Alliance of White Anti-Racists Everywhere – Los Angeles
healthcarereform
Birth Control Without Co-Pays and 4 Reasons to Care About Health Reform
06 months ago
This week the Institute of Medicine (IOM)–a nongovernmental, nonpartisan arm of the National Academy of Sciences–issued a major report urging the federal government to count birth control as preventive care under the health reform law. If the Obama administration, which commissioned the report, takes the IOM’s advice, insurance companies would be have to cover pregnancy prevention in full–without co-pays!
Although radical anti-choice folk, their mouthpieces, and even a few neutral media sources have branded this recommendation “free birth control,” it’s not. The women who plunk down about $5 to $50 a month for, say, the Pill are already paying their insurance premiums. This would just lighten their financial load.
Along with co-pay free coverage of the Pill, the morning-after pill, tube-tying and other FDA-approved contraceptive methods, the IOM report also recommends that insurance companies fully cover what the panel described in the report as:
- improved screening for cervical cancer, counseling for sexually transmitted infections, and counseling and screening for HIV;
- a fuller range of contraceptive education, counseling, methods, and services so that women can better avoid unwanted pregnancies and space their pregnancies to promote optimal birth outcomes;
- services for pregnant women including screening for gestational diabetes and lactation counseling and equipment to help women who choose to breastfeed do so successfully;
- at least one well-woman preventive care visit annually for women to receive comprehensive services;
- and screening and counseling for all women and adolescent girls for interpersonal and domestic violence in a culturally sensitive and supportive manner.
Now, if you’re an insurance company executive; you’re a member of the Family Research Council; you roll with the United States Conference of Catholic Bishops; or you vote against your own interests because you’ve been Tea Partied into believing that enriching insurance companies is a patriotic act, this is bad news.
If you’re a woman of color who doesn’t fit the description above, this IOM report, “Clinical Preventive Services for Women: Closing the Gaps” is particularly good news for you. A few (lesser known) reasons why:
Gestational diabetes is a big problem for us
Between two and 10 percent of women develop diabetes due to pregnancy. According to the American College of Gynecology and Obstetrics (ACOG), risk factors include:
- being Native American, Asian, Hispanic, African American, or Pacific Islander;
- being overweight;
- having a close relative with diabetes.
And women with gestational diabetes are more likely to:
- develop preeclampsia (a condition that can cause seizures and liver and kidney problems for mom, and the premature birth of baby);
- have a very large baby (which could mean a more complicated–and painful–vaginal delivery or even an emergency C-section);
- and have Type 2 diabetes after pregnancy
The IOM recs would compel insurance companies to cover screening for women who are 24 to 28 weeks pregnant and at the first prenatal visit for women at high risk for diabetes.
We really need better HPV testing
HPV (human papilloma virus) awareness, vaccination and testing has increased among women of all races. But the disease HPV causes, cervical cancer, continues to affect women of color most. According to the most recent available stats from the CDC:
- Latinas have the highest cervical cancer rate in the country.
-Black women have the second highest, followed by white, Native American and Asian/Pacific Islander women. - Black women are most likely to die of cervical cancer, followed by Latinas, Native American and Asian/Pacific Islander sisters.
- Most cervical cancer cases occur in the South.
By placing HPV DNA testing–which tells women if they have a high-risk HPV strain that causes cervical cancer–on the same level as the traditional annual Pap smear, the IOM is sending a message that it’s not a luxury item, but a necessity for women 30 and older, every three years.
The cost of a breast pump shouldn’t be an obstacle to breast feeding
Remember all of that drama earlier this year when Michelle Obama promoted breast feeding as a way to tackle childhood obesity and gave a special shoutout to black women because 40 percent of our babies aren’t breastfed at all? How Michele Bachmann ignorantly cast Obama’s advocacy as a sinister effort to establish a nanny state? (“To think that government has to go out and buy my breast pump for my babies, I mean, you wanna talk about the nanny state — I think you just got the new definition of the nanny state.”)
Well, the IOM offers a common-sense way to address the fine senator’s concern: Along with lactation counseling, the cost of renting a pump would be fully covered by insurance companies. At about $35 for a manual pump and up to $275 for an electric one that most working mothers would need, this could make a real difference for working poor women and women of color.
OK, so what’s next?
The Health and Human Services Department will reportedly decide on which of the IOM recommendations to adopt by August 1. Anti-choicers have already objected because they consider FDA-approved emergency contraception pills to be a form of abortion. And health reform bashers will likely push back on fiscal grounds since the IOM didn’t do a cost-benefit analysis. In short, we need to get busy telling everyone who will listen to do the right thing and not bend over for really loud, cynical minority.
