Health Care Reform

Today House Budget Chairman Paul Ryan (R-WI) released his vision for the next ten years. Despite having a section entitled "Fairness Restored," Ryan’s budget does anything but put forward a fair and equitable plan.

Chairman Ryan’s plan balances the budget on the backs of vulnerable women and their families. It would:

• Cut the funding available for programs like Head Start, child care, K-12 education, job training, and domestic violence prevention.
• Cut Medicaid and turn it into a block grant, allowing states to restrict eligibility and eliminate benefits. About two-thirds of adult Medicaid beneficiaries are women.
• Repeal the Affordable Care Act, eliminating the Medicaid expansions critical for low-income families, tax credits to help moderate-income families purchase health insurance, help with the cost of prescription drugs in Medicare and preventive health care services (including contraceptive services), and protections against discriminatory insurance company practices.

Last week at a lunch with African advocates for women’s rights, we discussed pregnancy rates in Africa and the United States. Across the continents one thing remained constant—women have better outcomes when they are able to control their fertility. They enjoy greater freedom to pursue academic studies or careers, and to plan their lives as they see fit.

The ACA’s contraceptive coverage rule affords 47 million women this freedom by ensuring that they will be able to access birth control and related information through private insurance without having to worry about the cost. While many celebrate the anticipated improvements to women and children’s health, others are infuriated by the rule.

Opponents to birth control have made speeches decrying the rule, hosted conferences and brought lawsuit, after lawsuit, after lawsuit... Since the lawsuits have proved to be a publicity-gaining tool, we can anticipate many more. Read more »

Have you ever tried to compare health plans? It isn’t easy. Insurance companies design brochures to sell their plans. They have pictures of people holding hands, pushing a child on a swing, smiling in the doctor’s office and just being happy. They highlight everything that is great about the plan and, by the time you get to the chart summarizing the benefits, you would think this is the best insurance plan ever.

Then you look at another plan’s brochure that also makes the plan seem like the best insurance plan ever. But you try to compare the benefits and you aren’t really sure what you are comparing. The brochures use different terms and different formats. You can’t find a description of maternity coverage. You are trying to figure out how all the dollars and percentages add up to actual costs.

Starting today, things are different. That is because plans now have to provide all applicants and enrollees a standard Summary of Benefits and Coverage (called the SBC for short) and a uniform glossary. The Summary is simple to read, short, and provides a standard chart of benefits and coverage examples that every plan must use. The Glossary provides standard definitions of important health insurance terms that impact your coverage. Read more »

I cried a few times yesterday. Not bawling tears, but a few drops of relief. A few drops for those who have been standing up to fight for our health care. A few drops for my friends’ children who will grow up in a country that provides them with the resources they need to thrive. A few drops for the women whose lives will be saved by learning about a condition from a simple preventive service. A few drops for the uninsured who will finally have affordable coverage in 2014. And a few drops for myself.

The promises of the Affordable Care Act are safe for one more day. There are so many promises of the law. These are a just a few promises the law makes to me:

• I will not be denied coverage for a preexisting condition.
• I will have access to preventive services without copays or deductibles.
• When I become eligible for Medicare (in many, many, many years), I will not have to worry about a gap in my prescription drug coverage.
• My friends don’t need to worry that their young children will hit an annual or lifetime dollar limit on their insurance.

Yesterday was a very good day for women at the Supreme Court. The constitutionality of the Affordable Care Act, was upheld, and its implementation will now continue. As a result, women will no longer be charged more than men for the same insurance; mammograms, Pap smears, contraception, and a host of other preventive services will be covered by insurance with no co-pay; women will no longer be denied insurance coverage because they are pregnant or have had a cesarean section or survived domestic violence; and millions more women will be covered by Medicaid. There is much to celebrate. But the Court's decision reveals that there are also important tasks ahead.

First, the Court held that states need not participate in the expansion of Medicaid as a condition of continuing to receive their current Medicaid funding. The ACA expanded Medicaid's coverage to reach all adults under 133 percent of the poverty level beginning in 2014. (Today the federal government only requires states to cover the disabled, the elderly, children, pregnant women, and parents.) Under the Court's ruling, states will have the option whether or not to provide that additional coverage. But there is much reason to be optimistic that all or nearly all states will do so. The federal government covers 100 percent of the costs of the Medicaid expansion for the first three years; it is in essence offering the states free money during that time. After that, the federal government's support will phase down — to only 90 percent of the costs of the expansion. By spending very little of their own money, states can ensure that those uninsured who are the poorest and most vulnerable — those least able to get insurance any other way — will receive health coverage. This should be an easy choice, but there is nevertheless work to be done to ensure that all states do the right thing and fulfill the promise of the ACA.

Second, while the result today was almost wholly good, the Court's opinion raised questions about how the Constitution will be interpreted in future cases. Read more »

The major health insurers held a hot-ticket event yesterday – first United Healthcare announced that it would retain key patient protections and health coverage guarantees, no matter how the Supreme Court rules on the Affordable Care Act, and by mid-afternoon it seemed like all of the other health plans wanted to be at the party, too.  

First, United Healthcare kicked off the festivities in grand style by promising that it would continue to cover preventive care without requiring patients to make copayments, allow young adults to stay on their parents’ health plans as dependents through age 26, and continue to follow the new law’s ban on lifetime benefit limits. United will also continue to enforce patient rights through a streamlined appeals process and will not seek to rescind a member’s coverage after they become sick (except in cases of a fraudulent insurance application).

Other insurance plans wanted to join the party. As the day wore on, Humana and Aetna announced that they would continue to honor identical or near-identical reforms, with Aetna emphasizing that they would also continue working with hospitals, doctors and other health providers to develop innovative delivery system reforms – another hallmark of the new law. The national Blue Cross Blue Shield Association “encouraged” local Blues plans to continue to honor these provisions from the ACA.

Other plans, such as CIGNA and Wellpoint, weren’t sure that they wanted to join the festivities. But most importantly, one type of guest wasn’t invited to the party at all. Namely, sick people. Read more »

This week is National Women's Health Week — a time for women to remind ourselves to put our health first. Some politicians are determined to put women's health first, too — first on the chopping block.

Opponents of the health care law are dead-set on finding ways to undermine it. And, if they win, our health will be undermined, too. Watch our new video! Then, share it with your friends, family, and co-workers and ask them to join the fight to protect the law.

For generations, women have overcome obstacles, exceeded expectations and fought for equality. Read more »

National Women’s Law Center is proudly taking part in the Health Equity Can’t Wait! blog carnival celebrating National Minority Health Month. Participating bloggers are health, consumer, civil rights, and provider advocates committed to promoting health equity. You can find all the posts for the carnival here.

Women pay about $1 billion more for health care on the individual market just because they are women. Yet women are only paid 77 cents for every dollar paid to their male counterparts. We are charged more and we are paid less.

And that’s only part of the problem. The wage gap is even greater for African American women and Hispanic women. But the cost of health care is still high. So what does that add up to?

Well, if you try to add up it all up, you find out that African American and Hispanic women are more likely to be uninsured than white women. You learn that African American women ages 45 to 64 are almost twice as likely to have a disability, handicap or chronic disease that limits activity compared to white women in the same age range. You discover that Latina women have higher rates of diabetes and hypertension. You read that older women of color are undertreated for their cancer pain. You realize that there is a problem. Read more »