Today, with Oregon Congressman Greg Walden's vote, the U.S. House of Representatives narrowly passed the most damaging women's health legislation ever. The American Health Care Act would:
- Take away health coverage for 24 million people.
- "Defund" Planned Parenthood -- by blocking people with Medicaid from accessing preventive care at Planned Parenthood health centers -- including birth control, cancer screenings, and STD testing and treatment.
- Eliminate protections that restrict insurance companies from gouging people with pre-existing conditions by imposing crushing premiums. Under this bill, health insurance companies could once again charge people tens of thousands of dollars a month because they had cancer.
- Undermine Essential Health Benefits standards, including maternity coverage and prescription drugs, which disproportionately affect women.
- Gut the Medicaid program, which approximately 1 in 4 women of reproductive age rely on to access no-cost, critical reproductive health care such as birth control, lifesaving cancer screenings and maternity care.
- Reduce access for all women, including those with employer-paid insurance, to no-cost preventive services, including birth control.
- Impose a nationwide ban on private insurance coverage of abortion.
The American Health Care Act (AHCA), including the provision to prohibit people with Medicaid from accessing preventive care at Planned Parenthood, has drawn widespread opposition from health care experts, including the American Public Health Association, the American Medical Association, the American College of Obstetricians and Gynecologists, members of Congress from both parties and a clear majority of American voters. About 54 percent of Planned Parenthood health centers are in rural, medically underserved or health professional shortage areas. Experts have repeatedly said that other providers cannot absorb Planned Parenthood's patients.
Statement by Mary Nolan, Executive Director, Planned Parenthood Advocates of Oregon:
"This bill is a cruel attack on women's health and an arrogant shield for granting tax breaks to billionaires. By supporting this bill, Congressman Walden just voted to block thousands of his constituents in Oregon, and millions of people around the country, from essential health care.
"This legislation 'defunds' Planned Parenthood, and blocks thousands of Oregonians from accessing birth control, cancer screenings and STI testing at Planned Parenthood health centers. That will make it harder for women in Oregon to prevent unintended pregnancy, harder to have a healthy pregnancy and harder to raise a family.
"Under this destructive and deadly bill, a woman who has ever been pregnant could be charged an additional $17,000 a year for coverage, because of her 'pre-existing condition.'
"Our supporters and patients denounce Greg Walden and D.C. politicians for voting to take away their care. Women and men across the country will continue to speak out to defeat this bill and efforts to block access to Planned Parenthood.
"The Senate should listen to the American people and reject the most damaging bill for women's health ever."
As attention now turns toward the Senate, three things are clear:
1. The Senate does not have the votes to pass the House version of the American Health Care Act, which includes "defunding" Planned Parenthood.
2. The Senate should listen to the 80 percent of the public (according to a recent Quinnipiac Poll) who support Planned Parenthood and oppose efforts to block people from getting care at Planned Parenthood.
3. The American people want Congress to keep the protections in the Affordable Care Act. A recent ABC-Washington Post poll shows that 62 percent of Americans, including 67 percent of Independents, want to keep national protections that cover essential health benefits, and not allow it to be varied by state.
The term "defunding" Planned Parenthood is a misnomer. Planned Parenthood does not get a check from the federal government, and it's not a line item in the federal budget. Planned Parenthood receives reimbursements, just like hospitals, clinics, doctors' offices and other healthcare organizations, for providing preventive care. Federal law already blocks federal funding from going to abortion services.
Background on the most damaging bill for women's health ever:
- Blocks low-income patients from receiving health care at Planned Parenthood health centers. Every year, 2.5 million women, men and young people rely on Planned Parenthood for essential health care services, like birth control and lifesaving cancer screenings. Many of these people, particularly those in rural areas and medically underserved areas, will have nowhere else to turn to for care if Planned Parenthood health centers are forced to close their doors. Women should be able to choose their healthcare provider the same as politicians in Washington, D.C. Despite false claims, community health centers simply cannot absorb Planned Parenthood's patients. States like Texas and Wisconsin have suffered serious public health consequences when communities lost access to Planned Parenthood.
- Eliminates protections for the millions with pre-existing conditions. By removing the community rating provision, insurers would be allowed to once again charge people with pre-existing conditions an exorbitant amount for coverage. The community rating provision prohibits people from being charged more based on health status, gender, health status, occupation and age.
- Discriminates against women. Despite the fact that the proposal claims to maintain the current prohibition on gender rating, it still allows insurers to once again discriminate against women. Eliminating the community rating provision disproportionately affects women: Insurers can claim having given birth, having had a C-section or having been a survivor of domestic violence is a so-called "pre-existing condition." For example, a woman who had breast cancer could face a premium surcharge of more than $28,000 a year for coverage, and a woman who was previously pregnant could face an additional charge of more than $17,000 a year for coverage.
- Eliminates maternity coverage, newborn care and other Essential Health Benefits (EHB) coverage standards. The bill guts the EHB provision, which requires the majority of health plans to cover services like maternity and newborn care, mental health services and prescription drugs. Approximately 13 million women who gained access to maternity coverage under the ACA stand to lose their coverage. Women also benefit from the EHB in other ways; for example, women are more likely to need prescription drugs to manage their healthcare needs, develop mental health needs and require lab services to diagnose autoimmune disorders. This is a direct attack on women of all ages, since women disproportionately rely on every one of the EHB standards -- not just maternity coverage (full list below).