And for a detailed debunking of anti-choice claims, read this.
Vermont Breaks Ground in Health Coverage for Migrant Workers
08 months ago
Vermont, land of rolling green hills dotted with black and white Holsteins and picturesque red barns. White people, everywhere, lots of them. Home of state-sanctioned town hall meetings that are models for participatory democracy. And now, the first state in our republic to enact universal health care for all. Two weeks ago, Gov. Peter Shumlin signed into law H. 202, “An act relating to a single-payer and unified health system.” It’s the first state to plunge into a single-payer system to implement national health care reform, which Harvard economist William S. Hsiao found was the best method to both reign in spiraling costs and diminish disparities.
Nationally, the need is perhaps more dire now than ever as safety net hospitals close down across the country. These hospitals are often places of last resort for care for the uninsured and for undocumented immigrants–populations that are disproportionately comprised of low-income people of color. According to the Kaiser Family Foundation, 44.4 percent of Latinos lack insurance, as well as 28.5 percent of black people and 21.2 percent of Asian Americans. In contrast, 16.5 percent of whites don’t have coverage.
Vermont takes one bold step towards reversing these disparities by extending coverage to the thousands of undocumented workers who toil in obscurity, hidden by the state’s rural isolation. That victory comes after a two-year, people-led movement to fight for single-payer care, under the banner of Healthcare is a Human Right–an effort that included a heroic, last-ditch campaign by the Vermont Workers Center to repeal an amendment that would have excluded undocumented workers.
Workers like Jose Obeth Santiz Cruz, who traveled a long way to toil without rights on Vermont’s farms. Santiz Cruz’s relatives and friends told him of opportunities to work in dairy farms–it would be hard work and a lonely life, but he could save money to send back to the village of San Isidro, in the Chiapas mountains, where he supported his parents and two siblings. So in early 2009, Santiz Cruz made the trek of over 3,000 miles, stopped at the Mexican border for 20 days before heading North.
His new home, framed by snow-capped Green Mountains to the east and New York’s Adirondacks to the west, was so different from Chiapas. But Santiz Cruz found work at a dairy farm in Franklin County and used his earnings in the initial months to repay the thousands of dollars he owed to the coyotes, as smugglers are called, who helped him cross the border.
One night two years ago, close to Christmas, Santiz Cruz’s coworkers found him dead in the barn. His clothing had gotten caught in a gutter cleaner, a chain-driven motor machine that scrapes out the gutter where cow waste collects. Unable to extricate himself, he was pulled into the motor and strangled to death. Santiz Cruz was only 20 years old.
Santiz Cruz’s death was a wake-up call to local residents that the farmworker community needed support. Migrant farmworkers, most hailing from Mexico or Guatemala, are a relatively new population in Vermont. They began fulfilling the need for labor on small family farms in the state roughly 10 years ago, after children of Vermont farmers chose to not follow the path of their parents into a profession that is increasingly hard to sustain. In 2009, 33 family dairy farms closed down. Those that remain open depend on migrant labor. A third of Vermont’s farmworkers are from Chiapas, many are indigenous Tojolabal, said Brendan O’Neill, cofounder of the Vermont Migrant Farmworker Solidarity Project.
The dairy industry in particular relies heavily on imported labor, with most farms employing one to two workers, the largest with 10 workers. Most of those workers are undocumented, like Santiz Cruz, having traveled north out of economic need; others come through guest worker programs. Farmworkers in Vermont earn anywhere from $5 to $10 an hour, the average is $7, working 12 to 15 hour days. Most stay for under two years, sending remittances home, before returning themselves.
These workers have until now gone without access to health care, without oversight of their working conditions for safety and health violations, and without recourse to other services that our social safety net extends to most of our citizens. (Well, it’s now a fight to preserve those services for anyone in this age of budget cuts). A 2007 report by the Vermont Department of Health found that farmworkers face many barriers to health care, including lack of language translation, transportation to providers, and fear of deportation.
“People live with bad injuries, through sickness; they don’t go to see doctors, because of fear of deportation,” explained O’Neill. “Up at the border, we have a really tense ICE presence: [it's] pretty common to talk to workers close to the border who literally never leave the farm. [They've] been there for two years and never stepped foot off the farm.”
As the migrant labor force continues expanding, the problems caused by their isolation from health care, among other services, is becoming more critical.
“We’re seeing more undocumented workers in different industries. Primarily, up til now, they were in the dairy industry, but now they’re at vegetable farms and doing construction,” said James Haslam of the Vermont Workers Center. “We’ve operated a workers rights hotline since 1998. We occasionally got calls [from undocumented workers] and they’ve increased, despite the fact that up til now all our materials are in English. Still, somehow, people find our number.”
