Health Care Reform—What’s At Stake for Women?

The firestorm about the public option may miss the point for women. Women’s groups have worked with the White House and legislators to put critical expansion of care in all the major health care reform bills making their way through Congress.

Bloggers and cable news folks talk about the schism between leftist Democrats and the Obama White House on health care reform. The outcry is about the prospect that a final health care bill might not contain a public option for health care insurance that would compete for customers along with plans offered by private insurers.

The major women’s groups, however, are focused on something else: winning long-sought expansions in coverage of basic health care for women. This is contained in virtually all the major reform bills moving forward in the House and Senate.

Today, women face higher costs for health care than men. Often, they don’t get needed checkups and medical tests because they can’t afford them. Researchers have found that more than half of all women delayed needed medical care because of the expense, compared to 39 percent of men.

More than a quarter of employed women work part time and are excluded from employers’ health care plans. Buying into plans as an individual is formidably expensive. And a quarter of all non-elderly women get health insurance through another family member, making them vulnerable if that person retires or loses a job.

Women are far more likely than men to have preexisting conditions due to a bout with cancer, diabetes, hypertension or other chronic medical problems—and often are blocked from existing health care plans as a result.

Whether or not they contain a public insurance option, the health care reforms moving through Congress would make major improvements in these and other factors that affect women’s health care. One medical study after another has bolstered the dramatic need for such changes if women are going to get adequate care at all stages of their life. National women’s groups as well as medical professionals have fought for years for these basic needs, which now have been written into the very fabric of the health care reform proposals. Most of them show up in the list of “essential benefits” that are covered in the Health Insurance Exchange, the entity where people would go to select health care insurance if they do not already have coverage.

• Maternity services would be required to be covered by all insurers in the exchange. Many private plans continue to limit coverage of maternity services today.
• Insurers would have to accept applicants with pre-existing conditions, including breast cancer survivors.
• Insurers no longer could charge women more than similarly situated men for health coverage.
• Part-timers could buy into the health insurance exchanges. That also would be true for women who lose their coverage when their husband goes on Medicare.

An August 6 report by the Joint Economic Committee of Congress spelled out the reasons why the current situation serves women poorly. “Women’s health needs differ from men’s so women are obliged to interact more regularly with the health care system—regardless of whether they have adequate insurance coverage or not. Women’s reproductive health concerns, including pregnancy and childbirth, contraception, and the consequences of sexually transmitted diseases require more contact with medical providers.

“Women are more likely than men to have one or more chronic diseases, including diabetes, asthma, hypertension, all of which require ongoing coordinated care,” the JEC report said.

Women also continue to earn less than men, comprise more than half of the country’s poor and whether married or not are most likely responsible for the health and well-being of their children.

Another significant change in the way women would be treated comes in a major expansion of preventive care.

For starters, cost-sharing would be eliminated on key preventive services delivered by Medicare, Medicaid and the insurers in the proposed Health Insurance Exchange.

This would include breast cancer screening, prenatal care, and an annual “well-woman” doctor’s exam, which is recommended by the American College of Obstetricians and Gynecologists to improve the overall health of women.

Under a Women’s Health Amendment by Senator Barbara Mikulski, D-MD., which was approved by the Senate Health, Education, Labor and Pensions Committee, health care plans would cover “preventive care and screening” and also would require health plans operating through the exchange to include federally qualified health centers.

These would include those health care providers that have proven to be the gateway for millions of women, especially lower income and minority women: community health centers, public hospitals, HIV/AIDS clinics, women’s health centers and others.

Expanding this provider network would go far to make sure adequate care actually gets to the country’s women.