Womenstake

Earning Less, Paying More for Health Care: Fighting a Battle on Two Fronts

by Lisa Codispoti, Senior Advisor, 
National Women’s Law Center 

Cross-posted from Disruptive Women in Health Care.

Between 2000 and 2006, health insurance premiums increased 87.5 percent—4 times more than wages. In addition to the burden of inflated health care costs, women are still paid only 78 cents for every dollar earned by men—with women of color earning even less. In a world where women are earning significantly less than men for comparable work, how can they also afford health care?

Pay inequity for women compounds the issues that already exist with our broken health care system. This is a system that makes unfair practices by insurance companies flourish, such as allowing health to be more expensive for women. For example, women pay higher premiums than men when they try to buy health insurance directly from an insurance company through the individual health insurance market (a practice known as gender rating.) Even worse is that many of these health plans do not cover maternity care or expect women to pay an additional fee (what is called a rider) to gain maternity coverage. Women are then left trying to stretch their already smaller paycheck for a much larger health care bill.

Read the full post.

See who else is writing about workplace fairness for women on this Equal Pay Day.

Motivated by NWLC Report Card, Arkansas Advocates Successfully Push to Prohibit Insurance Discrimination Against Domestic Violence Survivors

by Lisa Codispoti, Senior Advisor, 
National Women's Law Center 

This post is part of a series on Women and Health Reform.

It started with a group of Arkansas women’s health advocates who refused to accept that their state was ranked 49th in the country on women’s health.

They formed the Arkansas Women’s Health Workgroup and, on September 27, 2008, brought advocates from across the state—and speakers from across the country—together for a “Women’s Health Summit.” They generously invited me to speak about Arkansas’ performance in NWLC’s 2007 Women’s Health Report Card and about our Nowhere to Turn report, which addresses the challenges women face accessing affordable health care in the individual insurance market.

When I mentioned health insurance discrimination against survivors of domestic violence as one of the challenges women face in the individual market—as reported by the Women’s Law Project and Pennsylvania Coalition Against Domestic Violence—and noted that Arkansas was one of 9 states (and D.C.) that had not prohibited health insurers in the individual market from denying coverage to a women because they suspected that she was, based on her medical records, a survivor of domestic violence—the Workgroup was horrified. And motivated.

Sonseeahray Tonsall of Arkansas’ KARK 4 News had also been invited to speak at the event and vowed to get media coverage for this underreported problem. In only four days, she did.

Tonsall wasn’t the only person in the audience moved to take action. Pat Blackstone, Program Coordinator at the Arkansas Coalition against Domestic Violence, was also a presenter at the Summit. After learning that Arkansas didn’t have an anti-discrimination law, she and Jayne Ann Kita, the Director of the Coalition, went to work getting legislation introduced in the next state legislative session. Pat filled us in on their experience:

They researched existing laws in states that had already passed insurance protections for survivors of domestic violence and found enthusiastic sponsors for an Arkansas anti-discrimination bill in Representative Lindsley Smith of Fayetteville and State Senator Joyce Elliott of Little Rock. Several other legislators were also eager to co-sponsor – the ball was rolling. And then there was more good news: Blackstone learned that Jay Bradford, a former Representative and Senator in the Arkansas Legislature and a staunch advocate against domestic violence, had just been nominated by the governor to be the new state Insurance Commissioner.

Health Reform in a Post-Daschle Nomination World???

by Lisa Codispoti, Senior Advisor
National Women’s Law Center

This post is part of a series on Women and Health Reform.

This was a roller-coaster week on the health care reform front. Certainly the high-point: President Obama signing the Children's Health Insurance legislation into law, which was, as he said, a down payment on his commitment to comprehensive health reform. The low, of course, was the sudden withdrawal of Senator Daschle as nominee to lead the Department of Health and Human Services and the White House Office of Health Reform.

The question I've been asked over and over again (and many other bloggers have expressed their own opinions) is, what does this mean for health reform? My answer: While Senator Daschle's withdrawal is certainly a disappointing development, the drive for health reform is bigger than any one person. Just ask the more than 66 million people who voted for President Obama. Just ask the 30 million people who are members of the 700+ groups (including NWLC) who comprise Health Care for America Now who are actively working to achieve a guarantee of quality, affordable health care for all. Just ask the 47 million people who are uninsured in this country and the millions more who are one health care crisis away from financial catastrophe. And people who are losing their jobs in this economy -- and their health care.

While we certainly need a strong candidate to help lead this effort -- if we have any hopes of winning reform -- we can't afford to tie our collective hopes to one person: we all have to be in this together.

Women and the Individual Health Insurance Market: It's No Shopper's Paradise

by Lisa Codispoti, Senior Advisor
and Brigette Courtot, Policy Analyst
National Women’s Law Center

This post is part of a weekly series on Women and Health Reform.