The number of Latino farmworkers in Vermont peaked between 2,000 to 2,500, in 2005, according to Cheryl Mitchell, cofounder of the Addison County Farm Worker Coalition and former deputy secretary for Vermont’s Agency of Human Services. The population has gradually decreased as border control has stepped up efforts. With 3.9 percent of Vermont’s total population being people of color, it’s easy to target anyone not white. ”Vermont is such a homogenous state, so the potential for racial profiling is scary,” said Mitchell.
Five years ago, at the first public forum on farmworker solidarity, organized by Mitchell’s Addison County Farm Worker Coalition, the Mexican consulate reported that Vermont at the time had the most number of deportations per capita among all states in New England.
After Santiz Cruz’s death, local Vermonters organized a candlelight vigil in his honor. However, fellow farmworkers were afraid to attend, concerned that the border patrol would be present. O’Neill and other organizers with the Vermont Migrant Farmworker Solidarity Project raised funds to bring Santiz Cruz’s body to his home in Chiapas for
burial. They also created a film, “Silenced Voices,” about their journey to San Isidro with Santiz Cruz’s coffin. The village initially subsisted off of growing coffee, but was unable to sustain itself when global coffee prices fell and free trade agreements (like NAFTA) eliminated Mexican-government subsidies.
For now, O’Neill and his colleagues try to establish links between rural Vermont and the mountain villages of Chiapas–lands separated by vast distances, but united by farmers and workers who struggle under the same forces of global capitalism.
The victory to include undocumented farmworkers in universal health care is a temporary one. Haslam, of the Vermont Workers Center, anticipates more fights ahead. “What we’re doing in Vermont is going on the offensive for human rights,” he said, “building a proactive movement, not just defending what we have, but pushing for and really turning things around.”
One Year Later, People of Color Are Health Reform’s Strongest Backers
010 months ago
Today marks the first anniversary of President Obama’s signature legislation, the health care reform law known as the Affordable Care Act.
As Colorlines’ Jamilah King explained earlier this year, ACA has been under attack from conservatives who want it repealed because it apparently spells creeping socialism. While a measure to repeal the bill passed the House last month, it failed to pass the Senate–and would have been vetoed by the president had it passed.
David Weigel points to polling that shows a majority of Americans approve of health care reform or want the law to be even more liberal. Weigel adds:
There’s room here for Democrats to defend the law in 2012. Their biggest problem is that 48 percent of people over 65 oppose the law because it’s too liberal, and 46 percent either oppose it or want a more liberal law. These are the people who vote at the highest rate and think they have the most to lose if the law’s not repealed.
As for those who have the most to lose if the law is repealed? King:
According to Leslie Russell at the Center for American Progress, people of color are more likely to be left uninsured and suffer disproportionately from health disparities. Some of the estimates show that while 12 percent of white residents are uninsured, those numbers are nearly double for African-Americans. The numbers are about the same for Latinos and American Indians, whose rates of uninsured total about 32 percent.
Perhaps no surprise, then, that people of color support ACA in the highest numbers, with nearly 80 percent of blacks and 52 percent of Latinos in favor, according to one report. Despite the fact that the bill includes conservative provisions like one that bars federal funding for abortion care, which essentially restricts access to abortion for poor women, the Affordable Care Act will increase access to meaningful health care for women, people of color, and young people.
And it’s important to remember, as the budget debate continues, that ACA isn’t just good for people; it’s good for the deficit, too. While the GOP focuses on pushing through $61 billion in cuts to critical social services, the Congressional Budget Office estimates ACA reduces the deficit by $500 billion and increases revenue by $410 billion.
Global AIDS Watchdogs Worry U.S. Neglecting Its Leadership Role
01 year ago
This year, the AIDS crisis will turn 30, a testament not only to the epidemic’s resilience but also to a global movement’s long struggle for visibility and survival. There’s no debating that in those three decades, domestic and global efforts to stem the spread of HIV/AIDS made major strides. But activists say that efforts have slumped lately, and the U.S. is failing in its traditional role at the helm of the international response.
The Obama administration has taken an “integrated” approach to addressing HIV/AIDS through its Global Health Initiative, which tackles many health issues that often compound each other: HIV, infant and maternal health, malaria, tuberculosis, health systems and health workforce; as well as neglected tropical diseases.
That strategy was hailed initially by many global health watchdogs, who have long said that HIV can’t be addressed in a vacuum. But at least one group now says the more expansive strategy has camouflaged the shortchanging of HIV/AIDS programs.
