Opinion: Protecting California women’s access to affordable care

March 23 marked the one-year anniversary of the enactment of the Patient Protection and Affordable Care Act (PPACA). In recent months, some states have become engrossed in the politics of congressional repeal efforts and the legal reasoning underlying federal judicial opinions. Meanwhile, in California, we are committed to maintaining an aggressive pace in implementing the federal health care law.
Even as there is uncertainty over the law’s implementation, by moving forward with policies that remove antiquated barriers to adequate health care coverage, California will remain well-positioned to advance long-sought goals regarding coverage expansion, affordability, and health status improvements. Although the people of California will realize the greatest benefits from the expansion and improvement of coverage beginning in 2014, several PPACA provisions have already been implemented and will provide important transitional support. Many of these early provisions particularly benefit women.

PPACA makes important advances for women’s health. The law offers many opportunities to improve access to care and coverage for California women of all ages, ranging from insurance system reforms, to lowering out-of-pocket costs, and securing comprehensive benefits packages that address women’s health needs across the course of their lives.

This landmark legislation would expand access to affordable coverage in several ways by 2014, but, if the law is repealed, California women will be further obstructed from obtaining timely, cost-effective care and preventive services. Because of challenges associated with enacting major changes to the health care system, it is shortsighted fiscal policy to curtail investment in preventive programs with long-term cost saving benefits. Furthermore, California’s rising healthcare spending has reached a tipping point. Implementing the law is a critical step towards curbing the Golden State’s skyrocketing medical costs and making health care truly accessible and affordable for the women of California.

Much of the work required to successfully implement effective strategies for promoting value in California’s health care spending requires advance planning. A prime example of a proactive solution to the financing and delivery of health care is the recent introduction of ACOG-backed legislation to ensure that women receive equitable access to comprehensive maternity health coverage in California. While PPACA mandates maternity coverage in all new policies sold to individuals as of 2014, if the law is repealed, plans will not be required to include coverage of comprehensive maternity care services. Equal access to affordable maternity coverage is vital to obtaining prenatal care, which is essential to ensuring the health of women and their pregnancies. A lack of prenatal care negatively impacts public health costs.

The implementation of PPACA is likely to stabilize and reverse California women’s growing exposure to health care costs. Even though the challenge of high health care costs is not exclusive to the Golden State, the health care needs of California’s women coupled with the state’s intricate health care landscape mandate that California continue to forge ahead with implementation.

The health care needs of women require specific attention, especially during their reproductive years, which leaves women more vulnerable to problems resulting from an inability to obtain coverage. Estimates peg the aggregate number of uninsured California women (ages 18-64) at nearly 3 million. Of these uninsured women, 92 percent are projected to qualify for federal assistance under PPACA. Despite the fact that the new law provides a major opportunity to advance a culture of coverage and improve the health of California women, successful implementation of PPACA in California will be shaped by several of the state’s distinctive features.

California is home to some of the world’s best hospitals and health care providers, but also has the largest total number of uninsured citizens – more than 7 million — of any state. California’s large size means that health care is organized, delivered, and financed differently throughout the state. Barriers to timely, cost-effective care present an enormous challenge to the state, particularly among California’s less populated and underserved regions. Even where health care services are readily accessible, financial barriers may delay or prevent low-income California women from receiving timely, cost-effective care.

In a state as complex as most countries, California’s aggressive push forward is necessary to take full advantage of opportunities to improve state health care programs vital to women’s health and to obtain federal funds to help carry out the numerous PPACA provisions that will benefit millions of California women. The imperative to move forward comes at a time of continued state fiscal distress and state and federal political transition. The California Legislature is in the process of implementing tough budget cuts – further decreases in federal health care funding would truly be catastrophic to California’s women.

If California is successful in its implementation, the Patient Protection and Affordable Care Act holds the potential to transform access to comprehensive, quality reproductive health care and accomplish other reforms that will strengthen the state’s existing health care system’s ability to serve millions of women.

