Womenstake

Since When is Health Insurance that Covers Pregnancy or Cancer Considered "Cadillac" Health Care????

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

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

There is a very dangerous concept being sold out there that “something is better than nothing” when it comes to health insurance. That is, for the uninsured, having inexpensive bare-bones coverage is better than having no coverage at all.  It’s this notion that for people who can’t afford health insurance, we’ll just strip it down, cut out all those “extras” and poof! It’s affordable health coverage! This dangerous notion has most recently popped up in Florida, as the legislature there just passed legislation to allow insurers to sell bare-bones health coverage.  Governor Crist said that while he realized it wasn’t “Cadillac” health care, he called it "a model for the rest of the nation” and said that it would “provide a ‘golden opportunity’ for uninsured Floridians.” This sounds more like fool’s gold to me, because bare-bones coverage could only be a golden opportunity if you never get sick; the only golden opportunity here is for the insurance industry.

While it is good that plans would cover preventative care, insurers would sell supplemental plans that cover health services for pregnancy or cancer; basically, if you want this coverage, you have to choose it and pay more. But what’s not made clear is that if you buy one of these bare-bones plans and then you actually need more extensive coverage because you get sick, all too often you can’t get it, because insurers may exclude coverage for pre-existing medical conditions. Furthermore, people who have decent health insurance could lose what they have if their small employer switches to one of these bare-bones plans.

Uninsurance: Real Women, Real Consequences

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

News about America’s health care crisis is particularly prominent this week, since the national weeklong “Cover the Uninsured”  campaign began on Monday. Health advocates across the country have organized press conferences, community forums, and other such events this week to call attention to the plight of the 47 million Americans who don’t have health insurance. In recognition of the campaign, today we highlight the many women who are uninsured. In 2006, more than 17 million women lacked health coverage – that’s nearly one in five. 

So, who are the uninsured women? Last year, we answered that question in our issue brief Women and Health Coverage: The Affordability Gap. We found that almost two-thirds are poor or near-poor, living in families with incomes at or below 200 percent of the federal poverty level (that’s about $35,000 a year for a family of three). Most work full- or part-time. Women of color are over-represented among the uninsured, especially Latinas. Young women also make up a disproportionate share of those without coverage. A little less than 50 percent of all uninsured women are married, and more than a third live in a household with children.

Refusing to Accept Lowered Expectations for Health Reform

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

A very disturbing article appeared in “The Hill” – an “inside the beltway” publication that covers our federal government and the legislative/political process. With apologies to the staff of the Hill, it is probably very safe to say that the overwhelming majority of the American public has no idea this publication even exists. And typically I’m not one to argue that folks outside the beltway need to pay attention to that Washington-insider kind-of-stuff anyway. Today is a giant exception. The article, which provided a very bad start to my day, basically quoted several members of the Senate as saying that we needed to lower our expectations for any kind of comprehensive health reform in the next Congress. These Senators argue that—given how challenging reform will be—we should focus on smaller pieces until then. That, perhaps, we’re not ready yet for that kind of comprehensive reform.

Excuse me, but not ready? How many more of the uninsured and underinsured have to die before we’re ready? How many more people need to end up in medical bankruptcy before we’re ready? How many more people have to lose their health insurance when they lose or change their job before we’re ready? How many more employers have to face the awful choice of continuing to provide health care for their employees or face competition from around the globe that will put them out of business before we’re ready? How many more people have to face the skyrocketing costs of insurance before we’re ready?

This election needs to be about health care reform that will guarantee comprehensive affordable health care for all of us. If our elected representatives are not ready for health reform- they had better get ready. And we need to hold them accountable if they fail to do so.

Merely lowering expectations will not help a single person who is impacted by the health care crisis in this country. Do we have work to do? Absolutely. But I can assure you – we are quite ready for reform.

For Women, Life is Short(er)

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

So, what’s on your list of stuff to do at some point during your lifetime? Will you visit all seven continents? Open a restaurant? Bowl a perfect 300? Well, according to a new study on trends in life expectancy, some American women may not have quite as much time as they thought. A significant number of women (about one in five) in this country are experiencing stagnating or falling life expectancy, for the first time since the flu epidemic of 1918. In other words, women’s lives here are getting shorter. 