Obama’s fiscal year 2011 budget proposal inched up HIV/AIDS funding under the Global Health Initiative by 3.5 percent, according to the Kaiser Family Foundation; Congress has not yet passed that budget. But according to Health Global Access Project (GAP), which advocates for HIV/AIDS funding worldwide, funding has effectively plateaued or even retrenched during Obama’s first two years in office. The group says Obama’s policies could undermine the progress made under the President’s Emergency Plan for AIDS Relief (PEPFAR), a Bush-era initiative that marshaled U.S. and international money to invest in treatment and prevention in high-risk regions.
According to GAP’s analysis of PEPFAR spending, 2010 saw a 14 percent decrease from the previous year in the the anti-retroviral drug budget, as well as significant cuts in several country-specific programs in Africa. The group blasted the administration for “flat-lining the response to AIDS” and “decreasing investments in essential program areas for the first time since PEPFAR was funded.”
Ezekiel Emanuel, head of Obama’s Global Health Initiative, put a positive spin on economizing the AIDS budget. Stressing that “what counts are not dollars spent or drugs bought, but lives saved,” he argued in the Huffington Post:
What it takes to save lives of those with HIV and those most at risk to contract it is a comprehensive approach that recognizes the roles of other diseases (many inexpensively preventable), child and maternal health, and strong health systems play in saving lives and solidifying health gains in developing nations.
While a more holistic approach to global health is vital, AIDS activist Gregg Gonsalves wrote in the Washington Post, dollars do matter when it comes to fighting a virus as brutal as HIV:
AIDS activists have been global health activists all along, with many calling for health-care reform in the United States since the epidemic first appeared and for strengthening primary care in the developing world for more than a decade. What we don’t support is this administration’s either/or approach to global health.
Whether funding rises or falls in the upcoming federal budget, there will still be a yawning global gap in treatment and prevention resources, especially in the hard-hit African nations that had been a major recipient of PEPFAR dollars. According to UNAIDS, global spending on HIV/AIDS in 2009 amounted to less than $16 billion, while 2010 funding needs exceeded $25 billion. More than 60 percent of people in need of anti-retroviral therapy drugs still can’t get them.
What’s next? The President’s State of the Union Address was silent on AIDS as both a domestic and international issue, and the climate of austerity surrounding the forthcoming fiscal year 2012 budget will leave little room for tackling global epidemics.
“If Obama wasn’t willing to fight for AIDS in a Democrat-controlled Congress, activists worry about what he is likely to do with the Republicans coming in complaining about deficits and foreign aid,” said Health GAP policy analyst Brook Baker. He noted that even some of the sympathetic centrist conservatives, who supported PEPFAR under Bush, have now been “defeated by the tea partiers or fiscal conservatives. It’s going to be an uphill but winnable struggle.”
AIDS on the Home Front
The struggle to deal with AIDS in U.S. communities is also lagging. Today, several thousand people are still on the waiting list for the AIDS Drug Assistance Program (ADAP), a 32 percent increase over a year, according to The Body. Much of this is due to state government rollbacks and freezes on programs to deal with budget deficits.
The embattled healthcare bill contains several initiatives that could directly or indirectly strengthen access to treatment and prevention. But even those modest reforms are threatened by the Republican opposition, which could push decent medical care even further out of reach for people living with HIV and AIDS.
Phill Wilson, head of the Black AIDS Institute, wrote in a recent commentary that stigma and a lack of political momentum has fallen especially hard on Black communities:
When faced with discrimination, alienation and marginalization, people will not disclose their risk factors, use condoms, get tested for HIV, seek treatment or talk openly about HIV/AIDS.
The therapies, while effective, are very expensive (approximately $12,000 to $14,000 per year, not including the other costs of care). Without health insurance, many people living with HIV/AIDS cannot afford them. Many state-run, publicly funded AIDS drug assistance programs have waiting lists and are not able to accommodate everyone who needs these life-saving drugs.
Wilson is among those who have praised one major accomplishment of the Obama administration in the domestic epidemic: crafting the U.S.’s first comprehensive strategy for fighting HIV/AIDS. Advocates pushed hard to secure a commitment to create such a strategy from candidate Obama, and applaud the Office of National AIDS Policy for following through over the past two years. The question now is whether it will be implemented earnestly, including adequate funding. The hope is that the new National HIV/AIDS Strategy will allow resources to be targeted in the communities where the epidemic is most intense–among black Americans and, increasingly, in southern states.
