Health Care

The Senate Subcommittee on Appropriations for Labor, Health and Human Services, and Education and Related Agencies just approved a funding plan for those agencies in Fiscal Year 2014. The full Committee will consider the bill tomorrow.

During the Subcommittee’s consideration of the bill, Senators voiced their appreciation of the bipartisan effort and conversations leading up to the bill. Senator Barbara Mikulski (D-MD), Chair of the Subcommittee, expressed her commitment to get the bill on the Senate floor saying “If we move this bill, America and the people who live in it will be in a better place.”  Senator Mikulski explained that the appropriations bill laid the groundwork for expanding opportunity in America through empowering students, investing in education and getting people to work in the 21st century.

We agree. The bill not only rejects the painful cuts from sequestration—it provides additional funding in several key areas, especially early childhood education. Here are seven reasons we were dancing in our offices when we saw the details of the Senate Subcommittee’s FY 2014 Labor, Health and Human Services Education and Related Agencies appropriations bill:

1. Early Childhood Education: A $1.43 billion increase for Head Start, including Early Head Start - Child Care Partnerships, plus a $171 million increase for existing Head Start and Early Head Start programs; a $176 million increase for the Child Care and Development Block Grants, including $110 million for new quality improvement grants and $66 million for child care assistance as well as $750 million for Preschool Development Grants.
2. Implementing the Affordable Care Act (ACA): $5.2 billion to the Centers for Medicare and Medicare Services to implement the Affordable Care Act, an increase from $3.9 billion in FY 2013.  The ACA will help nearly 30 million Americans, including nearly 15 million women, to access high-quality, affordable health insurance.
3. Mental Health: $40 million for Project AWARE State grants, which will focus on making schools safer and connecting young people with mental health services, and $40 million in new funding to address shortages in the behavioral health workforce.

Yesterday's surprise announcement that the Obama Administration is postponing implementation of the health reform law's requirement that firms with more than 50 workers provide affordable, comprehensive health insurance or pay a small penalty set off a flurry of commentary and speculation. Much of this reaction focused on how the decision will affect larger employers and their workers — that is, very little — and others weighed in on the political implications of this move. The biggest impact on large employers is if they do not provide the requisite health insurance they will not have to pay the penalty for one more year. But little analysis and commentary considered what this decision means for low-wage workers' access to health insurance exchanges, nor the outreach and education challenges it creates. 

With or without this postponement, beginning January 1, many workers whose employers do not offer coverage, or whose employer offers coverage that does not meet minimum standards for premium affordability and sufficient benefits, will qualify for help with premiums and cost-sharing for coverage they purchase in the health insurance exchange operating in their state. These marketplaces will offer participants a choice among fully-vetted health plans that meet state and federal standards. Workers with good employer-sponsored health insurance won't be able to receive subsidies to purchase coverage in the exchange, but those workers without access to good employer-sponsored coverage, or coverage that exceeds 9.5 percent of their incomes, will qualify for this help. 

Today, low-wage workers are more likely to pay a larger share of the premium for employer-sponsored coverage than workers with higher earnings.  Read more »

Today marks the one-year anniversary of the Supreme Court's historic ruling that upheld the constitutionality of the Affordable Care Act (ACA). In National Federation of Independent Business v. Sebelius,  the Court upheld the constitutionality of two major provisions of the ACA: the individual mandate and the Medicaid eligibility expansion. However, the Court made one very significant change to the terms of the Medicaid provision: It held that the federal government could not condition a state's current federal Medicaid funding on participation in the coverage expansion, thereby giving states the choice to opt-out of covering more people through Medicaid. 

Today, Medicaid programs in all states cover low-income individuals with disabilities, seniors, children, pregnant women, and parents. But federal money provided through the ACA will enable states to reach people younger than 65 whose income is below 138 percent of the federal poverty guideline ($15,856 annually for an individual; $26, 951 for a family of three in 2012). 

For the first time, low-income childless adults will have access to Medicaid coverage in many states. 

If all states take this federal money, approximately 15.1 million currently uninsured adults [PDF] would newly qualify for Medicaid coverage. Covering more people through the Medicaid program is especially important for low-income women who make up over 60 percent of uninsured women in the U.S. and are four times more likely than higher income women to report fair or poor health.  Read more »

Approximately 238,000 uninsured Arizonans will now have access to health care coverage in the coming months, thanks to the state legislature's passing of Governor Jan Brewer's expansion proposal. 

Over two hundred thousand. That's a lot of people. 

