Health Reformers Say Women Win, No Matter What

WASHINGTON (WOMENSENEWS)–After 10 months of legislative wrangling to advance a health care reform bill, Democrats are making a big push for U.S. women’s support to meet President Obama’s goal of passing some sort of reform this year.

Their message: No matter which congressional version passes, health reform offers a historic opportunity to eliminate serious discrimination against women by insurers.

"We need this insurance reform to bring fairness to the insurance market and particularly for women," said Rep. Gwen Moore, a Wisconsin Democrat, at an Oct. 6 Capitol Hill press conference.

"It is imperative that we implement health care reform that eliminates the practice of categorizing such things as pregnancy, Caesarian sections and even domestic violence as pre-existing conditions," said Rep. Donna Edwards, a Democrat from Maryland, at the same press conference on women and health care. "If left unchecked, these discriminatory practices of the insurance industry would effectively eliminate coverage for millions of women."

Congress has advanced five health care reform bills beyond the committee level, leaving Democrats to meld them into one collection of elements.

Linda Douglass, spokesperson for the White House Office of Health Reform, says they are conducting a vigorous outreach program to woo women.

On Oct. 8, that program included nine Democratic senators who took to the Senate floor in succession to say women would benefit from all versions of health care legislation under consideration.

Women’s Groups Join Effort

In recent weeks, the Obama administration has dispatched Secretary of Health and Human Services Kathleen Sebelius and first lady Michelle Obama to portray health care reform as particularly beneficial for women at various events. One such event was a Sept. 18 White House meeting with about 120 leaders of various women’s advocacy groups.

Women’s advocacy groups are also joining the mobilization effort. Last week, for instance, the National Women’s Law Center launched "Being a Woman is Not a Pre-Existing Condition." The initiative includes promotional videos and a Web site that updates the status of women’s issues in the health care bills.

Insurers in a few states have expanded the definition of pre-existing conditions to include those with a history of victimization by domestic violence because it can result in higher medical costs.

"This is a shameful practice," said Edwards, a former director of the National Network to End Domestic Violence, based in Washington, D.C. "It must stop and it will stop when the president signs into law this year health care for all Americans."

In a 2008 report, the National Women’s Law Center found insurance policies sometimes legally discriminate on the basis of gender. Women are charged higher premiums than men of the same age for the same coverage. Many individual insurance policies exclude coverage for common medical needs specific to women, such as maternity care.

Both men and women face insurer rating systems that set premiums based on age and health status, which can make policies unaffordable to most people, according to the report’s authors.

Coverage Based on Care, Not Gender

Sen. Debbie Stabenow, a Michigan Democrat and a member of the crucial Finance Committee, said during an Oct. 6 conference call that coverage should be based on general types of care, such as prevention or hospitalization, not on "gender or other factors that make no sense in the context of insurance." The conference call was organized by the Democratic National Committee.

When asked why men’s policies should include services that only women can receive, Stabenow said it is a critical way to ensure women do not have to bear a higher financial burden than men.

Other health conditions that are mostly or completely gender-specific, such as prostate cancer in men and breast cancer in women, are generally included in all individual insurance policies regardless of the policyholder’s sex, according to insurance experts.

All versions of health care reform would require insurers to allow children to remain on parental policies through age 26.

This would enable young women to retain needed care between the time when they leave college and establish a career for themselves. Research finds that younger women tend to use more health care for annual exams compared to young men, who often go years without even annual checkups.

"I know this is a great concern for the women that I talk to," Stabenow said.

The advocates hope these changes will both expand access for many currently uninsured women, as well as offer new protections to women who already have insurance.

Female-Friendly Provisions

The bills also contain provisions that prohibit insurers from charging women more than men for coverage and eliminate co-payments on "recommended preventative services," such as breast cancer screening and well-baby visits. All insurance policies would also be required to cover critical primary care services, such as prenatal and maternity care.

Other aspects of health care reform will also have a greater impact on women, such as bans on insurers denying coverage for pre-existing conditions, since more women have conditions that are categorized in this way.

An October poll by the Associated Press found that women, like the general public, are generally split on their support for the health care bills advancing in Congress. However, it also found that women younger than 55 slightly favor the legislation.

A recent Zogby International poll found positions on health care reform falling along sharp partisan lines, with Democrats 10 times more likely than Republicans to rate the nation’s health care system as poor, and eight times more likely to say health care is a right, not a privilege.

Rich Daly is a writer in Washington, D.C.