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Tuesday, July 3, 2012

Health Care Decision Is Huge Win for Women

Consumer protections will be preserved

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Many Supreme Court watchers and political pundits predicted that the conservative majority on the bench would strike down portions—or all—of the federal Affordable Care Act (ACA), so those who care about women's health were relieved that the federal health care law was deemed constitutional.

The Chief Justice John Roberts-led majority affirmed the constitutionality of the individual mandate and preserved the expansion of Medicaid services, as long as states are not forced to extend Medicaid coverage or lose their federal funding for the program.

Although Gov. Scott Walker has delayed planning for health insurance exchanges, which will allow individuals and small businesses to shop for affordable private insurance plans, the court's backing of the ACA is a big win for women who rely on Medicaid or private insurance for their health care needs.

“This [decision] gives Wisconsin women security moving forward that they're going to be able to access the quality affordable health care that they need and deserve, when they need it,” said Sara Finger, executive director of the Wisconsin Alliance for Women's Health. “And it's going to stop the kind of discriminatory practices that have been happening for decades against women, just for being women in the health care system.”

Contraception Will Be Covered in August

The implementation of the provisions of the ACA has been slowly but steadily rolling out since it was enacted in March 2010.

On Aug. 1, the ACA will expand the preventive services for women that insurance companies must cover without co-pays or deductibles when they're obtained via an in-network provider. Topping the list of free services are Food and Drug Administration-approved contraceptives, as well as annual well-woman doctor visits, breastfeeding support and supplies, domestic violence screening and counseling, HIV and HPV screening and counseling and counseling for sexually transmitted infections.

Since late 2010, the ACA has required insurance plans to cover (without co-pays or deductibles) annual mammograms for women over 40, cervical cancer screenings, testing for sexually transmitted infections, osteoporosis screenings for women over 60 and folic acid supplements for women who may become pregnant.

Lon Newman, public affairs chair of the Wisconsin Family Planning and Reproductive Health Association, said the expanded preventive services were added because they will improve women's health and lower health care costs in the long run.

“There is a national public health interest in improving women's health and improving the health of babies and infants,” Newman said. “And in reducing teen births and lowering the abortion rate and reducing cancer. All of these things are included in this plan.”

According to a new compromise offered by the Obama administration, some religious employers—most notably, Catholic Church-affiliated employers—can seek an exemption from providing contraceptive coverage in their insurance plans, although that coverage would have to be provided by the insurance company itself.

Newman said he didn't see anything in last week's court ruling that spoke directly to the U.S. Conference of Catholic Bishops' rejection of the ACA because they feel that it curtails their religious freedom.

“I don't think the opinion strengthens [the bishops'] arguments,” Newman said.

Additional ACA consumer protections will take effect in 2014.

Prior to the ACA's passage, health insurance companies commonly charged women more for their insurance policies than men. According to the federal Department of Health and Human Services, prior to the ACA a 22-year-old woman could be charged 150% of a premium paid by a man the same age. That gender penalty will be illegal in 2014.

Gone in 2014 is denial of insurance coverage for a pre-existing condition. Here, too, women had to contend with discriminatory practices, since insurers often viewed a previous pregnancy as a pre-existing condition.

Setting Up the Insurance Exchange

The next battle, though, is over the state's health insurance exchange, where individuals and small businesses will be able to purchase affordable private insurance policies. The policies and services offered in the exchange haven't been determined yet, but in theory, at least, the exchanges will offer more options to men and women who don't want to depend on their partner's health insurance policy, plan on starting their own business, or do not have affordable health insurance through their employer.

Although the Walker administration had begun planning the state's insurance exchange in 2011, it stopped its efforts late last year while the ACA's constitutionality was being challenged. Even though the court has affirmed the ACA, the Walker administration is not going to move forward with the exchanges until after the November election. If Wisconsin doesn't submit a workable plan by Jan. 1, 2013, the federal government will set up the state's exchange instead.

State Rep. Jon Richards (D-Milwaukee) is among the legislators who have been pushing the Walker administration to jump-start its planning efforts so that the state can tailor it to our unique needs and health care system.

Richards is calling for a special session of the Legislature so that state policy-makers can resume setting up the exchange.

“An exchange is going to happen whether we design it or the feds design it,” Richards said. “It makes more sense for us to design it.”

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