FMLA: After 17 Years, It’s Time to Take the Next Step

Vicki Shabo, Director of Work and Family Programs

Vicki Shabo, Director of Work and Family Programs

The Family and Medical Leave Act turns 17 today.

At the National Partnership, we are like proud parents. We remember the long fight to pass it, and the moment on February 5, 1993 when we stood beside President Clinton as he made it the very first bill he signed. For the first time, we had a national law to address the challenges facing workers who struggle to meet their job and family commitments.

The Family and Medical Leave Act (FMLA) was a huge step. It meant that millions of workers could take unpaid, but job-protected, leave to recover from illness or care for a sick family member or bond with a new baby or new foster or adopted child. It meant fewer workers had to make impossible choices when illness struck or babies came.

But it was intended as a first step in a national commitment to ensuring that workers are able to meet their responsibilities to their families as well as their employers.

We’ve yet to take the next one.

To be fair, we’ve made some progress. In the last two years, certain new categories of workers — members of the military, military families, and flight crews — gained FMLA protection.

But on the 17th birthday of the FMLA, when seven in ten working families with children have all adults in the labor force, one in four workers have elder-care responsibilities, and the average couple in this country works close to 90 hours a week combined, we need swift, concerted action to help workers meet their work and family obligations.

Fortunately, there are signs that the federal government is moving in the right direction. The President’s proposed fiscal year 2011 budget and the Department of Labor’s (DOL’s) 2011 strategic priorities recognize the demands on families and working caregivers.

Here’s what we’d like to see:

Paid Family and Medical Leave. The biggest barrier to taking family and medical leave is the inability to forgo a paycheck. Two states — California and New Jersey — have paid family leave insurance programs up and running. Washington State approved a program in 2007 but has yet to implement it for lack of start-up funds; other states have been slow to follow suit for the same reason. But there is good news. Just this week, President Obama proposed a FY2011 budget with a State Paid Leave Grant program, which would set aside $50 million for states that implement their own paid leave programs. This funding would be a critical first step to expand access to paid family leave. Congressional proposals to develop a national family leave insurance system or to provide significantly more in start-up funding for state paid leave programs would do even more.

FMLA Expansion. Affordability aside, not all workers or workplaces are covered by the FMLA, which doesn’t extend to particular types of leave that workers commonly need. Bills now before Congress would extend FMLA access to people who work for smaller companies and to employees who worked only part time during the prior year, which would expand the law’s protection to more low-wage workers. Other proposed legislation would extend FMLA leave to grandparents, grandchildren, and domestic partners or same sex spouses; to domestic violence and sexual assault victims; and to parents who need to attend routine medical appointments or parent-teacher conferences.

FMLA Restoration. The Bush Administration put regulations in place that make it harder for workers to take the leave the FMLA provides. The Department of Labor has yet to revise or reverse those regulations. Fixing these regulations is straightforward and should be a priority.

Current, Comprehensive, and Routinely Collected Data. The government last collected comprehensive FMLA data in 2000 – a full decade ago. The lack of recent data makes it impossible to know either how the FMLA serves workers or how to fails to serve their needs. The President’s proposed budget includes a small increase in funding for DOL to investigate the feasibility of collecting data on work-family “balance” issues. In addition to adding a standard series of questions about family leave-taking and caregiving to ongoing government surveys, policymakers and advocates need updated, comprehensive data to so that public policies can better reflect caregivers’ needs.

To ensure that workers are able to fulfill their commitments at home and at work while maintaining their family’s economic security, give the FMLA a birthday present and take action now.

Celebrating Ledbetter: End Pay Discrimination Against Women Now!

Sharyn Tejani, Senior Policy Counsel

Sharyn Tejani, Senior Policy Counsel

This week we celebrate the one-year anniversary of enactment of the Lilly Ledbetter Fair Pay Act: a law that righted a terrible Supreme Court decision and set the stage for the next fair pay law we need — the Paycheck Fairness Act.

Lilly Ledbetter’s story is an inspiration.  Almost 20 years after starting work as one of just a few women at a tire plant, she received an anonymous note letting her know that she was being paid less than her male coworkers — even those who had worked there less time than she had.  She sued and a jury ruled in her favor, but the Supreme Court reversed the ruling.  Lilly continued fighting and she won where it matters most — in the court of public opinion and with Congress.  Read more about the case and the law here.

