What GOP health care plan means for women

Lodi News-Sentinel - - Nation / World - By Alexan­dra Zavis

Women’s health ad­vo­cates have as­sailed the plans put for­ward by con­gres­sional Repub­li­cans to re­place the Af­ford­able Care Act, say­ing they would cause dis­pro­por­tion­ate harm to half the adult pop­u­la­tion.

“Both bills are noth­ing short of an all-out at­tack on women’s health,” said Janel Ge­orge, di­rec­tor of fed­eral re­pro­duc­tive rights and health at the Na­tional Women’s Law Cen­ter.

Both the Se­nate plan, and the ver­sion that nar­rowly won ap­proval in the House of Rep­re­sen­ta­tives, would slash fed­eral spend­ing on Med­i­caid, which pro­vides cov­er­age to one in five women and pays for nearly half of all births in the coun­try.

Women with pri­vate in­sur­ance plans sold to in­di­vid­u­als could lose guar­an­teed ma­ter­nity cov­er­age in some states. And those on Med­i­caid wouldn’t be able to use their ben­e­fits at health cen­ters op­er­ated by Planned Par­ent­hood for one year.

That’s hardly a sur­prise, crit­ics say, con­sid­er­ing how lit­tle in­put women had in draft­ing the pro­pos­als to re­place Pres­i­dent Barack Obama’s sig­na­ture health care leg­is­la­tion. A work­ing group con­vened by Se­nate Ma­jor­ity Leader Mitch McCon­nell in­cluded 13 men, but no women.

“It is an out­rage that a bill, which will af­fect ac­cess to health care for mil­lions of peo­ple, was writ­ten in se­cret with no women se­na­tors and will not have a sin­gle pub­lic hear­ing,” said Nancy Northup, pres­i­dent of the Cen­ter for Re­pro­duc­tive Rights.

Faced with op­po­si­tion within their own party, Se­nate ma­jor­ity lead­ers this week de­layed a vote on their plan in or­der to give them­selves more time to win over re­luc­tant Repub­li­cans. They hope to have a re­vised ver­sion by Fri­day, so it can be as­sessed by the Con­gres­sional Bud­get Of­fice over the Fourth of July hol­i­day.

But as law­mak­ers head back to their home dis­tricts, pa­tient ad­vo­cacy groups, med­i­cal or­ga­ni­za­tions, re­pro­duc­tive rights ac­tivists and oth­ers are mo­bi­liz­ing for an­other push to sink the bill.

Here are some of the ways that the leg­is­la­tion could af­fect women:

Med­i­caid cuts

Both plans would slash hun­dreds of bil­lions of dol­lars from Med­i­caid over the next decade, leav­ing states with some un­pleas­ant choices: limit el­i­gi­bil­ity, of­fer fewer ben­e­fits, re­duce the rates paid to health care providers or spend more of their own money.

Any cuts would dis­pro­por­tion­ately af­fect women, ex­perts ar­gue, be­cause women make up the ma­jor­ity of adults who de­pend on the pro­gram that in­sures more than 70 mil­lion poor Amer­i­cans.

There are a num­ber of rea­sons for that. Women are more likely than men to work in low­pay­ing jobs that don’t of­fer in­sur­ance. They tend to live longer and have more health needs, par­tic­u­larly dur­ing their re­pro­duc­tive years. And they are more likely to be car­ing for de­pen­dent chil­dren or el­derly fam­ily mem­bers.

The pro­posed cuts to Med­i­caid spend­ing could af­fect more than the cov­er­age avail­able to women: They could dam­age women’s eco­nomic se­cu­rity, Ge­orge ar­gues. Med­i­caid sup­ports jobs in the health care in­dus­try that are over­whelm­ingly filled by women, in­clud­ing nurs­ing home em­ploy­ees and home health aides.

The Repub­li­can bills would also give states the op­tion to im­pose work re­quire­ments on Med­i­caid ben­e­fi­cia­ries who are not preg­nant, dis­abled or el­derly. Un­der this pro­vi­sion, women could lose their cov­er­age if they don’t re­turn to work 60 days af­ter giv­ing birth.

Elim­i­na­tion of ben­e­fits

The Repub­li­can bills would al­low states to do away with re­quire­ments that pri­vate health plans sold to in­di­vid­u­als of­fer ba­sic ben­e­fits such as ma­ter­nity and new­born care.

States could also scrap manda­tory cov­er­age of men­tal health ser­vices, in­clud­ing coun­sel­ing for de­pres­sion, which is more preva­lent among women than men. Even cov­er­age for pre­scrip­tion drugs, which women use more than men, may no longer be guar­an­teed.

Pro­po­nents ar­gue this would al­low greater flex­i­bil­ity to tai­lor po­lices to in­di­vid­ual needs. But crit­ics say elim­i­nat­ing so­called es­sen­tial ben­e­fits could re­turn the in­di­vid­ual mar­ket to the days when cer­tain kinds of cov­er­age were hard to find _ and of­ten un­af­ford­able when avail­able.


Vivian Bigelow, a nurse prac­ti­tioner, dis­cusses birth con­trol op­tions with a pa­tient at a Planned Par­ent­hood health cen­ter in Plano, Texas. The Repub­li­can health­care plans would pro­hibit Med­i­caid re­cip­i­ents from us­ing their ben­e­fits at Planned Par­ent fa­cil­i­ties for one year.

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