The legislature made the right decision yesterday, and now hundreds of thousands of hard-working, low-income women and families will have access to health care because of it. Not only will these residents have access to health coverage that includes preventive care, chronic disease treatment and other essential health services, but they also benefit from an increased sense of economic security and knowing that they will not be subjected to financial ruin in the case of a medical emergency. Read more »

Hospital mergers don’t typically come to mind when thinking about threats to reproductive health.  But, because Catholic hospitals do not provide certain reproductive health services, including contraception, abortion, tubal ligation and vasectomies, a wave of mergers between secular (and even public) hospitals and Catholic affiliated hospitals in Washington state is doing just that.

If all of the proposed mergers in the state were to be completed, almost half of Washington’s hospital beds would be controlled by Catholic health systems. In fact, all of the beds in 10 of Washington’s 39 counties could be subject to religious restrictions, forcing residents to travel significant distances to find a secular hospital.  If the proposed merger between Harrison Medical Center and Franciscan Health Systems is completed, for example, residents in Bremerton would have to take an hour long ferry ride to get to the next closest acute care hospital. Read more »

I love my baby.  He is so sweet and his laughter makes any bad mood float away.  But not only is my baby oh so sweet, he also made me aware of a breast lump. I noticed it once I started nursing him, because, really, I never really paid much attention to the issue of breast lumps and never did any self exams. 

I know, I know, health groups like American Congress of Obstetrics and Gynecologists advocate women to have “breast self awareness,” and to report any changes to your breasts to your health care providers. But, since I don’t have any risk factors, I just never thought I would be in trouble. Well, after finding that not-so-small lump, I felt guilty. I realized even though I’m a huge advocate of preventive health, I wasn’t doing the one simple step of taking care of myself by getting preventive health screenings. And I realize, this is what preventive health is about, it’s about taking those steps to get ahead of health concerns before the health concerns get ahead of you. Read more »

I have written many a blog here at the National Women’s Law Center explaining why Medicaid is important to women’s health. Nearly 70% of adults on Medicaid are women and the program provides important benefits to women including family planning services, comprehensive maternity care, treatment for chronic conditions, treatment for breast and cervical cancer, and long-term care services and supports. If you’re a regular reader, you may have even seen my blogs explaining that Medicaid’s cost sharing limits and low or absent premiums are vital to low-income women who have limited disposable incomes to cover their family’s basic needs. 

But today, I’ve got a few new reasons. Three million reasons to be exact. Because three million is the number of women’s health sector jobs that Medicaid spending supports. Every time a Medicaid recipient visits a doctor or hospital, receives a lab test, or is admitted to a nursing home, payments for these services help support the salaries of the employees at these facilities. And most of these employees are women. In fact, women comprise nearly 80% of the health sector workforce. Read more »

Last Friday, District Court Judge Carol Jackson dismissed a case filed by O’Brien Industrial Holdings and Frank O’Brien (the owner) against the HHS rule requiring health insurance coverage of birth control with no co-pay. In a decision that is worthy of reading a couple of times over (PDF), Judge Jackson explained in careful detail why, in fact, the HHS rule does not violate the statutory or constitutional claims made by O’Brien and his for-profit mining company (in which he claimed that the rule violated the company’s and his religious liberty).

There are some great lines in the decision. One of my favorites is:

The rule does not "directly and inevitably prevent plaintiffs from acting in accordance with their religious beliefs. Frank O’Brien is not prevented from keeping the Sabbath, from providing a religious upbringing for his children, or from participating in a religious ritual such as communion. Instead, plaintiffs remain free to exercise their religion, by not using contraceptives and by discouraging employees from using contraceptives..."

Such a line says what we have been saying all along... the birth control rule does not violate religious freedom. 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 »

When you hear the word lobbyist, what comes to mind? Special interests, back-door wheelings and dealings, and other generally shady shenanigans, right? Not always, as it turns out.

Last Tuesday, I had the opportunity to lobby my representatives in Congress as part of Intern Advocacy Day, a joint endeavor between Advocates for Youth, SIECUS, CHANGE, and Choice USA. Over forty interns from various health advocacy organizations around DC gathered near the Capitol to advocate on behalf of two very important pieces of legislation, the Real Education for Healthy Youth Act and the Global Democracy Promotion Act.

As an NWLC intern and as a person who cares about the rights of women more generally, I was eager to urge my congressional delegation to champion these bills. Although they differ wildly in scope, both pieces of legislation are premised on the idea that the best way to promote healthy, empowered decision-making is through the provision of uncensored, scientifically accurate information that is free of ideological biases and paternalistic assumptions.

The Real Education for Healthy Youth Act, for instance, sets forth a policy vision for federally funded comprehensive sex education programs. It outlines standards that sex education curricula must adhere to in order to receive federal funding, directs grant money to comprehensive sex education programs that prioritize information over ideology, and allows for education that is inclusive of lesbian, gay, and bisexual students. Read more »