Womenstake

Young, Brilliant, and Baffled by Health Insurance

by Lauren Hunter, Outreach Intern, 
National Women’s Law Center 

This post is part of a series about young adults and health care reform. 

Last week, I was talking on the phone with a good friend from high school, Sara, about the monumental changes in her life. She just returned from a semester in Spain, has been preparing to move into an apartment with her boyfriend and is contemplating life after college graduation. The latter – one component in particular – was inducing panic.

“After I graduate, my parents’ health insurance won’t cover me. When I mentioned to a friend who graduated a few years ago that I was hoping to get a job with health benefits, she laughed at me! I have no idea how to buy health insurance on my own or what kind I need or whether I can afford it.”

Her sense of impending doom resonated with me and highlighted the absurdity of our current system. Sara is an intelligent, organized, competent 21-year-old. She has supported herself financially for three years, rented an apartment for one, studied in a foreign country for six months and will graduate from college a semester early with a killer GPA. 

Yet the thought of attaining health insurance terrifies her.

And Sara is not alone. Many young adults have struggled to access and understand convoluted health insurance policies. Many young adults have faced or are close to someone who has faced unaffordable premiums or out-of-pocket costs. And many young adults have thought about forgoing health insurance. In fact, 27.5 percent of Americans ages 18-24 lack health insurance – the highest rate in all age groups. 

Gender disparities in health care make the situation worse for young women. Due to the practice of gender rating, many health insurance plans are unaffordable: the National Women’s Law Center discovered that 25-year-old women have been charged up to 45 percent more than 25-year-old men for the same exact insurance plans. In addition, many plans don’t offer adequate coverage of reproductive health services, such as prescription contraceptives. Since the average American woman is trying to avoid or postpone pregnancy during more than 22 years of her life, affordable health coverage that includes reproductive health care is crucial to her well-being.

Policymakers must not ignore the youth – young women in particular – when they reform our broken health care system. Obtaining health insurance must be simple, affordable, and appealing for the young and healthy, as well as for everyone else.

DC Rallies to Support Health Care Reform

by Judy Waxman, Vice President for Health and Reproductive Rights, 
National Women's Law Center 

Advocates around the country are mobilizing in Washington, D.C., next week to show their support for health care reform.

And we want you to be one of them.

Join the National Women’s Law Center and our partners for two rallies to support the fight for meaningful health care reform this year!

This summer, Congress is working to fix our broken health care system. And to make sure that health care reform meets the needs of women and their families, we are working with our partners to bring your voices into the debate.

On the evening of Wednesday, June 24, advocates will be gathering in downtown Washington, D.C. at Freedom Plaza to support health care equality for women, people of color, and minority populations. The event will feature Members of Congress, prominent health care advocates, live cultural events, and dinner for all those who register for the event. 

And on the morning of Thursday, June 25, thousands of health care advocates will be coming to Washington, D.C., to lobby every Member of Congress in support of quality, affordable health care for all. The event will include a rally with thousands of health care advocates and a march to the Capitol Hill.

Come out and show your support for meaningful health care reform this year!

Thank you for continuing to fight with us for high-quality, affordable, accessible, and comprehensive health care for all.

Just Released: Kennedy Bill Makes Headway for Health Reform

Confronts obstacles faced by women

The Health, Education, Labor and Pensions (HELP) Committee unveiled the full text of its health care reform bill, “Affordable Health Choices Act,” this afternoon. The following is a statement by Marcia D. Greenberger, Co-President of the National Women’s Law Center (NWLC):

“This is a momentous day for our country, and for the millions of Americans who can’t afford to wait any longer for meaningful reform that will guarantee quality, affordable comprehensive health care for all. Senator Kennedy’s leadership on the Affordable Health Choices Act reflects a lifetime of dedication to health care issues, and the nation owes him a debt of gratitude for lighting a fire under health care reform.

“This bill reflects years of work, expertise, and careful consideration of options. The critical headway it makes towards women’s ability to secure access to quality, affordable health care throughout their lives reflects this extensive work and expertise.

“Senator Kennedy’s bill underscores that quality, affordable and comprehensive health care for women and their families is attainable now.

