On October 15, the Senate Health, Education, Labor, and Pensions Committee held a hearing, “What Women Want: Equal Benefits for Equal Premiums.”
Jim Guest, president of the Consumers Union, said, “The reasons women are disproportionately impacted in the current health care system are well documented: lower incomes, more part-time work, more small businesses, more periods of unemployment to care for children or aging parents, more bankruptcies, higher use of medical services and so forth.” He continued, “In the thousands of stories we gathered in recent years of people’s experiences and concerns with the health-care system, the reality is clear: Common health needs specific to women too often are not covered under current health insurance practices. We heard from numerous women who found themselves with coverage delayed or denied because of very common health needs, such as benign fibroids, previous fertility treatments, pregnancies and the like.”
“Although the leading Democratic health care reform bills in Congress the Senate HELP Committee’s Affordable Health Choices Act, the Senate Finance Committee’s America’s Healthy Future Act, and the House Education and Labor Committee’s America’s Affordable Health Choices Act intend to help women, they would leave all Americans, including women, worse off than they are at present,” said, Diana Furchgott-Roth, senior fellow at the Hudson Institute. “First, everyone, including women, would pay more for health insurance. Second, the higher cost of health insurance premiums would lower cash wages for Americans. Third, those on government plans, such as Medicare and Medicaid, predominantly women, would receive worse care. Fourth, the economy-wide effects of health care reform mandates would discourage job creation and incentives to work by raising taxes.”
Ms. Furchgott-Roth added, “Young women would have to pay substantially more for health insurance than they do at present because premium differentials for health insurance would be capped. All women would have to pay more due to the government’s definition of a qualified plan. One feature of the health reform bills is that variation in premiums would be limited. Under the House Democrats’ bill, for example, the most expensive premium could not be more than twice as much as the cheapest for the same plan, and variation would only be allowed on the basis of age. This means that younger women would have to pay far more in premiums than they would otherwise.”
Marcia Greenberger, president of the National Women’s Law Center (NWLC), discussed the results of a report issued by NWLC: “Nowhere to Turn: How the Individual Health Insurance Market Fails Women,” saying, “The [NWLC] investigated two phenomena: the “gender gap” the difference in premiums charged to female and male applicants of the same age and health status in samples from each state and the District of Columbia…and the availability and affordability of coverage for maternity care across the country…Based on this research, NWLC found that the individual insurance market is a very difficult place for women to buy health coverage. Insurance companies can refuse to sell women coverage altogether due to a history of any health problems whatsoever, or charge women higher premiums based on factors that include gender, age and health status. This coverage is often very costly and limited in scope, and it fails to meet women’s needs. In short, women face too many obstacles obtaining comprehensive, affordable health coverage in the individual market simply because they are women.”
Ms. Greenberger explained, “Under a practice known as gender rating, insurance companies are permitted in most states to charge men and women different premiums. This costly practice often results in wide variations in rates charged to women and men for the same coverage…In the vast majority of states, individual market insurers can use evidence of a ‘pre-existing’ condition to deny coverage or exclude important health benefits. Simply being pregnant or having had a Cesarean section is grounds enough for insurance companies to reject a woman’s application…After reviewing over 3,500 policies available to women across the nation in 2008, NWLC found that the vast majority of individual market health insurance policies do not cover maternity care at all. Just 12 percent included comprehensive maternity coverage (i.e., coverage for pre- and post-natal visits, as well as labor and delivery, for both routine pregnancies and in case of complications) within the insurance policy.”
Director and Senior Fellow of the Beverly LaHaye Institute at the Concerned Women for America Janice Shaw Crouse, focused part of her testimony on abortion, saying, “We have two primary concerns about health care reform relating to abortion whether it funds and covers abortion and whether it allows health care workers freedom of conscience. In spite of all the rhetoric to the contrary, all the health care reform bills currently before Congress mandate abortion funding and coverage. As pointed out so effectively by Americans United for Life (AUL), all of the pro-life amendments that came before the various committees were rejected. It is very clear that any health care reform bill must contain express language prohibiting abortion funding and coverage. Otherwise, ‘courts and administrative agencies will interpret health care reform to include it, based on prior interpretations of Medicaid’s “Mandatory Categories of Care.” In addition, the Hyde Amendment, as added yearly to HHS [Labor, Health and Human Services, Education, and Related Agencies] Appropriations [bill], is insufficient to prevent abortion funding and coverage under the health care bills.’ In short, without explicit wording prohibiting abortion funding and coverage, health care reform will involve all American taxpayers in explicit financial support for abortion-on-demand.”
Karen Ignagni, president and chief executive office of America’s Health Insurance Plans, discussed some of the programs insurance companies have implemented to address women’s health care: “Health insurance plans, in addition to supporting health reform, have been very active in developing innovative programs to improve health care quality and health outcomes for women. These programs including several that we discuss below focus on a wide range of women’s priorities and health care needs.” She noted, “On October 10, Kaiser Permanente and Dr. Brigid McCaw received a national award from the Family Violence Prevention Fund for creating and implementing an innovative and comprehensive approach to domestic violence prevention. This innovative program by Kaiser Permanente uses health education materials, posters, flyers, and other information to encourage people to speak up about domestic violence. Under this program, clinicians receive training so they are comfortable raising this issue, providing a caring response, referring patients to on-site domestic violence services, and offering information about community resources. The program is enhanced by Kaiser Permanente HealthConnect, which enables the organization’s more than 14,000 physicians to electronically access the medical records of members nationwide. It includes tools that make it easier for physicians to identify victims of domestic violence, provide a consistent caring response based on clinical practice recommendations, and make referrals to other Kaiser Permanente services and community resources.
Amanda Buchanan of Idaho and Peggy Robertson of Colorado also testified.
During questions, Chair Barbara Mikulski (D-MD) asked Ms. Robertson to reread a portion of a letter from the Golden Rule health insurance company in Colorado, which Ms. Robertson submitted with her testimony: “In order to consider coverage without a rider, we require that certain requirements be met. One requirement is that some form of sterilization has occurred since the C-section delivery.” In response, Sen. Mikulski said, “That concept…put me on the edge of my chair…No one, no one in the United States, in order to get health insurance, should be coerced in sterilization. I find it offensive and I find it morally repugnant and I intend to do something about that.”
