Women have cause to celebrate

By Roberta Riley, JD

It seems fitting that this summer, as landmark health reform legislation unfolds, three women in my family will celebrate milestone birthdays. As we turn 80, 15 and 50 respectively, my mother, daughter and I will relish this historic moment. Our little trio has survived heart attack, cancers and a perilously complicated pregnancy. Without quality medical care, none of us would be alive. Yet we’ve also felt the sting of wrongs inflicted on women in our current system, so we’re very pleased that health reform, at long last, will address many serious disparities. To commemorate this sweet, hard fought victory, our birthday cake will be big, delicious and chocolate. Grandma gets the first slice since her decades of community service epitomize the tenacity demanded of this epic effort.

A veteran of many political battles, she was never fooled by the Republican propaganda that “health reform will rip away Grandma’s Medicare.” Knowing that older women are far more likely than their male counterparts to live in poverty, she realized reform opponents were simply preying on fear. In reality, by trimming the corporate subsidies in the Medicare Advantage program, health reform will strengthen the long term solvency of Medicare.

So, rejecting the scare tactics, we will celebrate the many good things health reform will bring to older women and men. Co-pays for preventive care will be eliminated next year, which means seniors will no longer be forced to choose between seeing the doctor and buying food. Measures to address the shortage of family physicians will soon kick in. And seniors now saddled with high drug costs as a result of the infamous Medicare Part D “donut hole” will benefit immediately as those costs taper off and are eventually eliminated. Early retirees will benefit from the new subsidies to firms that offer health coverage to retirees between age 55 and 65.

We will also celebrate the benefits health reform brings to younger women who, even today, typically earn lower salaries than men yet must pay higher health premiums. Insurers are now banned from this form of sex discrimination, Hallelujah!

When Medicaid coverage is expanded to those earning up to 133% of the federal poverty level, or roughly $29,000 a year for a family of four, up to 4.5 million women will be newly eligible.

In 2014, families earning too much to qualify for Medicaid, but too little to afford good health insurance now, will benefit from health insurance exchanges which will enable people to choose the quality health plan that best fits their needs. Approximately 11 million women will receive subsidies to help pay for exchange-based health plans.

Women are more likely than men to work for small businesses that don't offer health insurance now, so they will benefit from the new tax credits to help small businesses provide coverage. And starting this summer, those under age 26 will be allowed to remain on their parents’ health insurance policy.

We will celebrate the new CLASS program, which will help alleviate burdens on family caregivers, who are predominantly female; direct access to obstetrical and gynecological care; and provisions allowing nursing mothers who work for employers with over 50 workers a reasonable break time and location to express breast milk.

Presumably, once the Obama administration spells out the pending regulations governing preventive care, contraceptives will be covered. Stay tuned.

Unfortunately, our scrumptious birthday cake will feature a bittersweet frosting. Health reform marginalizes one key component of women's health care: Abortion. Some states will forbid abortion coverage altogether. Anyone fortunate enough to purchase a health plan with abortion coverage through an exchange is required to make two separate payments: one for abortion coverage, another for the remainder of the premium. This burdensome requirement will almost certainly deter health insurers from offering abortion coverage. And that is a real setback for my daughter’s generation, since most plans now cover abortion.

It hurts to witness the erosion of a right that women of Grandma’s generation struggled to attain. But I take comfort in knowing it is easier to improve major legislation by amendment than it is to start from scratch. So three generations of my family will celebrate, and then forge on until the job is done.

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Roberta Riley, JD is an attorney and health care consumer advocate. In 2001 she argued and won a groundbreaking federal court decision requiring employers to cover prescription contraception in worker health plans. In recognition of her achievements on behalf of women, she has received several honors, including a Ms. Magazine Women of the Year Award. Recently appointed to the Washington State Health Reform Realization Panel, she lives in Seattle with her husband and daughter.