Is the Senate Health Care Bill a Step Backward for Women's Health Care?


Monday evening, after a rousing speech in Philadelphia pushing for health reform passage, President Obama will celebrate International Women's Day with a White House reception honoring women around the world for their achievements.

This recognition is important. However, International Women's Day - the brainchild of a group of predominantly socialist women with revolutionary dreams of equality and basic human rights for all - presents an opportunity for a little more expansive thinking on the part of the Obama administration.

One item that's ripe for rethinking, ASAP: the gender discrimination that is burning a hole through the Senate health reform bill that's headed for a House vote next week.

Though the Senate bill lacks the Stupak stamp of shame, it certainly doesn't come up short in the department of reactionary anti-choice provisions. Currently, the vast majority of private health plans cover abortion procedures. The Senate plan endorsed by President Obama would severely complicate payments for abortion-inclusive plans, requiring individuals covered by those plans to write two separate checks - one to cover abortion procedures and one for all other coverage. Insurers then must deposit abortion payments and everything-else payments into two separate accounts.

Chances are, the new regulations would drive insurance companies to drop abortion coverage from their plans, according to health policy analysts. These eliminations would impact millions of Americans: more than one-third of adult women in the US have had at least one abortion. When it comes to choice, the health reform plan in its current state marks a dangerous step backward.

The bill's shortcomings for women don't stop at abortion. Earlier in the health-care-push season, Obama promised a plan that would eliminate "gender rating" - the practice of charging more for women's coverage than for men's. Gender rating is still going strong in 40 states. Insurance companies rally around the excuse that the policy is "actuarially based"; that women cost more to insure than men, mostly due to pregnancy- and birth-related medical care. Beneath that flimsy statistical veil, it's blatant discrimination: Insurance companies acknowledged that themselves 40 years ago when they abandoned race as a price-determining factor.

Despite the president's promise, the Senate bill upon which we're pinning our hopes for health reform would not eradicate gender rating. It would openly permit the practice for employers of businesses with 100 employees or more, giving large employers an obvious incentive to hire men over women to keep down insurance costs. Gender rating also puts businesses with a mostly female workforce - childcare centers, some school districts and nurse associations - at a disadvantage. According to the National Women's Law Center, "One such employer with a predominantly female workforce estimated that, due to gender rating, her annual premiums were $2,000 higher per employee."

As the health care debate drags on and on, there's a lot of shushing going around. Many leading Democrats are hoping to sweep the Senate bill's discriminatory flaws under the rug. After all, health reform is desperately needed, and it would be really nice to finally push a passable bill through before we all lose our sanity (not to mention our insurance).

However, as it stands, the health reform bill would endanger the basic human rights of many women. This International Women's Day, it's time for Congress and the president to stop ignoring the bill's consequences for women's health coverage - and start discussing options for averting them.

Planned Parenthood President Cecile Richards calls for Congress to fix the legislation's abortion caveats during reconciliation - a move that could prove very difficult, since reconciliation is designed to address only items that are relevant to the budget. Jodi Jacobson at RH Reality Check notes that the only route to a true repair job may be a "future bill aimed at making technical fixes to health reform."

Either way, the work to protect women's health coverage from these sweeping restrictions and limitations must begin now. As the International Women's Day reception festivities wind down at the White House tonight, the president should do some hard thinking about how to ensure the basic human right of health care for women here at home. 

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