Pence: De-Funding Planned Parenthood Won’t Hurt Women’s Health

Congressman Mike Pence, who is heading up the effort in the House to revoke taxpayer funding for the Planned Parenthood abrotion business says nothing in his amendment will hurt efforts to promote women’s health.

Pence, in a new opinion column at National Review Online, says the notion that women would be unable to have access to low-cost breast canccer screenings or other medical care and treatment is phony.

On Feb. 18, 2011, with bipartisan support, the House of Representatives passed the Pence Amendment, which would end taxpayer funding for Planned Parenthood. In response, Planned Parenthood used its vast resources to launch slick Madison Avenue television ads portraying the group — the nation’s largest abortion provider — as an altruistic organization that provides health-care services to the poor and has only an incidental interest in abortion.

Despite efforts to suggest otherwise, the Pence Amendment does not reduce funding for cancer screenings or eliminate one dime of funding for other important health services to women; the money that does not go to Planned Parenthood as a result of the Pence Amendment will go to other organizations that provide these services. If the Pence Amendment becomes law, thousands of women’s health centers, clinics, and hospitals will still provide assistance to low-income families and women. The Pence Amendment would simply deny any and all federal funding to Planned Parenthood.

Planned Parenthood clinics focus mainly on abortion — and because money is fungible, there is no way to fund the useful services without freeing up money for the organization to spend on abortion. In 2009, the group made only 977 adoption referrals and cared for only 7,021 prenatal clients, but performed a record 332,278 abortions. In other words, a pregnant woman entering a Planned Parenthood clinic was 42 times more likely to have an abortion than to either receive prenatal care or be referred for adoption. Planned Parenthood recently made plain the centrality of abortion to its mission by mandating that every one of its affiliates have at least one clinic that performs abortions within the next two years.

Advocates for the abortion industry have sought to portray efforts to defund Planned Parenthood as a “War on Women,” but the issue is big business, and that business is abortion. This legislative battle is about Big Abortion vs. American taxpayers. As Abby Johnson, a former Planned Parenthood director, recently said, “Planned Parenthood’s mission, on paper, is to give women quality and affordable health care and to protect women’s rights. In reality, their mission is to increase their abortion numbers and in turn increase their revenue.”

According to its most recent annual report, the organization raked in $1.1 billion in total revenue. Of that amount, $363.2 million came from taxpayers in the form of government grants and contracts. While current law prohibits Planned Parenthood from directly using tax dollars on abortions, taxpayers subsidize its overall operation, freeing up funds that can be diverted to direct spending on abortion.

And Big Abortion routinely puts profits over women’s health and safety. When women testify in favor of tightening safety standards at clinics, Planned Parenthood fights them. And despite the fact that 88 percent of Americans favor informed-consent laws that provide information about the risks of, and alternatives to, abortion for women, Planned Parenthood opposes these efforts and works to keep women in the dark. And tragically, in some instances, Planned Parenthood has refused to cooperate when law-enforcement officials have sought information to help girls they believed to be victims of child rape or molestation.

Society needs to prepare now for ageing

A ground-breaking report released today highlights the wide range of health care needs affecting older women.

It warns that individuals, communities and health care systems need to be prepared for major health and social changes associated with ageing.

The Women, Health and Ageing report, from the internationally-renowned Australian Longitudinal Study on Women’s Health (ALSWH), also highlights the increasing levels of serious health risks, illness and disability among future generations.

The joint University of Newcastle and University of Queensland study has repeatedly surveyed more than 40,000 women since 1996, and the current report focuses on changes in the health of women born between 1921 and 1926.

Significant findings of the study were:
• Most older women in the study were living with multiple conditions and increasing levels of disability
• Arthritis is a particularly common condition affecting most women in the study, leading to poor quality of life, pain, physical and social limitations and increased health care use
• Women with stroke or cancer have highest use of health care services and had a particularly poor quality of life
• Conditions such as diabetes could be better managed in accordance with current guidelines
• Some surgical interventions may have a profound effect on women’s continued well-being.

