to compete for this latest round.) At the state level, nearly half of the governors mentioned early care and education in their state of the state addresses this year, indicating they recognize that giving children get a strong start helps children, and their states, succeed in the future. Read more »

Prevention > Politics. EC = BC.

Months later, I am still very concerned about the decision by the Department of Health & Human Services (HHS) to overrule a judgment by the Food & Drug Administration (FDA) to expand over-the-counter availability of the morning-after contraception Plan B One Step. Anyone who is concerned about unintended pregnancy must support increased access to a range of contraceptive methods, including emergency contraception (EC).

The impact of unintended pregnancy among young women is staggering. Teen pregnancy, which is at unacceptably high levels in the United States and is higher than most other developed nations, has far-reaching consequences well into adulthood. Only about 50% of teen mothers receive a high school diploma by 22 years of old, versus about 90% of women who had not given birth during adolescence. And, dropping out of high school alters a young woman’s life for decades, and perhaps even generations. Why then would we not do everything we can—use every tool at our disposal—to increase access to emergency contraception? The stakes are too high, reducing unintended pregnancy is too important. Read more »

Would you let someone make your contraceptive decisions for you? Didn’t think so.

Last February, the Department of Health and Human Services released an interim final rule stating that student health plans would be treated as individual health insurance plans, meaning that they would have to cover the women’s preventive health services. Let’s translate that out of “legal-ese:” the Department will require student health insurance plans (not student health centers) to cover preventive services for women, such as contraception, screening for sexually transmitted infections, and screening for interpersonal and domestic violence, without co-pays or deductibles. Read more »

The Highs and Lows on Birth Control Access Coverage

A few weeks ago we shared the very exciting news that the Obama administration had held strong and we’d secured no-cost birth control for millions of women through the Affordable Care Act. This was a huge and important step for women’s health and something the National Women’s Law Center has been working towards for over a decade.

But, unfortunately, this decision and final rule has not quieted the opposition. Instead, those opposing the rule are continuing to push back and decry this significant advancement. We’ve posted a number of responses to the negative press and quotes, and we’re continuing to fight back by working with our state partners and submitting letters to the editor to newspapers across the country. Read more »

Critics Get It Wrong on Contraceptive Coverage

Opponents of the recent contraceptive coverage announcement by the Department of Health & Human Services are trying to twist this major advance on contraception into a fight about abortion. In the Washington Post, Michael Gerson states that the rule requires Catholic-affiliated organizations to provide insurance coverage for "abortifacients." CNN's Belief Blog claims the new rule "forces employers to cover contraception and abortion." While both advance several faulty arguments, it's time to put to rest the claim about abortion. The rule is directly and explicitly limited to FDA-approved contraception. Read more »

One more time…

Abortion. [uh-bawr-shuhn]

Contraception. [kon-truh-sep-shuhn]

These are not the same. Yet I’ve repeatedly seen claims that the HHS decision on contraceptive coverage requires religious employers to cover “abortifacients.”

Clearly, those opposed to the preventive services rule know they are on shaky ground when it comes to rallying their troops against contraception. After all, their troops are using the stuff en mass (but hopefully not in Mass). Ninety-eight percent of Catholics have used a form of contraception opposed by the Vatican. The “abortifacients” claim is based on the fact that the preventive services rule requires coverage for emergency contraception. Some still seem to think that EC causes an abortion. It does not. I repeat. It does not. If you don’t believe me, then turn to another source, like the Catholic Health Association. Read more »

A Change is Gonna Come, and It Finally Has…

Yesterday I had the pleasure of gathering with several women who shared very personal stories about how they have struggled in our current health care system. I also heard a lot about how the new health care law is helping women in so many important ways.

Robyn, a mother of three shared her story about her son, Jax—a delightful cutie who was possibly the best behaved child I have ever seen (not a peep in over an hour!)—who was diagnosed with a genetic disorder. Jax would have likely reached a lifetime limit on health coverage but, thanks to the health care law, Robyn does not have to worry about that. Instead of constantly worrying about her son’s coverage and her family’s financial stability, she can instead enjoy her three beautiful children and continue working at a job she loves. Read more »