Washington clearly has a stake in the global battle against HIV/AIDS, but how do we reconcile that urgent need with the chilling fact that black men in the nation’s capital experience rates of HIV that rival that of Sub-saharan Africa?
In reality, the trajectory of the U.S. AIDS crisis over the past generation ties directly into the global dynamics of the epidemic. Wherever the disease spreads, it sharpens patterns of gender, racial and socioeconomic inequality, and the most acute suffering takes place in communities historically excluded from the institutions that dictate how health resources are invested.
Thirty years on, the fight against AIDS can still claim many victories: International cooperation has yielded breakthroughs in treatment and prevention as well as medical research. The Obama administration removed funding restrictions on international programs that were based on anti-abortion and anti-prostitution ideologies.
All that has merely laid the groundwork for defeating the crisis. While AIDS will outlive the election cycle, the economic cycle, and perhaps even this generation, the U.S. commitment to combating the disease suffers from a shortsighted vision. Keeping up the fight shouldn’t force us to divide inadequate resources across interconnected needs, especially when we’ve already seen how far a little cooperation can take us.
The GOP’s Biggest Health Care Victory? No Race in the Debate
01 year ago
It’s certainly not surprising that the House of Representatives voted to repeal the Obama administration’s historic health care reform bill Wednesday night. For the new Republican House majority, it’s a largely symbolic vote that will likely get thwarted by the Senate. But what’s been stunning is that both sides of the aisle have largely ignored the issue of race.
That omission is crucial when you consider that the lack of good, quality health care is among the most racialized policy discussions around. Time and again, statistics have shown that on average people of color are sicker, have less coverage and get worse care.
Take these facts, for example: This month the Centers for Disease Control released an analysis that showed that racial health disparities are more ripe now than ever. Black babies are up to three times more likely to die than infants born to women of other races. Meanwhile heart disease and stroke remain at the core of inequalities in life expectancy between whites and African-Americans.
This sort of mounting evidence of persistent health inequalities has led some officials to call for not just reform, but health equity.
“Access to healthy foods, healthy housing, health care, safe neighborhoods, education and employment opportunities, and transportation – often collectively referred to as social determinants of health – play as important a role in keeping us healthy as they do in making us sick,” Baltimore Health Commissioner Dr. Oxiris Barbot said in a statement last week.
Similarly, studies have shown that people of color are more likely than whites to go without insurance. According to the Center for American Progress, twelve percent of whites are uninsured, while that number is nearly double for African-Americans. For Latinos and American Indians, the uninsured rate is nearly triple that of their white counterparts.
The tally of who lives and who dies from preventable diseases is also a good estimate of how important race is to the health care debate. For instance, asthma rates are highest among black children, who have a 500 percent higher death rate from the disease than white children. On the whole, people of color experience higher mortality rates from certain cancers that are much more amenable to treatment when diagnosed and treated earlier.
Yet the reason that some of those diseases go untreated or under treated has a great deal to do with the type of care patients of color receive when they do visit a doctor. According to CAP, one in five Latinos report not seeking medical care because of language barriers. Kai Wright has reported that the Right’s colorblind attack on health care is a decades-long struggle that’s proved especially costly to patients of color. Pointing to a landmark 2002 study from the Institute of Medicine (IOM), Wright remarked on the poor quality of care offered to folks of color who do have insurance:
[The IOM study] declared that even given the same insurance, the same income and the same type of treatment facility, people of color were less likely to receive quality care. The disturbing gap existed across a wide range of treatments-breast cancer screenings, angioplasties, hip fracture repairs, and on and on. Whites were even more likely to get an eye exam than nonwhites.
The IOM cited a host of complex and dynamic causes for this inequality. There were structural factors, such as financial incentives to limit services given to poor patients; communication factors like missing translators or English-only signage and literature; even factors driven by the patients themselves, whose own beliefs and preferences led them to refuse certain types of care or fail to follow doctors’ instructions. But what grabbed everyone’s attention was the IOM’s charge that at least part of the disparity results from care providers making racist and stereotyped decisions about when and what treatment to offer.
These sorts of colorblind attacks on health care won’t be ameliorated with the passage of one bill, but it seems like a good place to start. While the GOP’s effort to repeal health care reform probably won’t go too far any time soon, it seems like an opportune moment to begin schooling the public on exactly what the bill’s intended to do, and who could benefit the most.
GOP Attack on Health Care Reform Is a Fight Against Racial Justice
01 year ago
House Republicans are making good on their pledge to repeal every provision of the new law in a vote next week. And while it’s a long shot that the GOP’s effort will make it through both houses of Congress, what’s clear is that less than 72 hours after assuming power Republicans are already breaking their own promises and potentially putting the lives of millions of poor and uninsured people of color at risk.