“One of the exciting aspects of the bill is that it confronts many of the particular obstacles faced by women in our current health care system, and eliminates many insurance industry practices that are especially harmful to women.

“For example, it bans the discriminatory insurance practice of gender rating, whereby women are charged more than men in the individual insurance market, even with maternity benefits excluded, and – in the case of group coverage – employers are charged based on the gender make-up of their workforce. The bill would also ban the insurance industry practice of rejecting applicants based on health status or history – a harmful practice that has, for example, prevented survivors of domestic violence and women who have had caesarean sections from getting health coverage.

“We commend Senator Kennedy for his visionary leadership on health care, and look forward to working with Congress and the Administration to enact meaningful reform that will guarantee quality, affordable comprehensive health care for all.”

Health Reform Can't Come Soon Enough: New Findings on Medical Bankruptcy

by Brigette Courtot, Policy Analyst, 
National Women's Law Center 

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

There’s a new study out on medical bankruptcy, but if you’re in an otherwise good mood, read it at your own risk. The findings are dismal, disheartening…nearly any gloom-inspiring adjective will do. If the term is new to you, the medically bankrupt are those who have filed for bankruptcy and report illness or medical bills as factors in their filing. It turns out that in 2007, the majority of all bankruptcies—a whopping 62 percent—had a medical cause. For the most part, those filing for medical bankruptcy were well-educated, middle-income earners, and had health insurance when they filed. Researchers also found that being female significantly increases the odds that a person will file medical bankruptcy—no surprise there, since we have plenty of evidence that because women have lower incomes and greater health care needs than men, they are more likely to face unaffordable medical bills and debt, and to delay or skip necessary care because of cost.

The fact that a single medical event could leave a family in financial shambles demonstrates just how broken our health care system is. Fortunately, though, there’s some exciting news to balance these depressing new findings—in the coming weeks, we’ll begin to see the details of how Congress plans to fix our fragmented and failing health system. During this critical time, NWLC is advocating for the types of health reform that will guarantee that women and families won’t go bankrupt when they need health care. We’re calling for a reform plan that includes adequate subsidies to help moderate and low-income individuals and families obtain coverage; a minimum standard for health insurance benefits to ensure that everyone has comprehensive coverage; and, a limit on out-of-pocket spending (e.g. copayments, deductibles) so that families have the security of knowing they won’t face financial devastation when they’re also facing illness or injury. This new study reminds us that health reform is about peace of mind; for the millions of Americans living in fear of losing their homes/savings/kids’ college funds because of medical bills, reform can’t come soon enough.

Get Involved: Rally & Lobby Day for Health Care Reform

by Judy Waxman, Vice President for Health and Reproductive Rights, 
National Women's Law Center 

Thousands of health care advocates from around the country will be mobilizing in Washington, D.C. at the end of June — will you be one of them?

This summer, Congress is working on fixing our broken health care system. And to make sure that health care reform meets the needs of women and their families, we are working with our partners at Health Care for America Now (HCAN) to bring the voices of Americans from across the country straight to Capitol Hill.

Sign-up today and find out more about how you can take part in one of the biggest health care reform rally and lobby days this year.

On June 25th, 2009, thousands of health care advocates will descend on Washington, DC to lobby every Member of Congress in support of quality, affordable health care for all. The event will include a rally with thousands of health care advocates and a march to the Capitol Hill.

If you can’t make it to Capitol Hill, you can still participate in the many echo events that will be taking place around the country at the same time. Sign-up today to find out more about how you can be part of the voice for health care reform that works for women and their families.

Thank you for continuing to fight with us for high-quality, affordable, accessible, and comprehensive health care for all.

Health Care Affordability Problems Persist for Women

by Brigette Courtot, Policy Analyst, 
National Women's Law Center 

A recent analysis by the Commonwealth Fund shows that women experience cost-related health access barriers at higher rates than their male counterparts. These new findings echo those of a similar study conducted by the National Women’s Law Center and the Commonwealth Fund two years ago. Though women are no more likely to be uninsured than men, they are more likely to skip or delay necessary health care because of cost, and they report more problems paying medical bills and with accrued medical debt. These inequities are a result of women’s lower incomes (in 2007, women earned 0.78 cents for every dollar men earned) and the fact that they need and use more health care than men. Women’s responsibility for their children’s health care is an additional factor, as women with medical debt or bill problems are more likely than their male counterparts to be single with children.

