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Skipped a recommended medical test or .... TPA must pay for ... in Brief: Restric! ng Insurance Coverage of Abor!on, January 2014. WA. OR. WY. UT. TX. SD. OK.
Women  Were  a  Cri9cal  Part  of  the  ACA  Debate   The White House Blog Health Insurance Reform as a Women's Issue: The First Lady's Take Comprehensive  Health  Care  Reform:       An  Essential  Prescription  for  Women A  Report  by  the  Joint  Economic  Committee Representative  Carolyn  B.  Maloney,  Chair   Senator  Charles  E.  Schumer,  Vice  Chair

March  of  Dimes  Calls  for  Health  Coverage   for  Women  of  Childbearing  Age  and  Children   Join YWCA to tell Congress that now is the time to pass comprehensive healthcare reform.

AMA president says pregnant women are barred from buying individual health policies

 AARP  on  What  Health  Reform  Means  for  Women   Health Care: A Basic Right

Healthcare Reform in America You can make a difference!

Costs Are a Barrier to Care for Many Women   Percentage of men and women who say they or a family member have done each of the following in the past year because of COST:

27%  

Put  off  or  postponed  gePng  needed   health  care  

40%  

Skipped  a  recommended  medical  test  or   treatment  

20%   33%  

Didn’t  fill  a  prescrip3on  

Cut  pills  or  skipped  doses  of  medicine  

Had  problems  gePng  mental  health  care  

Men  

22%   32%   15%   23%   10%   14%  

Source:    Kaiser  Family  Founda3on  Health  Tracking  Poll  (conducted  September  12-­‐18,  2013)   hAp://kff.org/health-­‐reform/poll-­‐finding/kaiser-­‐health-­‐tracking-­‐poll-­‐september-­‐2013/  

Women  

Millions  of  Uninsured  Women  Could  Gain  Access  to   Affordable  Coverage,  but  Many  Are  in  the  Gap   Insurance  Coverage  of  Women  in  the  U.S.,  2011-­‐2012  

Eligibility  for  Coverage  

2.6  million   Employer  Based/ Private   65%  

6.8  million   Uninsured   19%  

4.4  million   Medicaid   12%  

2.4  million   2.5  million  

Unsubsidized     Marketplace  -­‐  14%   (income  ≥  400%  FPL)    

Tax  Credit  Eligible  -­‐  37%    

Medicaid  Eligible  -­‐  24%     Coverage  Gap  -­‐  13%    

(income  below  100%  FPL  in  a   state  not  expanding  Medicaid)  

Undocumented  -­‐  13%  

Other  Government   4%   96.3  Million  Women     18.7  Million  Uninsured  Women   Ages  19  -­‐  64         are  not  legally  authorized  in  the  U.S.  Medicaid  Eligible  includes  women  eligible  for  Medicaid   NOTE:  Undocumented  refers  to  those  who   in  all  states.  Percentage  may  not  add  up  to  100%  due  to  rounding.     SOURCE:  Kaiser  Family  Founda3on  analysis  based  on  2014  Medicaid  eligibility  levels  and  2012-­‐2013  Current  Popula3on  Survey,  U.S.   Bureau  of  the  Census.  

Impact  of    the  Supreme  Court  Ruling:       Half  of  states  will  be  not  be  expanding  Medicaid  in  2014   VT  

WA   MT      OR  

ID  

NV      CA  

 ND  

 WY  

   MN    WI*  

 SD  

   CO  

 UT  

  AZ  

 NM  

 PA*    IL  

 KS    OK  

MO  

 TX  

 OH  

 IN*  

WV    KY  

 AR*  

 AL  

VA  

  NH  

MA    CT   RI   NJ   DE   MD      DC      

NC  

 TN    MS  

  AK  

 MI*  

 IA*  

 NE  

 NY  

  ME  

 SC    GA  

 LA    FL  

HI  

Implemen9ng  Expansion  in  2014  (26  States  including  DC)   Seeking  to  Move  Forward  with  Expansion  post-­‐2014  (2  States)   Not  Moving  Forward  at  this  Time  (23  States)   .     SOURCES:  State  decisions  on  the  Medicaid  expansion  as  of  December  11,  2013.  Based  on  data  from  CMS,  available  at:   hAp://medicaid.gov/AffordableCareAct/Medicaid-­‐Moving-­‐Forward-­‐2014/Medicaid-­‐and-­‐CHIP-­‐Eligibility-­‐Levels/medicaid-­‐chip-­‐eligibility-­‐ levels.html.  Data  have  been  updated  to  reflect  more  recent  ac3vity.  

