Womenstake

Oklahoma Passes Law Prohibiting Health Insurance Discrimination

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

Good news out of Oklahoma! Last week, Governor Henry signed SB 1251 into law, to prohibit discrimination against DV survivors in health insurance. The bill, which was introduced by state Senator Jim Wilson, prohibits any insurance plan issued or renewed on or after November 1, 2010, from denying, cancelling, or refusing to issue or renew coverage based on an applicant’s status as a DV survivor, denying a claim based on an applicant’s status as a DV survivor, or treating domestic abuse as a pre-existing condition. It passed both chambers of the state legislature unanimously.

This important—and long overdue—accomplishment makes Oklahoma the third state (along with Arkansas and North Carolina) to have passed a law or issued formal regulations to prohibit health insurance discrimination against DV survivors since October 2008, when the National Women’s Law Center publicized data—first reported by the Women’s Law Project and Pennsylvania Coalition Against Domestic Violence—which showed that in nine states and D.C. (Arkansas, Idaho, Mississippi, North Carolina, North Dakota, Oklahoma, South Carolina, South Dakota, and Wyoming), it was still legal for insurance companies to deny coverage to survivors of domestic violence.

Health Reform’s Progressive Credentials: Exhibit A - the Medicaid Expansion

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

Back when the public plan option was dropped from the health reform bill, I recall that many of my friends were deeply disheartened. "Without it," they wondered, "is this bill really the progressive victory we’d hoped and fought for?" I confidently assured them that it was and offered plenty of evidence to support my claims: an end to insurance company discrimination against women and people who get sick, and health insurance subsidies to make coverage more affordable for low- and moderate-income families, to name two. But the Medicaid expansion—a provision that will make up to 4.5 million uninsured low-income women newly eligible for comprehensive health insurance coverage —was Exhibit A.

Thinking back on that conversation now, I’m reminded of a comment that a colleague—and long-time Medicaid expert—made the day after health reform was signed into law; it was her words that really drove home for me the magnitude of our accomplishment. "I have all this useless knowledge now!" she joked. "Which states don’t provide Medicaid coverage to childless adults at any income level; how many states have income thresholds for working parents below 75 percent of poverty—now that Medicaid will be expanded to everyone with incomes at or below 133 percent of the federal poverty level, I don’t need to worry about it anymore!"

Health Reform’s Good and Bad Contributions to National Day to Prevent Teen Pregnancy

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

Health reform carries both good and bad news for those of us honoring National Day to Prevent Teen Pregnancy today. I’ve always been one to swallow the bad news first, so let’s start there: thanks to an amendment from Senator Orrin Hatch (R-Utah), the Patient Protection and Affordable Care Act (PPACA) restores $50 million in annual funding, through 2014, for abstinence-only-until-marriage programs under Section 510 of Title V. 

Remember Section 510 of Title V? You know, that discriminatory, ideological law that requires that federally funded abstinence-only programs teach things like: "sexual activity outside of the context of marriage is likely to have harmful psychological and physical effects"? I know, I know, we wanted to forget it, too; we hoped we had already resolved this issue back in June, when funding for the program lapsed. And considering that 23 states had already rejected Title V federal funding due to concerns about the efficacy of abstinence-only programs, our optimism wasn’t so farfetched. But it was, it turns out, premature.

Health Reform and Freedom

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

On Sunday, during the House debate on health reform, Rep. Marsha Blackburn pronounced that “freedom dies a little bit today.” Whether or not you agree with her depends, I suppose, on your definition of freedom. 

I know that I don’t want to live in a country where insurance companies are free to deny coverage to survivors of domestic violence and sexual assault, to treat pregnancy as a pre-existing condition, or to rescind coverage when an enrollee who’s been dutifully paying her premiums for years suddenly becomes ill. I don’t want to live in a country where states are free to decide that even a single mother earning $3,000/year shouldn’t be eligible for public health insurance (I’m looking at you, Arkansas).

Here’s what else I know: For the woman leaving an unhappy job to start her own small business—without fear of trying to find insurance on her own—the health reform signed into law yesterday is freedom. For the mother who breathes a sigh of relief when she finds coverage for a child with a pre-existing condition, health reform is freedom. For the woman on Medicare who can afford the prescription drugs that keep her active, health reform is freedom. For the woman who wants to have a child and is able to do so without hesitation, confident that her insurance will cover the costs of prenatal care and labor and delivery, health reform is freedom. For the young woman who can take that unpaid internship at the company of her dreams, knowing that she can get health coverage from her parents, health reform is freedom.

Those are the freedoms that define the American dream. Those are the freedoms we’ve been fighting for. Congratulations to all.

BREAKING NEWS: Health Reform Bill “Fixes” Include Raising the Reimbursement Rate for Primary Care Providers under Medicaid

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

In January, we wrote a blog praising health reform’s Medicaid expansion but wondering whether there would be enough providers participating in the program to ensure that the 16 million people newly eligible for Medicaid will be able to access the care they need. On Monday, the New York Times published an article that asked the same question.

Those concerned about Medicaid reimbursement levels—and what that means for patients—received some good news yesterday afternoon, when the package of “fixes” to the Senate health reform bill was released. Under the revised bill, to prepare for the dramatic increase in Medicaid enrollment in 2014, states would be required to increase their reimbursement rates for primary care services under Medicaid in 2013 and 2014—and the federal government would pick up the whole tab. For those two years (at least!), Medicaid reimbursement rates for primary care would have to equal the higher rates paid under Medicare. The required rate increase would only apply to primary care services provided by specialists in family medicine, general internal medicine, and pediatric medicine; regretfully, states would not be required to increase the payment rates to OB-GYN specialists for the important primary care services they provide.