The overwhelming majority of people get their health insurance from an employer or through a public program like Medicare or Medicaid. So it’s not surprising that most people have absolutely no idea how tough it is to buy insurance directly from an insurance company in the individual insurance market. And for women –- it is a particularly tough place.   

At the National Women’s Law Center, we just released a report identifying the many obstacles women face in getting affordable comprehensive health coverage in the individual insurance market. The barriers include being rejected for coverage for reasons that are relevant to women, being charged more than men for the exact same coverage, and experiencing great difficulty in finding affordable health coverage that includes comprehensive maternity care.

There are many federal laws that protect women who get their health insurance through their employer.  Those federal protections simply don’t apply when you try to buy coverage in the individual insurance market.

Insurers can reject applicants for a variety of reasons -– many very relevant to women.  For example, a woman can be rejected simply because she had a Caesarean section (in 2005, 30% of all births were by C-section). In nine states and the District of Columbia, it is still legal to be rejected for coverage because you are a survivor of domestic violence.

Their Glass is Still Half-Empty: More Details on Uninsured Women

by Lisa Codispoti, Senior Advisor
and Brigette Courtot, Policy Analyst
National Women’s Law Center

This post is part of a weekly series on Women and Health Reform.

Last week we wrote about the Census Bureau’s recent release of 2007 data on health insurance coverage in the United States. On the simplest level, the news looks positive, with fewer uninsured women—and uninsured Americans in general—in 2007 than in 2006. 

But since when was anything about health insurance simple?  The message became more complex when we found that the 2007 decline in uninsurance was only due to an increase in the number of people with public health insurance.  We summed up last week’s blog post discussion on this by warning readers not to be fooled by the seemingly positive news – our fight for progressive health reform is far from over!

Now that we’ve had another week to work with the Census data, we have found even more evidence of women’s need for comprehensive health reform. For certain groups of women, the news on 2007 insurance rates is not even seemingly positive. Things just went from bad to worse. Period. The data shows just who lost out:

Digging Deeper: The Story Behind the New Uninsurance Numbers

by Lisa Codispoti, Senior Advisor
and Brigette Courtot, Policy Analyst
National Women’s Law Center

This post is part of a weekly series on Women and Health Reform.

We were so prepared. In the days leading up to Tuesday’s Census Bureau release of 2007 health coverage data, we formatted spreadsheets to analyze the new numbers. We drafted potential language for our press release. We listened to the forecasts of health economists, predicting that the number of uninsured Americans would continue its upward trend this year.

And then we got the data. Surprise! The number of uninsured Americans did not increase, as expected. Instead, there was a modest decline in the uninsured, from 47 million in 2006 to 45.7 million in 2007. Rates of uninsurance decreased for women specifically; in 2007, 281,000 fewer women (ages 18 and older) were uninsured, and the proportion of uninsured women dropped slightly from 15.1 to 14.8 percent. Though women of color are still considerably more likely to lack insurance than their white counterparts, rates of uninsurance went down for women across race categories with one exception – more Asian, Native Hawaiian, or Pacific Islander women were uninsured in 2007 than in 2006. Uninsurance among Hispanic women fell by 2 percentage points – the largest decline of all.

So, what gives?  How can the number of uninsured Americans be going down when we know that a) more and more people are skipping necessary care because they can’t afford it, b) the cost of health insurance premiums is growing much faster than wages, and c) fewer small and medium-sized businesses are offering health coverage to their workers each year?

Sometimes Numbers Speak Louder than Words in the Case for Health Reform

by Lisa Codispoti, Senior Advisor
and Brigette Courtot, Policy Analyst
National Women’s Law Center

This post is part of a weekly series on Women and Health Reform.

Sometimes, the numbers just say it all. Last year, our issue brief Women and Health Coverage: The Affordability Gap reported some distressing numbers about women’s struggle to get affordable health care (we found, for instance, that over a third of all women had medical debt problems). New survey data published in two reports  from the Commonwealth Fund shows just how bad things are. If anything speaks to the need for health reform that will guarantee quality affordable health coverage for everyone, it is numbers like these (with style credits to the ever-fascinating Harper’s Index):

