Friday, April 9, 2010

Health Reform Gets Underway & Meanwhile, the action has started on abortion coverage!

The clock has already started ticking down toward the effective dates of several features of the new health reform law. What do women and our families need to know? How can women's health advocates make our views known to the federal and state officials charged with implementing the law? RWV will keep you up to date through this newsletter, our blog and upcoming conference calls, webinars and community education sessions.

This week's newsletter explains new coverage options becoming available for previously-uninsurable people with pre-existing conditions and gets you up to speed on the abortion coverage battle that is beginning to unfold out in the states.

New options for people with pre-existing conditions

We will see health reform unfold in stages from now through 2014, and then beyond.

The first people to benefit from health reform will be those who have pre-existing conditions and have been turned down for health insurance coverage, quoted premium prices that are not affordable or seen their policies cancelled when they got sick.  For women, common pre-existing conditions include breast cancer, ovarian cancer and diabetes. Some insurers have also ruled that having been a victim of domestic violence or having had a cesarean section delivery in the past can count as a pre-existing condition!

Shirley Fleming, a 40-year-old survivor of breast cancer, spoke movingly at an RWV speak-out in New York City last spring about what it was like to lose your insurance coverage after getting sick, and then be unable to afford new coverage: "I've lived in this country and worked all my life. Why don't I have health coverage when I need it?"  

So, what does health reform do about this problem? Within 90 days after enactment of the law (so, by late June), people with pre-existing conditions who have been unable to find or afford insurance will be offered the chance to obtain affordable coverage through a safety-net program known as a "high-risk pool." The federal government will allocate $5 billion to establish a national high-risk pool and help states establish or improve their own pools. This option is intended as a temporary measure until state health insurance exchanges open in 2014 and insurers are prohibited from denying coverage to adults with pre-existing conditions.

As many as 2 million Americans are expected to be helped by this program. Want to learn more about what this could mean for you or a loved one? The easiest-to-understand explanation comes from National Public Radio.

If you are a wonky women's health advocate (like some of us in RWV!) who wants to help shape the way this coverage option unfolds in your state, you can find the most extensive set of resources on the website of the health reform advocacy group Families USA.  If you want to learn more about what's at stake for women in the shaping of the high-risk pools and how you can get involved, watch our blog or email us.

Meanwhile, the action has started on abortion coverage!

You thought the abortion coverage debate was over when President Obama agreed to sign that executive order and Rep. Bart Stupak voted for the health reform bill? Think again!

The health reform law maintains existing unjust restrictions on the use of federal funding for abortion coverage in Medicaid, the Federal Employees Health Benefit Program, the Indian Health Service and health insurance provided to women in the military and Peace Corps volunteers.  Those of us who hoped a new President might be able to help ease or even overturn these so-called Hyde Amendment restrictions had our hopes dashed by a Congress in which the Democratic majority, unfortunately, is not also a pro-choice majority. Recent media coverage in The Nation and other publications has examined this sobering reality and what we must do to change the situation.

The new twist is how the abortion restrictions are going to be applied to the coverage that women will be able to purchase in the state insurance exchanges that will be launched in 2014. States have been given two options to consider: 1) prohibit abortion coverage in the state exchanges or 2) allow abortion coverage, but adopt regulations that prevent the use of any federal insurance subsidies to purchase health coverage that includes abortion.

While these state exchanges won't open for business for almost four years, a fierce abortion coverage battle already has broken out in some states. The Guttmacher Institute reports that lawmakers in five states, including Tennessee and Oklahoma, have already introduced bills to ban abortion coverage in their state insurance exchanges (option 1) The Wall Street Journal reported on this state-level activity today.

Meanwhile, HHS Secretary Kathleen Sebelius, members of the National Association of Insurance Commissioners (NAIC) and women's health advocates are busy trying to figure out how to carry out option 2, which requires the strict segregation of federal subsidy monies from any abortion coverage. This option includes the notorious 2-check scheme that RWV and other reproductive justice advocates campaigned against ( prior to the final vote on health reform.

Sebelius must issue guidelines for states on how to implement this segregation scheme. RWV and other women's health advocates will be weighing in on ways to make the requirements less onerous for women and insurers. The last thing we want to happen is that insurance companies will decide this is all just too much trouble, and drop abortion coverage entirely!
What can you do?

First, go to your reliable pro-choice state legislators to discuss how to prevent a total ban on abortion coverage in your insurance exchange. Ask them to let you know immediately if any anti-choice legislators plan to propose a bill that would ban abortion coverage. Discuss with them any ideas they may have about how to stop such a bill from becoming law. Let them know this is a top priority for you! Then, let us know at, so we can help with messaging and strategy if such a bill emerges in your state.

Second, get together with other progressive health reform advocates in your state to contact your state insurance commissioner's office or your governor. Ask for the formation of a consumer advisory council to help in the development of your state's insurance exchange and the rules by which it will operate. A council already is operating in the state of Washington and a strong pro-choice advocate has a seat! Wisconsin's Governor is moving to appoint a health reform implementation panel in his state. In New York, Health Care for All New York (RWV sits on the steering committee of this coalition) has already written to ask for creation of such a council. Need advice on how to do this, or a sample letter? Contact us at

Third, let HHS Secretary Kathleen Sebelius know that as she prepares to implement health reform, women's health advocates are closely watching what she does to prepare the implemention guidelines for the executive order as well. Show up when she visits your city, as RWV's Philadelphia coordinator, Rebecca Foley, did this morning:

"As the leader of the Raising Women's Voices Coalition of Southeastern PA and an active member of the local Health Care for America Now Coalition (HCAN), I was invited to attend a small town hall meeting on the health care reform law featuring Secretary Kathleen Sebelius.  This meeting in Northeast Philadelphia was hosted by Congresswoman Allyson Schwartz and Congressman Chaka Fattah, and there were about 50 invited guests in attendance.  Secretary Sebelius spoke about the benefits of health care reform, particularly those provisions that will take effect very soon. She acknowledged there is much work to be done and she is up for the challenge and ready to implement this long awaited important reform.

Secretary Sebelius will be in New York City next week at a forum sponsored by the Business and Labor Coalition of New York. Get the details about how you can attend here. Go to the administration's Health Reform website
 and use its features (such as emails and live chats with HHS officials) to let them know we want the guidelines to make it possible for women to purchase abortion coverage with our own money in state health insurance exchanges.

As always, stay tuned to Raising Women's Voices for the latest news and information!

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