What is especially distressing about the new analysis is that the affordability problems women encounter in the health care system are only getting worse. In 2007, we reported that 43 % of nonelderly women experienced problems accessing health care because of cost; now, this figure has risen to 52% (the corresponding statistics for men are 30% and 39%, respectively). Reports of medical debt and outstanding medical bills have also increased — two years ago, we found that 38% of women (and 29% of men) had these problems, but now 45% of all women (and 36% of men) struggle with these financial burdens.

The study reveals that affordability problems are becoming more commonplace for women regardless of their income level or insurance status. While women who are uninsured or underinsured (i.e. insured, but with coverage that requires high levels of out-of-pocket spending relative to income) are most likely to have trouble affording health care, even insured women are struggling to keep up with health care costs. One in three women with health insurance year-round reported cost-related problems with accessing care. Similarly, a third of all women with annual incomes over $60,000 have trouble affording the health care they need.

What types of necessary health care are women are putting off because they can’t afford it?  The list includes cancer screenings, treatments or tests that a doctor recommended, follow-up care with specialists, and prescription drugs to help manage chronic diseases. Without this care, women are at risk of developing more complicated and costly illnesses or injuries later on. It’s exhibit #1 in the case for comprehensive health reform — when health insurance is unavailable or inadequate, people don’t get the care they need to stay healthy, quality-of-life suffers, and we all pay the price somehow, whether it’s in lower workforce productivity, poor health status for a significant — and growing — proportion of the population, added pressure on the health care safety-net, or cost-shifting to pay for increasing levels of uncompensated care. As the Commonwealth Fund authors aptly conclude, “the experiences of U.S. women highlight the fragmentation and failings of the nation’s health care system.” Women’s experiences tell us that health reform must place a high priority on affordability, by guaranteeing health insurance that sufficiently covers the health needs of women and their families, with built-in cost protections to ensure that both premiums and out-of-pocket costs do not impose a barrier to necessary care.

Tell Your Members of Congress We Need Real Health Care Reform

by Judy Waxman, Vice President for Health and Reproductive Rights, 
National Women's Law Center 

Have you seen them yet? Opponents of real reform are mobilizing and stepping up their efforts to block comprehensive health care reform. They're also presenting so-called health reform proposals that will only keep the current broken health care system in place. Don't let them take away our chance to make real change that matters to women and their families — Call or visit your Members of Congress and tell them that we need comprehensive health care reform this year. 

Your Members of Congress need to know that health care reform that meets the needs of women and their families will result in health care that is:

• Affordable: Health insurance premiums should not be based on such factors as health status or gender, but rather on a family’s ability to pay for health care. 
• Comprehensive: Health care 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. 
• Accountable: Any plan for health reform should include a watchdog role for government to ensure that health insurance companies do not improperly delay or deny coverage based on a person’s health history, age, or gender. We should have a real choice; keep the insurance you have if you like it, or choose between a private and public health insurance plan. 
• Equitable: Health care reform must ensure there are no gaps in access to care, and work to root out disparities in health care access that currently exist. 

Congress is at home for their "recess" — and so this is one of the last chances for you to call or visit Congress at home and tell them how to make health care reform legislation work for women and their families. When they return, they will be rapidly working to finish drafting health care legislation. It is critical that they hear from you that women and their families need real reform. Call or visit your Members of Congress while they are home and tell them how health care reform can work for women and their families.

Also, if you haven't had a chance, take some time to share your health care stories and ideas with the Obama Administration.

Patients' Choice Act: Nice Rhetoric, Swiss Cheese Policy

by Julia Kaye, Health Policy Associate, 
National Women's Law Center 

We’ve discussed many times before the difficulties that women face accessing health insurance in the individual health insurance market. So it’s heartening to know that members of Congress from both sides of the aisle have come to recognize the severe failures of the current health care system—nowhere more obvious than in the individual market—and more importantly, are introducing legislation to reform it.