The  ACA  Makes  Many  Insurance  Reforms  Affec9ng  Women   Before  ACA   •  No  uniform    na3onal  policy  regarding   dependent  coverage  age  limits      

Aier  ACA   •  Dependent  coverage  extended  to  age  26,   Uninsured  rate  for  women  19-­‐25  fell   from  30%  in  2009  to  25%  in  2012  

•  Pregnancy  and  history  of  domes3c   •  No  pre-­‐exis3ng  condi3on  exclusions   violence  could  be  considered  pre-­‐exis3ng   condi3ons   •  Individual  insurance  plans  could  charge   higher  premiums  to  women.    Many  did.    

•  Plans  are  no  longer  permiAed  to  use   gender  to  determine  premiums:  gender-­‐ ra3ng  banned    

•  Individual  insurance  plans  typically   •  Individually  purchased  plans  and   excluded  maternity  care,  considered   employer-­‐based  plans  include  maternity   pregnancy  a  “pre-­‐ex”,  or  required  costly   care   riders  for  coverage.    Only  employer  plans   required  to  cover  maternity  care.       •  Plans  were  not  required  to  cover   •  ALL  new  plans  must  cover  recommended   preven3ve  services  without  cost  sharing.     preven3ve  services  without  cost-­‐sharing.     Source:    Kaiser  Family  Founda3on,  Health  Reform:  Implica9ons  for  Women’s  Access  to  Coverage  and  Care,  2013.    

Adult  Preven9ve  Services  to  be  Covered  by  Private  Plans  Without  Cost  Sharing       Cancer    

Chronic   Condi9ons  

Vaccines    

Healthy  Behaviors   Pregnancy  

Reproduc9ve  and   Sexual  Health  

ü Breast  Cancer  

ü Cardiovascular  health   ⁻  Hypertension   screening   ⁻  Lipid  disorders   screenings     ⁻  Aspirin    

ü Td  booster,   Tdap  

ü Alcohol  misuse  

ü STI  and  HIV   counseling  (adults  at  

ü Type  2  Diabetes  

ü   Hepa99s  A,  B  

–  Mammography  for   women  40+*   –  Gene3c  (BRCA)   screening  and   counseling   –  Preven3ve   medica3on    

ü Cervical  Cancer   ‒  Pap  tes3ng  (women   21+  )  

‒  High-­‐risk  HPV   DNA  tes9ng  ♀  

ü Colorectal  Cancer   ⁻ 

screening  (adults  w/   elevated  blood   pressure)  

ü Depression   screening  (adults,   when  follow  up   supports  available)  

ü Osteoporosis   One  of  following:   screening  (all  women   fecal  occult  blood   65+,  women  60+  at   tes3ng,  colonoscopy,   high  risk)   sigmoidoscopy     ü Obesity  Screening     (all  adults)   Counseling  and   behavioral   interven3ons  (obese   adults)  

ü MMR   ü Meningococcal  

ü Pneumococcal   ü Zoster     ü Influenza,     ü Varicella     ü HPV  (women   and  men   19-­‐26)    

screening  and   counseling  (all  adults)  

ü Diet  counseling   (adults  w/high   cholesterol,  CVD  risk   factors,  diet-­‐related   chronic  disease)  

ü Tobacco  counseling   and  cessa3on   interven3ons    (all   adults)  

ü Interpersonal  and   domes9c  violence   screening  and   counseling  (women   18-­‐64)♀

ü Well-­‐woman  visits   (women  18-­‐64)  ♀  

ü Tobacco  and  cessa9on   interven3ons  

ü Alcohol  misuse   screening/counseling    

ü Rh  incompa9bility   screening    

ü  Gesta9onal  diabetes   screenings♀     ⁻  24-­‐28  weeks  gesta9on     ⁻  First  prenatal  visit   (women  at  high  risk  for   diabetes)    

ü Screenings   ⁻  ⁻  ⁻  ⁻  ⁻ 

Hepa33s  B   Chlamydia  (