While this fix doesn’t go all the way towards solving the problem, it’s a significant improvement from the original Senate bill and an important step towards ensuring that the millions of people gaining Medicaid eligibility under health reform will gain access to the care they need. Though at this time, states will only receive extra federal dollars to help them afford this rate increase for two years, we will work tirelessly in the coming years to ensure that states receive the federal support they need to maintain these higher reimbursement rates in 2015 and beyond.

Two States and D.C. Take Steps to Finally Outlaw Insurance Discrimination Against Domestic Violence Survivors—But Women Need Federal Health Reform That Will Go All the Way

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

Two additional states and D.C. have finally stepped up efforts to put an end to one of the most outrageous health insurance industry abuses: discrimination against survivors of domestic violence.  While we’re grateful for the (long overdue) legislative commitment in South Dakota, Oklahoma, and D.C. to solving this problem, not all their bills completely solve the problem, and other states have not yet acted at all—yet more evidence for why, when it comes to regulating insurers, women need minimum protections that apply in all states.
 
In October 2008, the National Women’s Law Center publicized data—first reported by the Women’s Law Project and Pennsylvania Coalition Against Domestic Violence —which showed that in nine states and D.C. (Arkansas, Idaho, Mississippi, North Carolina, North Dakota, Oklahoma, South Carolina, South Dakota, and Wyoming), it was still legal for insurance companies to deny coverage to survivors of domestic violence.  Due largely to the dedicated efforts of local advocates, Arkansas quickly responded by passing a law outlawing the practice. 

President Obama’s Bipartisan Health Care Summit: The Good, the Bad, and the Ugly

by Julia Kaye, Brigette Courtot, and Kelli Garcia,
National Women's Law Center

A colleague of ours equated yesterday’s Bipartisan Health Care Summit to a Superbowl for the CSPAN crowd. The event featured an all-star lineup from the White House, HHS, and Congress — though notably, only a paltry four female members of Congress were among the 33 Congressional attendees — with each team in strategic formation on either side of the (not-entirely-objective) referee. 

While we can’t speak for the rest of the American people, we were certainly riveted (CNN covering a debate about actuarial values? Be still our hearts!). But for those of you who: a) couldn’t justify watching TV for an entire workday to your boss; or b) couldn’t be paid enough to watch politicians debate health policy for 7 hours, here’s a roundup of the good, the bad, and the ugly:

Adding Emergency Contraception to the Basic Military Formulary - Then and Now

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

It appears the Pentagon is finally taking steps to right a longstanding wrong.

This week, the Pentagon posted minutes from a November meeting of the Department of Defense’s (DoD) Pharmacy and Therapeutics Committee, at which the Committee overwhelmingly voted to add two brands of emergency contraception (EC) to the military’s basic formulary.  This would ensure that EC is universally available at military pharmacies. 

Although Plan B® – one of the few dedicated emergency contraceptive pills currently on the market – was at one time approved for the formulary, the approval was mysteriously rescinded for what appear to be political reasons.  Here’s how it went down:

Open Letters to My Family and Friends on Why They Should Demand Comprehensive Health Reform NOW

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

For two weeks, I’ve been alternately frustrated and furious with the mixed signals on health care reform that are coming from Capitol Hill. Now, I have no doubt that the White House and Congressional leadership are committed to passing health reform; indeed, the President’s budget, released this week, assumes its passage. But too many members irrationally fear that the victory of a state senator from Massachusetts who voted for, and continues to support, comprehensive health reform in his state somehow equates to their being voted out of office in November if they finish the job of passing a comprehensive health reform bill that will allow almost everyone to get health insurance, make sure that insurance is real, and start to bend our nation’s health care cost-curve.

But this weekend, while at Families USA’s annual Health Action conference, I was reminded of something that knocked me out of my misery and into action: Congress works for us. 

If we each hold ourselves responsible for making sure that our friends and family understand what health reform entails and then call Congress to demand its passage, our collective voice will give our elected officials the motivation they need to pass the greatest investment in our nation’s health and financial security since the creation of Medicare and Medicaid in 1965.

The Onion’s Abortion Satire Brings Tears to The Eyes

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

You know when a comedian presents a social commentary so fantastically apt that you turn, head shaking, eyes tearing with laughter, to the person beside you to heartily exclaim, “That’s soooo true!”? 

What about when a comedic website presents a social commentary so scarily plausible that you turn, head shaking, eyes tearing with frustration and anger, to the person beside you to bitterly observe, "That’s practically true"?

Last week, the headlines on The Onion News Network announced: "New Law Requires Women to Name Baby, Paint Nursery Before Getting Abortion." Commenting on the new law, one Onion analyst agreed, "It's just common sense that viewing an ultrasound image of a fetus and then painting a nursery either pink or blue helps give women the information they need to make sure they’re making the right decision!"

If only it were just a joke.

As we wrote about back in October, two new laws relating to abortion in Oklahoma are now being challenged in the courts. One would require women seeking an abortion to fill out a lengthy and invasive questionnaire about her reasons for seeking the procedure (as well as her marital status, education level, and more); the other would require the physician to conduct a sonogram of the pregnancy before performing the abortion and to describe the fetus in detail. This law would also mandate the use of a vaginal transducer (a probe for the ultrasound that’s inserted in the vagina) for certain women, if it would provide the clearest image.