Access to affordable, quality health care is a core component of our advocacy platform, as we recognize that the road to fully empowered women starts with healthy women. This past legislative session we witnessed political ideology taking the place of sound health policy when the NCGA opted not to expand Medicaid in NC, a move that would have provided quality health care coverage to approximately 250,000 women in the state. We and our members believe this was a short-sighted decision on the part of lawmakers, and one of the reasons we will be bringing women to the Moral March on Saturday, February 08. We hope you will join us!
(piece below by Jina Dhillon, past president, NCWU)
NCWU is dedicated to the advancement and empowerment of all women in North Carolina. A key determinant of women’s autonomy and progress is their ability to access health care services meeting their unique needs. The Affordable Care Act (ACA) goes a long way in supporting women’s access to health care. Some public officials and media outlets are focusing on what they see as the negative aspects of health reform, including a bumpy start to enrollment for health coverage in 2014. NCWU recognizes that women in North Carolina stand to gain enormous benefits under the ACA, and it’s critical to remember some important things about health reform that are often missing from the public dialogue. Here we’ve laid out just a few of the major opportunities in the ACA for women’s health. This information is further detailed in the linked publications, which we hope you will find useful.
The United States continues to be plagued with historically startling rates of maternal mortality (defined by the World Health Organization as the death of a woman while pregnant or within 42 days of end of pregnancy…from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes). Women of color disproportionately experience pregnancy complications that can lead to death. This disparity is a major problem in North Carolina– in 2011 the rate of maternal mortality per 100,000 live births was 11.8 for white women and 28.1 for black women. For reference, the Healthy People 2000 goal is 3.3 maternal deaths/100,000 live births. In response to this, the ACA made vast improvements to data collection requirements that can help identify the health status of underserved communities and individuals experiencing health disparities. This is a critical step in addressing maternal health disparities, and states may also receive dedicated federal funding to implement these data collection protocols for maternal health and outcomes.
The ACA also requires expansion of Medicaid programs to cover all low-income individuals up to about 138% of the federal poverty level. Due to the Supreme Court’s ruling in 2012, expansion is now optional, and North Carolina has declined the generous federal funding to support Medicaid expansion. Approximately a quarter of a million women in North Carolina could have gained access to Medicaid if the state expanded the program. This includes women who were previously ineligible for Medicaid; for example single women, women without children, and women living with HIV. Medicaid finances an estimated 40% of all births in the United States, and women of color comprise approximately half of all female Medicaid enrollees aged 19 to 64. Failing to expand Medicaid means access to this vital and affordable public insurance program is lost for thousands of North Carolina women—withholding their opportunity to obtain coverage for needed preventive, screening, and treatment services to improve their health prior to and during pregnancy. It’s not too late, though. North Carolina could still expand in future years, although the federal financial support will be slightly less generous.
The ACA’s requirement that most Americans enroll in public or private health insurance means that more women will have the means (via federal subsidies created by the ACA) to access health coverage meeting their needs. The ACA specifically requires coverage for women’s preventive services, at no cost, that includes:
- screening for gestational diabetes;
- testing for human papillomavirus (HPV);
- counseling for sexually transmitted infections (STIs);
- counseling and screening for human immune-deficiency virus (HIV);
- breastfeeding support, supplies, and counseling;
- screening and counseling for interpersonal and domestic violence; and
- all FDA-approved contraceptive methods, sterilization procedures, and patient education and counseling for women with reproductive capacity.
Insurers are also no longer able to discriminate based on sex, denying coverage based on “pre-existing conditions” such as pregnancy, cesarean sections, or domestic violence. Insurers in the individual and small group markets will no longer be permitted to charge women higher premiums than men.
The ACA not only ensures that more women will have access to insurance coverage, but it also requires that the coverage be robust. Requiring most health plans, starting in 2014, to cover minimum “essential health benefits” is an important step by the ACA in closing the gaps in existing insurance. Notably for women, most health plans will now be required to cover maternity care. Prior to this, a study by the National Women’s Law Center found that 87 percent of insurance plans sold on the individual market did not cover maternity care.
All of this information and more is detailed in the linked publications. We urge you to read through these materials, make copies, and share them with your networks. The ACA seeks to reverse many of the historic inequities in the public and private health insurance market, as well as respond to the unique needs of women seeking health care.
The next time someone complains about “Obamacare”, ask them if women’s health matters. If they say yes, drop some knowledge about why health reform is so critical for women, and in turn families and communities.
If they say no….it’s time to march.