First, let’s break down the fight. The attempt to repeal the health care law is primarily about attacking one of the Obama administration’s biggest accomplishments, thereby setting the stage for the 2012 presidential elections. Republicans are set to vote on their repeal of the health insurance bill, formally known as the Affordable Care Act next Wednesday, and for all that effort they still haven’t managed to come up with a better name for it other than, “Repealing the Job-Killing Health Care Law Act.” Since they already control the House, the bill’s expected to pass fairly easily. Though it faces considerably more challenging odds in the Democratic-controlled Senate, President Obama said Thursday that he’ll veto any repeal measure that reaches his desk.
In the president’s promise to veto the repeal effort, the White House cited new data from the Congressional Budget Office that showed just how much is at stake if Republicans get their way. The CBO found that if Republicans do get their repeal, an additional 32 million people would be left uninsured, bringing the total amount of non-elderly adults without coverage to 17 percent, a number that’s roughly equivalent to what it is today. Perhaps more noteworthy, though, is the office’s estimate that a repeal would add $320 billion to the federal deficit over the next decade. Coincidently, that’s exactly what the party promised to avoid doing in the first place.
Of course, House leadership already knows this. So they’ve simply decided to change their own rules and continue lying to the public about what repealing the law would really mean. This week Majority Leader Eric Cantor defended the party’s apparent disregard for their own mantra of fiscal responsibility.
“About the budget implications, I think most people understand that the CBO did the job it was asked to do by the then-Democrat majority, and it was really comparing apples to oranges,” Cantor told the New York Times. “It talked about 10 years’ worth of tax hikes and six years’ worth of benefits. Everyone knows beyond the 10-year window, this bill has the potential to bankrupt this federal government as well as the states.”
Ezra Klein points out at the Washington Post that Cantor’s views and comparisons simply have no merit.
Perhaps more importantly, Cantor’s lies have helped push his party’s agenda at the expense of raising the public’s awareness. For instance, a Kaiser Health Tracking poll released last spring found that while 46 percent of the American public favored reforming the law, that view was based largely on the uninformed belief that it would add to the federal deficit. And that was as untrue one year ago as it will be for the next two decades.
But if the health care bill were to be repealed, people of color and many of the country’s poorest residents stand to lose the most. According to Leslie Russell at the Center for American Progress, people of color are more likely to be left uninsured and suffer disproportionately from health disparities. Some of the estimates show that while 12 percent of white residents are uninsured, those numbers are nearly double for African-Americans. The numbers are about the same for Latinos and American Indians, whose rates of uninsured total about 32 percent. Even for those people of color who are insured, they’re more likely to get substandard care. And it’s well documented that people of color face much higher rates of cancer, obesity, diabetes, and heart disease.
Conservatives have gone to great lengths to portray the bill as a “job killer,” when really it’s an effort to catch up to every other industrialized nation in the world in offering affordable public health insurance to working people. According to many liberal observers, such a move could free a large swath of the public from the jaws of over zealous private insurers.
So the fight to maintain the health care law is as much a battle for racial justice and health equity as it is one of maintaining one of the Democratic party’s landmark victories of the past two years.
Concerns Loom as Health Care Reform Goes Into Effect
01 year ago
Six months after the passage of health care reform, the bill became a little more real for millions of Americans. Today, a set of key components of the Patient Protection and Affordable Care Act went into effect, and it’s big news for hundreds of thousands of people who’ve either been kicked off of their insurance, or prevented from getting it altogether. But as the GOP mounts an aggressive attack campaign, advocates worry that society’s most vulnerable are still left out in the cold.
There are four important changes to keep an eye on. First, it’s now much harder for insurance companies to deny or terminate coverage to sick people. Second, the new rules allow young adults to remain on their parent’s health insurance plans through the age of 26. Medicare recipients can also now use their coverage to pay for expensive medications, and lastly, private insurers are required to cover a broader swath of preventative services.
As Karen Davis writes for the Huffington Post, today’s changes mark a significant step forward in the four-year process of implementing the new health care bill. But the reform process is far from over.
Today, as part of their new Pledge to America, the GOP vowed to rollback the President’s signature health care reform bill if they gain control of Congress after November. And as these threats mount, advocates are gearing up to ensure the bill is not gutted.
Eesha Pandit, Director of Advocacy at MergerWatch, says, “we have to make sure that the most vulnerable members of our society actually get access to health coverage they can afford.”