UQ’s Professor Annette Dobson said although extrapolation from one age group to the next was difficult, the situation may be substantially worse when today’s young women age, mostly because of the growing problem of obesity and higher uptake of smoking.

Professor Julie Byles, from the University of Newcastle, warned older women should not be treated as one homogenous group.

“While physical abilities have declined for many women in the study, large numbers continued to maintain quite high levels of good health. Likewise, even though women were ageing and had increasing levels of disability and needs for care, many were still providing care for others and making major contributions to their communities.

“Ageing well needs healthy inputs throughout life and requires starting early. The study findings also show clear trends according to women’s education levels, body weight, and past and current smoking.”

The study confirms from a long-term perspective, lifetime maintenance of low risk behaviours is the best prospect for reducing the impact of chronic conditions and associated health care costs.

The Women, Health and Ageing report was released at the Australian Association of Gerontology NSW Rural Conference at Cessnock today.

The study is funded by the Department of Health and Ageing and is available online.

The ALSWH is funded by the Australian Government through the Department of Health and Ageing.

Researchers based in Newcastle work in collaboration with HMRI – a partnership between Hunter New England Health, the University of Newcastle and the community.

Millions of Women Could Lose Insurance Coverage for Abortion

Amid celebrations marking the first anniversary of the health care law, there is serious concern about the future of insurance coverage for abortion for millions of women. As a direct result of the Affordable Care Act, an unprecedented drive to ban insurance coverage of abortion is sweeping across the country. This is a coordinated, opportunistic attack that is blind to women’s real lives and unjust to women’s real needs. If it succeeds, the damage to women’s health care may well exceed that of individual state laws such as mandatory counseling and sonograms, forced delays, and bans on specific procedures.

Few people are aware of how devastating this attack is, which is why education and advocacy are the main thrust of the Religious Coalition for Reproductive Choice’s national campaign, Insure Women, Ensure Our Future (http://rcrc.org/InsureWomen/index.html). Essentially it involves the insurance exchanges being set up by states, the marketplaces where millions of people will get and purchase insurance starting in 2014. Medicaid recipients will get insurance there, but so will people who pay for insurance and get insurance through their employer. After the health care law was signed, five states almost immediately passed bills to prohibit insurance plans on the exchanges from covering abortion except in dire circumstances such as to save the woman’s life. Now, a year later, 22 more states are considering similar bills. Nearly half of those are also considering making it illegal for all private plans to cover abortion.

Along with low-income women who receive Medicaid, an estimated 14.5 million women who are insured by their mid-sized and large employers would be affected by these restrictions, according to the Employee Benefits Research Institute. In addition, anti-choice Republicans have passed two bills to restrict coverage — HR 3 (the “No Taxpayer Funding for Abortion Act”) and HR 358 (the “Protect Life Act”). While these may not make it out of the Senate, they pose another threat.

Contrast that to the fact that about 80 percent of private plans now cover pregnancy termination and the impact becomes clearer.

The challenge now is to educate policymakers and voters about the extreme nature of these restrictions and stop these bans. This a pro-choice country at heart — some people may have reservations about abortion but they are firmly and consistently in favor of options that include family planning, contraception, and sexuality education and in favor of women making decisions with dignity and minimal governmental interference. One in three women will have an abortion procedure at some time in her life. Millions of women should not be penalized because some don’t approve of this procedure.

Insurance coverage for pregnancy termination has had a low profile until now because it was not threatened. Now that it is, it is critical to understand that insurance helps guarantee access to needed reproductive health care services. It is also critical to make it clear that there are already ample safeguards against taxpayer money being used for abortion except in limited, dire circumstances; that is a red herring, a tactic to divert attention from the real goal of further restricting access to a procedure that is an integral part of women’s reproductive health care.

Progress in expanding health care coverage to millions of Americans and doing away with injustices in the system is long overdue and should be celebrated. But victory at the expense of women’s comprehensive reproductive health care is no victory at all.