On Wednesday, Senators Coburn and Burr and Representatives Ryan and Nunes held a press conference to announce the release of the Patients’ Choice Act of 2009 (no bill’s been released yet, but a 15-page summary is available here), in which they rightly acknowledged that “the health care system in America is broken.” The heart of the bill is a new model of state-based marketplaces for individuals seeking insurance, or “state health insurance exchanges.” By requiring plans participating in these exchanges to provide coverage regardless of age or health status, to meet a minimum benefit standard, and to be subject to an independent board that will penalize companies that cherry-pick healthy patients and reward companies that seek patients with pre-existing conditions, the bill aims to create “a consistent and fair market, so that everyone can afford coverage.”

And to sweeten the deal, every individual with a healthcare plan will get a tax rebate of $2,300 for individuals or $5,700 for families. Et voila. Affordability problem…solved?

Unfortunately not. The rhetoric is nice, but the policy’s swiss cheese. Let’s poke our way through some of the holes:

Wasting Women's Time with Abortion Restrictions

by Jen Swedish, Health Law Fellow, 
National Women's Law Center

As you are probably aware, this is National Women’s Health Week, and the theme is “It’s Your Time.”  Since Monday, my colleagues have blogged and vlogged about the importance of timing for women in health care – and health insurance coverage, in particular. 

Timing is also crucial for women seeking reproductive health care services.  Twenty-four states currently require women to receive counseling and then wait, usually for 24 hours, before they can receive abortion care.  Proponents of these laws often argue that the counseling and waiting period is essential to ensure that a woman seriously considers the information she has been given before she decides to have an abortion.  Opponents, on the other hand, contend that women are able to make informed decisions about their pregnancies without state-mandated counseling and waiting periods. 

A new report from our friends at the Guttmacher Institute provides fodder for the opponents’ arguments.  Guttmacher found that these laws do not, in fact, cause women to change their minds about having an abortion and, in reality, have very little impact on birth and abortion rates.  A troubling finding of the report indicates that mandatory counseling and waiting period laws may actually postpone the timing of some abortions, increasing the likelihood of more expensive and less safe second-trimester procedures.

As National Women’s Health Week draws to a close, I’d like to emphasize that mandatory counseling and waiting period laws needlessly waste women’s valuable time without benefiting their health. 

It's Our Time: Let's Spend Less of It Worrying about Health Insurance

by Brigette Courtot, Policy Analyst, 
National Women's Law Center

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

If you haven’t already heard, this is National Women’s Health Week, and—as Julia pointed out in yesterday’s blog—the theme this year is “It’s Your Time.”  As in, this is women’s time to get informed and take action to improve their health.  While I appreciate the theme’s intent, my take on women’s time is a little different.  Time is valuable.  There never seems to be enough of it.  And way too much of women’s valuable time is spent worrying about health insurance.  How many women do you know who spend their time worrying about how to get health insurance, how to keep it, how to use it, what it covers, how much out-of-pocket spending it requires…and so on?  

I can think of several women in my own life, right off the bat.  Last year, my partner and I spent far too many hours figuring out the cost implications of getting job-based coverage singly versus as a family—all because federal tax laws treat health coverage for same-sex couples differently from the coverage that heterosexual couples have (2 guesses as to which couple gets a raw deal).  A few months ago, my mother-in-law spent the better part of a week figuring out what consequences her participation in a clinical cancer trial would have on her supplemental Medigap coverage.  A neighbor lost his job this past winter, and his wife spent hours researching how she might quickly get her whole family—including her 9-month-old baby—affordable health insurance, and then more time pleading with her own workplace to waive their plan’s waiting period so the family would not experience a dangerous gap in coverage.

I recently blogged about another friend’s health insurance nightmare; unfortunately that ordeal is still taking up way too much of her time.  Let’s not forget the good friend who had a covert courthouse wedding months before her church ceremony so that she could qualify for her partner’s job-based coverage—she agonized over that for more than a month.  Enough already!  It doesn’t have to be like this!  That’s why we’re fighting for health reform that provides women and their families with a guarantee of affordable, comprehensive health coverage—coverage that is easy to get, keep, understand, and use.  For women, health reform holds the promise of less time spent worrying about health insurance, and more time to devote to the things that bring us happiness.