1. 2 in 3: The proportion of adults who were uninsured or underinsured, reported problems paying medical bills, or went without needed care because of cost in 2007.
2. 79 million: Number of American adults with medical debt or bill problems
3. Percentage of insured versus uninsured women over 50 who received a mammogram in the past 2 years, respectively: 81, 45
4. The proportion of adults paying off medical debt over time: greater than 1 in 4 (28%).
5. The percentage increase from 2005 to 2007 in the number of working-age adults who are grappling with medical debt: +32
6. The proportion of adults with medical debt or bill problems who were insured at the time care was provided: 6 in 10
7. 28 million and 21 million: the numbers, respectively, of adults in 2007 who used up all their savings or incurred large credit card debt due to medical bills.
8. Percent of those with medical bill or debt problems who were unable to pay for basic necessities like food, heat, or rent because of these problems: 29 
9. Chance that someone who is self-employed or employed by a company with fewer than 20 workers was uninsured during the year: 1 in 3
10. Chance that an employee in a company with more than 500 workers was uninsured: 1 in 10
11. Percent of American adults who do not feel very confident in their ability to get high quality, safe health care when they need it: 71

Do these figures anger you?  Then join us and Health Care for America Now! a national campaign to ensure a guarantee of affordable quality health care for all.

WANTED: A Health Care System That Women Can Count On

by Lisa Codispoti, Senior Advisor
and Brigette Courtot, Policy Analyst
National Women’s Law Center

This post is part of a weekly series on Women and Health Reform.

Findings from a new poll released yesterday by the National Women’s Law Center and Peter D. Hart Research Associates shows that women are very ready for comprehensive health reform. Two-thirds of women support major changes or a complete overhaul of the current health care system. Another 28 percent think the system needs some improvements, but that it should remain largely the same. Hardly any women—a mere 4 percent—think the system is working pretty well as it is. (And we can’t help but wonder where those lucky ladies are getting their health care. They must know something that the rest of us don’t.)

Women are ready for change because they’ve already spent too much time worrying about how they’ll get the health care that they or their families need. Compared to men, women are less likely to feel confident about their ability to afford health care in the next few years.  In fact, more than half of all lower-income women polled (i.e. those making $25,000 a year or less) said they weren’t at all confident that they would be able to afford care for themselves or their families in the future.

Women aren’t just aware of the problem; they’ve also identified a solution.  Most women see a role for government in advancing policies and programs that will lead to healthy families. As the NWLC co-presidents noted yesterday in the Huffington Post, “Women are looking for leadership that will help to address issues that are critical to their lives.” In fact, the overwhelming majority of women—84 percent—say it’s extremely or very important for Congress and the next administration to guarantee access to quality, affordable, comprehensive health care. 

We still have a long way to go to provide families with a health care system they can count on. But these new poll findings are encouraging because they show that women are on the same page when it comes to health reform. We’re ready for a better health system and we know what we need to do to get there!

Are State Solutions Practical? Thoughts on Hurricanes and Health Reform

by Lisa Codisopti, Senior Advisor
National Women’s Law Center

This post is part of a weekly series on Women and Health Reform.

Greetings from balmy New Orleans, where I am participating in the annual meeting of the National Conference of State Legislatures (NCSL)! I'm writing this blog post from the Morial Convention Center—a site that played such an unfortunate back-drop to human misery in the days (indeed years) following the wrath of Hurricane Katrina, and which still serves as a reminder of our government's utter failure to help those who had every right to expect it.

Now, three years post-Katrina, I am attending meetings of the NCSL Health Committee, wondering if— and how—our government will help the millions of Americans who don’t have access to high-quality and affordable health care. As the Health Committee begins to develop principles for federal health care reform, we must be mindful not only of state roles in national-level health reform but also the varied approaches to reform that states have already taken to address the health care crisis on their own.

Indeed, states have been at the forefront of health reform since a federal solution has been remarkably absent. But, as I've often said, state efforts are neither big enough nor fast enough to meet the challenges of health reform. They will, for instance, inevitably hit one major roadblock—fluctuating state budgets. It is clear that we need federal action to fix our health care system.

Health Care for America Now: A Collective Fight for Progressive Health Reform

by Lisa Codispoti, Senior Advisor
and Brigette Courtot, Policy Analyst
National Women’s Law Center

This post is part of a weekly series on Women and Health Reform.

This has been an exciting week for us, with lots of momentum (and press!) building up around Tuesday’s public launch of the major coalition for health reform that we are proudly a part of – Health Care for America Now. We joined this coalition because health reform must be a top national priority. Too many women and their families don’t have access to affordable, high-quality health coverage. Too many others are worried that—as health care costs and insurance premiums rise—they will lose the coverage that they now have. We will continue to fight for progressive health reform that meets the needs of women across the country, and thanks to the Health Care for America Now coalition, we know that we aren’t alone. We’re united with over a hundred other organizations representing people from all walks of life - teachers, small business owners, communities of color, nurses, rural residents, faith-based groups, medical students, and so many more. We urge you to find out more about where Health Care for America stands on important health reform issues and to tell us which side you are on in the fight for progressive health reform. Stay tuned for more exciting news about our work with the coalition in the future.