With the recent proposed bill on health care reform looming, I find myself to be something quite common: an uninsured woman. I know I’m not alone. According to a recent study conducted by the Commonwealth Fund, 70 percent of adult women under the age of 65 were at risk of inadequate coverage with nearly 45 percent of women being uninsured or underinsured.
It’s an alarming fact, but understandable. On average, women are more likely to pay for medical services out-of-pocket than men. They’re also more likely to seek medical services than men, especially during their reproductive years. Lastly, women tend to prioritize attention to their children or spouse’s healthcare needs instead.
Will new reforms to health care make any difference for women? Yes and no. Among other proposed bills, H.R. 3200, “America’s Affordable Health Choices Act of 2009,” has been under fire for some time, and the following is only meant as a guide. Nothing is guaranteed at this point, and there are more than a few bills being discussed, debated and eventually decided.
Going public
If you are a woman, the highly contested public option may or may not help you. Simply put, the public option would allow uninsured men or women to have insurance under a public health insurance plan, similar to private insurance companies. But this main reform has some benefits for women that Alison Gaulden, vice president of public affairs for Planned Parenthood Mar Monte, is pleased to see.
Under the current health care system, women have continually put preventative testing on the back burner because of high costs or no insurance. Skipping routine tests is something that, in Gaulden’s opinion, is unfortunate and also completely wrong if you’re a woman. Pap smears, mammograms, HIV checks and cervical cancer tests all fall under preventative testing—10 minute tests that can be lifesavers.
If you recall being told you cannot see your old gynecologist under your new employer, the public option would help ensure that you could see your doctor of choice regardless if you’re with Employer A or B, says Gaulden. The hope is with the new reforms, women will have more access to those much-needed preventative tests at a more affordable rate.
“With more people having insurance, they’re more likely to do the preventative care,” says Gaulden.
As Gaulden explains, a public option cuts down on women simply opting out of tests because of insurance issues or, in many cases, privacy issues. Meaning, one doctor is more than enough for doing these very private tests. If you can stick to one doctor, you’ll see him or her more frequently.
The public option would also include essential community health providers, such as Planned Parenthood, Urban Indian Centers or HIV Centers, under the list of available public option providers, instead of as a provider for just non-insured or underinsured people.
However, Valerie Clark doesn’t see the plan as so black and white. She’s president of Clark & Associates, one of Nevada’s largest insurance agencies, with more than 500 clients nationwide. On Oct. 8, Clark will speak at a Reno-Sparks Chamber of Commerce Forum “Healthcare Reform: What is it? How does it affect me?” Clark has worked in the health insurance business for more than 15 years and has also worked as a nurse. She says that this plan can lead to good and bad consequences.
“The general rule of thumb is when you enhance a benefit, you add cost to it,” says Clark.
Even with public health insurance, a doctor doesn’t need to offer his or her services under the public option, says Clark. “There’s no one that can guarantee your doctor is going to accept anything,” says Clark. She also adds that Nevada’s insurance laws already require preventative tests under all insurance plans. So given the new reforms, the public option may not be a big change for women in Nevada who have health insurance. But for those who don’t, they would have access to care they didn’t have before.
Valerie Clark, president of Clark & Associates, will moderate the Oct. 8 healthcare forum on reform.
Photo By clint demeritt
Come again?
Under the new health care reform, pre-existing conditions will be all but eliminated. The Obama administration’s plan requires that “insurance companies cover pre-existing conditions so all Americans, regardless of their health status or history, can get comprehensive benefits at fair and stable premiums.”
One significance of this is that many times pregnancy has been labeled as a pre-existing condition, according to the National Association of Insurance Commissioners. Many states, including Nevada, may not give you insurance based on your bundle of joy. Or if they do, they can place restrictions on the number of months of coverage, which doesn’t usually last the entire gestation.
“They do have pre-existing clauses, whereas if you are treated for something to be pre-existing for six months, you have to wait,” says Clark. “That would go away, but there is a price tag to that. The other thing that would be built into the plan is that there would be a cap for the amount you would have to pay out of pocket.” Clark says it’s difficult to even estimate what the cap may be or what the price tag would be, given that nothing has been passed.
This pre-existing condition clause would go further. If you have breast cancer or cervical cancer, for instance, companies could not deny you insurance. The new health-reform would aim to get rid of many of these pre-existing condition guidelines and as a result, insure more people and provide more medical benefits to those who became sick or in many women’s cases, pregnant.
Get it under control
Somewhere in the debate, the A-card has been thrown around. In some cases, religiously affiliated insurance companies do not provide insurance for abortion and birth control. Saint Mary’s Medical Center, part of Catholic Healthcare West, is one of these. When contacted to see what changes St. Mary’s would see in women’s health care as a result of the bill, Saint Mary’s couldn’t provide any changes, or for that matter, anybody who could speak about the health-care reform and how it relates to women’s health.
Gaulden stresses the point that if you are a woman being insured under a plan such as Saint Mary’s but would like to receive birth control, the public option would give you a choice for birth control, be it for cycle management or family planning—and it would be at an affordable rate.
President Obama has more than once been outspoken in his support of Roe v. Wade, and the health care reform would keep the court decision intact. However, there is no plan in the health care reform that would mandate abortion coverage. In fact, in 2002, the Alan Guttmacher Institute compiled a study of health insurance coverage in the nation and found that 86 percent of employer-based insurance plans already offered abortion coverage, including those in Nevada.
More than anything, the new reforms will provide women with health care that treats the whole woman, instead of just the pieces.
“We’re at the backbone of keeping society going,” Gaulden says. “Women are ultimately responsible for themselves and their families and their partners. And if we’re not helping them, nobody is.”