Pandit explains that there is a still a fight to ensure that abortion coverage is available. And, she adds, “in the coming years each state will create an insurance exchange, and we have to make sure that health coverage in the exchanges is affordable.”
And, beyond affordability, there remain serious questions about access. “There’s going to be a major expansion of Medicaid,” explains Pandit, “and we have to make sure there are enough doctors and nurses and community heath centers to treat people.”
Community health clinics, which have received billions of dollars in aid from the health care bill, may be one of the few places where those who lack access to health coverage can access care. Clinics function as safety net providers, and when people really need health care, that’s where they go.
But if the GOP gains control of Congress, even these provisions may be in danger, along with three and half years worth of future changes.
Despite the broad expansions that the Patient Protection and Affordable Care Act will usher in, there are some who were explicitly excluded from coverage. “Undocumented immigrants are completely excluded from the bill,” says Pandit. “These Clinics will be important points of access to health care for them. It’s important that we fight to make sure they’re fully funded, meaning that the money promised to strengthen and expand the network of CHC’s actually gets out to them.”
Regardless of what happens in November, ensuring that health care funding goes to those most in need will continue to be a battle. Advocates say they’re waging it.
Recession Pushes Health Care System from Bad to Worse
01 year ago
The new census report may be restating the obvious: the recession hit, poverty spikes–what did you expect? But the last part presents one of the corollary impacts of economic devastation: a battered and bruised health care system.
According to the Census Bureau:
The number of people covered by private health insurance decreased to 194.5 million in 2009 from 201.0 million in 2008. The number of people covered by government health insurance increased to 93.2 million in 2009 from 87.4 million in 2008.
Kaiser Health News reports that government-run medical programs have absorbed much of the fallout:
While the numbers of people on Medicare remains stable, the percentage of people covered by Medicaid, the federal-state program for people with low incomes, rose from to 15.7 percent of Americans from 14.1 percent. Nearly 48 million Americans are in Medicaid programs.
With an uninsured rate of about 20 percent, adult women are in an especially precarious position, straddling an eroding private insurance system as well as an overstretched safety net, according to the National Women’s Law Center:
Last year, over 6.5 million fewer people had job-based coverage. The proportion of women ages 18-64 with this type of insurance fell from 64 percent to 61 percent from 2008 to 2009. Public health insurance programs, like Medicaid, provided a safety-net for many women (an additional 1.2 million women had public health insurance in 2009); without these critical programs, women’s uninsured rates would be considerably worse.
But the growth in Medicaid coverage has not offset the drop-off in employer-sponsored coverage, which, for all its outrageous costs, remains a pillar of the system.
The new healthcare reform plan is supposed to help expand Medicaid coverage, but those changes won’t go into effect until 2014. In the meantime, the Economic Policy Institute points out that we should brace ourselves for an escalating crisis as employer-sponsored coverage falls another half-percentage point by 2011. Overall, we can expect another half million non-elderly people to join the ranks of the uninsured.
On top of that, there was major increase in the uninsured rate among people with household incomes of $50,000 or more, which means many uninsured “middle class” households could end up with nothing to fall back on except the new private insurance exchanges, which will leave their coverage at the mercy of corporate profit motives. As we’ve reported before, the exchanges might deepen racial and gender imbalances in healthcare access, freighted with crippling costs as well as harsh restrictions on reproductive health services.
In addition to the poor, near-poor and people of color, another group left behind are millions of immigrants, who are subject to discriminatory federal restrictions or, if they’re undocumented, are completely excluded from the system. The rise in the uninsured rate was steeper for non-citizens than for the native-born:
Among the foreign-born population, the uninsured rate increased for noncitizens in 2009 to 46.0 percent from 44.7 percent in 2008… The proportion of the foreign-born population without health insurance in 2009 was nearly two and one-half times that of the native-born population in 2009.
Obama, making his pre-election rounds in the Beltway, nonetheless keeps pushing health reform as a victory for Latinos (perhaps to take the sting off the utter failure of immigration reform).
So it goes. When it comes to who has the right to be healthy in this country, what’s stunning about the census numbers is not what has changed, but how patterns of inequity have become even more entrenched and so many lawmakers remain numb to the crisis (or even push to “ repeal and replace“). Maybe with another few hundred thousand newly uninsured people next year, Washington will finally figure out that ignoring the pain won’t make it go away.
Clock Ticks on Stopping Abortion Ban in Insurance Pools
01 year ago
About 48,000 people have petitioned against the Obama administration’s plan to make sick women pay for health care by sacrificing their reproductive rights.