- Forces new mothers with Medicaid coverage to find work shortly after giving birth. The bill gives states the option to impose work requirements as a condition of obtaining Medicaid coverage. It also gives states the ability to revoke Medicaid from new mothers if they don't find work within 60 days of giving birth. Work requirements are generally unnecessary and harmful, as nearly 60 percent of Medicaid enrollees who can work do, and if they don't work it's as a result of a major impediment. Work requirements disproportionately impact women, as they account for 62 percent of Medicaid enrollees who are not working. Work requirements for new mothers are especially harmful.
- Kicks millions of women and men off their insurance. The Congressional Budget Office reports that 24 million people will lose coverage over the next 10 years, 14 million of which will lose Medicaid coverage due to the bill's measures to kick people off of Medicaid.
- Ends Medicaid expansion. The AHCA will effectively end the Medicaid expansion, which has provided coverage to at least 11 million people, starting January 1, 2018, and will result in women, disproportionately women of color, losing critical access to care. Approximately 20 percent of women of reproductive age rely on Medicaid to access no-cost, critical reproductive health care such as birth control, lifesaving cancer screenings and maternity care.
- Guts the Medicaid program. The AHCA provides states the option to receive federal payments in the form of a block grant or per capita cap, both of which will slash the amount of federal support states receive today and will force states to either come up with extra money or make difficult decisions about which services, benefits or eligibility groups to cut. Reduced federal funds for state Medicaid programs will disproportionately harm women -- women of color in particular. For example, to save money, states may choose to limit coverage of prenatal visits and family planning services, or states may cut people from their programs.
- Imposes additional costs on women. The AHCA will require people to pay more for less coverage. First, the bill reduces financial assistance by repealing the existing cost-sharing subsidies that assist with copays and deductibles, and replacing the ACA-created tax credits, which fluctuate by need, with less generous tax credits for low- and middle-income individuals. This will disproportionately impact women, particularly women of color, given the inequities in earnings for women, and exacerbate healthcare disparities, given insured people of color already report less confidence in being able to afford care.
- Reduces women's access to no-copay birth control. While the bill does not specifically repeal the no-copay birth control benefit, the fact that millions of women will lose coverage means they will no longer have access to no-copay birth control. Under the ACA, more than 55 million women gained access to no-copay birth control in the private insurance market, and approximately 16.7 million women benefit from Medicaid coverage, which also covers birth control at no cost. Paying out-of-pocket for birth control pills can cost a woman up to $600 a year, which is simply unaffordable for many young women and people with low incomes. A recent poll found that 33 percent of women could not afford to pay more than $10 for birth control.
- Creates a nationwide ban on abortion coverage. The AHCA will coerce insurance plans to drop coverage of abortion because it will prohibit individuals from using their federal financial help to purchase a plan on or off the ACA Marketplace that covers abortion. At least 870,000 women will lose access to ACA Marketplace insurance plans that cover their full reproductive healthcare needs, including abortion, and millions more could lose access to abortion coverage in other plans given this provision extends outside of the Marketplace. Insurance plans, when not barred by state law, typically cover abortion. Women -- no matter how much money they make or how they get health insurance -- should be able to able to access the full range of reproductive health care and make their own decisions about pregnancy based on their own unique circumstances.
Rolling back the ACA's Essential Health Benefits will hurt women:
1. Ambulatory care: Women make up approximately 60 percent of outpatient visits.
2. Emergency services: Women account for 6 in 10 visits to the emergency room.
3. Hospitalizations: Women are 70 percent more likely than men to have had an in-patient hospital stay.
4. Maternity and newborn care: Approximately 13 million women could stand to lose maternity coverage. Prior to the ACA, only 12 percent of individual market health plans covered maternity care. And, prior to the ACA, some insurance plans did not cover C-sections at all; when they did, they charged women 25 percent more in premiums.
5. Mental health and substance abuse: Women are 40 percent more likely than men to have mental health needs. Additionally, women are roughly 75 percent more likely than men to report having recently suffered from depression.
6. Prescription drugs: Women are more likely than men to need prescription drugs to meet their daily healthcare needs.
7. Rehabilitative services: Women are more likely to suffer from a stroke and require rehabilitative services to help them regain motor or speaking skills.
8. Lab tests: Some of the most common lab tests are specifically geared to women, including pap smears, pregnancy tests, mammograms, BRCA gene testing (breast cancer testing) and many other lab services that are necessary to diagnose and treat conditions that disproportionately impact women like autoimmune disorders, thyroid disorders and urinary tract infections.
9. Preventive services and chronic disease management: 55 million have received access to no-cost birth control, well-woman visits, domestic violence screenings and STI/HIV screenings thanks to the ACA.
10. Pediatric services: In two-parent households where at least one parent is a woman, women tend to bear a disproportionate share of childcare and caregiving responsibility for children. In addition, 80 percent of single-parent households are headed by women.