Researchers say that this trend reversal is driven by “increases in death from diabetes, lung cancer, emphysema, and kidney failure…and the slowing of the historic decline in heart disease deaths.” First we learn that U.S. life expectancy now lags behind 41 other countries, (despite the fact that we spend more on health care per capita than any other nation) and then we find out that the gap in life expectancy between rich and poor Americans is growing, and now this?

However depressing the news may be, we were still glad to see it splashed over the front pages of major newspapers like the Washington Post. It is the perfect “poster story” for why health reform matters for women. When our health system fails, our lives get shorter. It also points to the need to address health disparities for women – especially in rural areas. If we can improve women’s access to comprehensive and affordable health coverage, we also improve their ability to schedule that mammogram, get the supplies they need to manage their diabetes, or visit a doctor to learn how to control their blood pressure. And when women can get the care they need, they’ll live healthier…and longer. Long enough to cross off all that stuff on their list.

When Health Insurance Isn't

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

A recent New York Times article about huge copayments for “Tier 4” prescription drug coverage has created quite a stir. Here’s a little scenario to demonstrate how Tier 4 coverage works (or—more accurately—doesn’t work):  Imagine that you are insured, and you’ve just been diagnosed with breast cancer. Or multiple sclerosis. Or Lupus. You think, “Wow.  This diagnosis really sucks. But, there are treatment options and at least I have health insurance. Things will be okay.”

But, wait…not so fast. If you need Tier 4 drugs, maybe you shouldn’t be so optimistic.

The pharmacy tier system is nothing new. Drugs are divided into different “tiers”, and copayment amounts—which are almost always a fixed fee—increase by tier. The rationale is that a tier system will encourage people to use less costly drugs, since often there is a CHOICE that people can exercise: pay less for the generic if available, or if they prefer the brand, pay a little more. Tier 1 (i.e. a copay of around $10) generally includes generic drugs. Brand name “preferred” drugs are usually Tier 2 (i.e. a copay of around $20), and Tier 3 typically everything else (i.e. a copay of around $35). These three tiers are all that most of us have ever known. 

Love. Health Insurance. Taxes.

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

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

Oh, the things we do for love. Why else would I agree to sushi when I’d rather have Thai, tune into NPR’s “Car Talk” even though it bores me to tears, and get out of bed to investigate midnight noises that — as a heavy sleeper — I would normally snore straight through? I do these things because they are part and parcel of being in a committed relationship, and because they make the person that I love feel happy and safe. This makes sense, no?

Our current health insurance system recognizes — and even promotes — this desire to provide for and protect our loved ones in some important ways. First, most employers offer health insurance to their employees’ family members, as part of their overall compensation package. In addition, the employee doesn’t pay taxes on the health benefits that the employer gives their family members. For workers, this is a good deal all around — benefits for the people they care about, and no taxes. Still making sense, right?

Unless, of course, you aren’t married to that person that you love. Workers with unmarried domestic partners (whether same- or opposite-sex) can pretty much kiss that good deal goodbye. They should consider themselves lucky if their employer even offers health insurance coverage for their partner — about three out of four American employers don’t. If they beat those odds and are fortunate enough to work at a place that does offer partner benefits, they’ll find that (unlike their married co-workers) their loved one’s coverage is taxed as part of their income. Same committed relationship. Same health benefits. Unequal taxes. This is where things stop making sense.

Health Reform in Our Own Backyard

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.

Like most things, living in Washington D.C. does have its drawbacks. But lately, there are a lot of things to cheer about in our fair city – a brand spanking new baseball stadium, gorgeous cherry blossoms all around, and a just-introduced health reform proposal for universal coverage.