Though tens of millions of uninsured Americans won’t see much change until the major reforms kick in around 2014, the Obama administration will in the meantime set up short-term “high-risk insurance pools,” to cover people who would otherwise be blocked from the private insurance market due to “preexisting conditions.” But the planned guidelines for this limited program contain a catch: no abortion coverage. So after the public comment period ends later this month, the administration will be poised to force an unprecedented abortion restriction on women who are conveniently desperate for any kind of health care.
As I’ve mentioned before, this quiet concession to the anti-abortion lobby isn’t just unethical and unhealthy from a reproductive justice standpoint; it’s also legally unnecessary. Despite similar existing restrictions in other federal programs, and Office of Health Reform Director Nancy-Ann DeParle’s insistence that “no new ground has been broken,” the near-total ban would be a fresh blow to abortion access. Jessica Arons at the Center for American Progress pointed out that the new restrictions would undermine abortion access across the board by impacting even those abortions financed by private (not taxpayer) funds.
The irony of this “reform” is that high-risk insurance pools are supposed to serve as a “bridge” for people historically excluded by the industry. This includes many women suffering from conditions like diabetes or cancer, which disproportionately impact the poor and people of color. So for marginal relief from medical apartheid, those women will just have to avoid unwanted pregnancy for the next few years, or they’ll wind up sick, pregnant and in deep trouble.
While the insurance-pool rules aren’t yet finalized, the ban could play into a much larger conservative strategy to capitalize on health care reform. It’s no surprise that the abortion rights of the sickest and most vulnerable women are the first to be attacked, but this may just be a practice run for an all-out war on reproductive choice.
State Lawmakers Harden the Colorline in Reproductive Health
01 year ago
A handy legislative round-up from the Center for Reproductive Rights sums up the many ways state lawmakers have worked to limit women’s reproductive freedom in the past legislative session. And what a year it’s been.
Leading the charge are a slew of proposed bans on abortion coverage in private insurance exchanges under the health care reform program. As of mid-July, five states (Arizona, Louisiana, Mississippi, Missouri, Tennessee) had enacted bans. Proposed bans in Florida and Oklahoma were narrowly thwarted by a governor’s veto.
Remember that various federal medical programs already contain abortion restrictions–which the White House may soon quietly but dramatically expand as the health care reform plan is implemented. But advocates point out that some of the recent state-level proposals would go much further, not only by targeting the private insurance market but also banning abortion entirely, without federal law’s explicit exemptions for rape and incest.
Backing up the push for outright abortion bans is a more subtle anti-choice attack through coercive ultrasound policies, which pressure women to view an ultrasound image before terminating a pregnancy. (The assumption being, apparently, that women who seek abortions must be either mentally deficient or misguided victims of liberal brainwashing).
While such policy proposals impact all women, it’s almost a given that they’ll fall especially hard on those who are poor, of color, or immigrants. It’s no wonder that anti-choice politics have found a home in Mississippi, where legal abortions among Black women are extraordinarily prevalent. Anti-abortion policies are also predictably virulent in Arizona, where Latina immigrants have been demonized as criminal breeders who are “dropping anchor babies” like landmines.
Oddly, Latinas, as political images, are simultaneously victims of a rollback on reproductive rights as well as targets of paranoid delusions about allegedly excessive fertility. Politicians seem bent on both denying them the dignity of motherhood and robbing them of control over their sexual and reproductive lives.
Yet the schizoid politics behind these campaigns recall the long, disturbing history of draconian reproductive policies and the Latino community, according to University of Arizona Women’s Studies professor Nicole Guidotti-Hernández, writing at Ms.:
Not only does the theory of the anchor baby frame the Latina body as “uncontrollable” in its reproduction, but it also criminalizes women for having children and, therefore, accessing social services. The implication is that all Latina women are not citizens, have too many children, can’t control their sex drives, have children to access U.S. citizenship by proxy and are to blame for the overtaxing of the U.S. welfare system. This could not be further from the truth.
These ideas about Latina women’s bodies and hyper-reproduction are not new. Feminist historians such as Elena Gutierrez, Natalia Molina and Laura Briggs have all documented how the state has long targeted Puerto Rican women and women of Mexican origin. Public health policies were often designed to demean and discipline the bodies of Latina women, casting their sexualities as “deviant.” The colonial desire to supposedly “save these women from themselves” — in actuality, to save the state from welfare costs — are localized in the figure of what Gutíerrez has called “the hyper-fertile baby machine.”
We may be past the era of cruel reproductive social engineering, but we may see something more sinister now emerging in its place: an era of political dehumanization of women of color, which is poised to legislate away their power to determine when and how they will raise the next generation of their communities.