The Healthy DC Act sets a goal of universal health coverage for District residents by 2010. After a quick analysis of the proposal, here are some early thoughts:

• We love that Healthy DC explicitly states the need to expand health coverage that is affordable, accessible, and comprehensive;
• It’s also great that the new program would offer broad coverage to uninsured residents, with many of the benefits that women need to stay healthy like preventive care, prescription drugs, maternity care, and mental health services;

Gender Bias: Just What the Doctor Ordered

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.

As good Catholic schoolgirls, we heard it all the time growing up - “Actions speak louder than words.” And a new Canadian study of gender bias among physicians confirms that indeed, what doctors say isn’t the same as what doctors do, and this is a problem. When surveyed, doctors say that a patient’s gender has no effect whatsoever on their decision to refer that patient for a total knee arthroplasty (AKA a new knee). So researchers trained two people—one man and one woman—to act as standardized patients with identical levels of knee osteoarthritis. This pair of patients visited more than 70 doctors, presenting the same set of symptoms (and the same medical history and health status) in exactly the same way, and ending their descriptions with the exact same line, “Do you think I need a new knee?” But doctors’ recommendations weren’t exactly the same for these two patients; it turns out that the male patients were twice as likely as the female patients to receive a recommendation for a new knee (and researchers indicate, by the way, that a new knee is in fact the right treatment decision for a patient with this level of osteoarthritis).

Faith, Hope, and Charity in Health Care - Not Exactly What You Might Think

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. 

Since this series began, our health reform blog posts have generally provided graphic examples of the extent of the nation’s health care crisis (with one exception).  As if we needed any more evidence, some recent news stories help make the case for comprehensive health reform:

Faith:  Last week this story described the growing number of faith-based alternatives to health insurance, otherwise known as “faithcares” or “biblical healthcare solutions”. Basically, these are ministry-administered health financing pools that people can join in lieu of purchasing health insurance coverage. For those who don’t have access to affordable real health insurance, faithcares might be the only option for protection against unexpected or catastrophic healthcare costs, since they require lower premiums than that of a typical employer-sponsored or individual health insurance plan. But faithcares sure aren’t for everyone - members must be nonsmokers, moderate- (or non-) drinkers who go to church regularly, don’t have premarital sex, and live by biblical principles. Even for those who fit this description, there is another major problem with faithcares – they are NOT health insurance plans, so they are pretty much unregulated. As the article points out, nothing about these financing models is guaranteed– “If members don’t [send in money] there is nothing to share.” –and this can and has led to problems with members getting their due reimbursement for health costs. Also, because there is little government oversight of faithcares, they are especially vulnerable to fraud or mismanagement. A few years ago a faithcare was required to pay back over $20 million dollars in unpaid claims, because the founder had diverted much of the financing pool to his personal bank accounts.

When Health Insurance Gets in the Way of Health Care

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.

Yesterday, we learned that one-quarter of American young women ages 14 through 19 have a sexually transmitted infection (STI). Educating adolescents about the risks of STIs, and how to protect against them, is one way to respond to this shocking statistic –- an earlier NWLC blog post covered why comprehensive sex education should be promoted over ineffective abstinence-only programs. Another important way to prevent the spread of STIs is by ensuring that all sexually active people are regularly screened for these infections.

So, shouldn’t it be as easy as possible to get an STI screening? We thought so, but then we got this e-mail from a co-worker:

“During my recent annual visit with a new gynecologist, I was shocked by the doctor’s response to my request that she screen me for STIs along with my annual Pap test. Although my gynecologist didn’t exactly dissuade me from getting screened, she warned against having it done during my annual visit. In her experience, insurance companies often refuse to pay for STI screening done during an annual exam; insanely enough, she finds that insurance companies are more likely to cover STI screening when the patient returns for a second pelvic exam.”

What?!? Let’s be honest – what woman wants to endure more than one pelvic exam a year? Raise your hand ... we thought not! And there’s the time and expense to consider as well. Although our co-worker has health insurance and we work for an organization that would allow time off to return for a second pelvic exam, not all women are nearly as fortunate: 18 percent of women in the United States lack health insurance coverage, and D.C. only recently became the second city in the country to require employers to grant employees paid sick leave.