But even after Congress passed the Lilly Ledbetter Fair Pay Act, and President Obama made it the first bill he signed into law, wage discrimination persists.  Women still are paid just 77 cents to a man’s dollar and the inequities remain, even when education and type of job are factored out. For some alarming statistics on the extent of the wage gap, click here.  So, as Lilly Ledbetter said on the day that her bill was signed, now we need to pass the Paycheck Fairness Act

The Paycheck Fairness Act will help stop wage discrimination in four important ways:

  1. Making it harder for employers to justify wage discrimination;
  2. Prohibiting retaliation against workers who ask about employers’ wage practices or disclose their own wages;
  3. Authorizing the government to collect wage data so civil rights enforcement agencies can target their resources; nad
  4. Offering employers technical assistance to help them analyze their pay data and make sure they are not discriminating.

Learn more about the Paycheck Fairness Act here.

The House of Representatives has already passed the Paycheck Fairness Act, and it has 35 cosponsors in the Senate.  Click here to let Senators know that you support equal wages for women and the Paycheck Fairness Act. 

Let’s honor Lilly Ledbetter and give ourselves something else to celebrate. Take action today!

Are Workplace Wellness Programs Really as Innocuous as They Seem?

Sabrina Corlette

Sabrina Corlette, Director of Health Policy Programs

So, what’s wrong with the workplace wellness programs included in the Senate’s health care reform bill?  That’s a fair question, and one you may have asked yourself if you saw some of the recent coverage of the issue.

To be clear, many workplace wellness programs are innovative, effective, and help employees and their families get and stay healthy, which benefits employees and employers alike.  These workplace wellness programs should be implemented, studied, and then the best of them should be replicated (as the House health reform bill proposes.)

Unfortunately, in the name of “workplace wellness” the Senate bill creates a loophole that would allow employers and insurance companies to discriminate against people based on their health status.

Some may say, “What’s wrong with wellness? How can you be against that?”  As usual, the devil is in the details, and the language in the Senate bill is so nuanced that answering the question “what’s the problem” can stump even the top policy wonk or the most informed journalist.

Here’s my attempt at a plain English explanation.  To start, there are two important things to know in order to understand why the Senate bill would create a loophole that would allow insurance companies to continue to discriminate based on pre-existing conditions.

First, under current law employers are allowed to do some cost-shifting.   Did you think corporations would take money from their own profits to help motivate people to get healthy? Yeah, right.  No, what’s happening is that employers raise everyone’s insurance premium, and then give a “reduction” to those who meet certain health targets and call it a reward.   Those who can’t meet the health targets — for whatever reason — get charged more than their healthier co-workers.

Second, current law says a reward or penalty to an employee under these programs cannot exceed 20 percent of the cost of their health plan.  The Senate bill ups the ante and could eventually allow employers to charge an employee up to 50 percent of their health plan.   With the cost of insurance soaring – an average family policy could cost $20,000 by 2016.  This means people could be charged as much as $10,000 more for their insurance than their co-workers, simply because they have high cholesterol, high blood pressure, or weigh more than they should.   If this sounds like discrimination based on health status (something lawmakers have promised health reform would fix in our current system), that’s because it is!

Knowing that, consider the many reasons an employee may not be able to meet a health target and keep in mind that not all those reasons are within the employee’s control.   Scientists have understood for some time that some conditions like high cholesterol are often a function of genetics.  Also, certain ethnic and racial groups face genetic predispositions to conditions such as hypertension and diabetes.  Recent studies have also suggested that, because of the disruption to their body’s natural circadian rhythm, people who work the night shift are more at risk for high blood pressure, high cholesterol, and heart disease.

Women, in particular, stand to lose the most if this back-door discrimination is allowed.

Women want to make healthy lifestyle choices for themselves and their families, yet in practice they often neglect their own health because they put the needs of their children, spouses and aging relatives before their own.  And research shows that women are more likely than men to suffer from chronic conditions, meaning that women could pay disproportionately more for health insurance under these programs than their male colleagues. Such disparities are even more acute for low-income women and women of color.

This potential for discrimination is particularly troubling for the many women with lower incomes who work multiple jobs to support their families. These women often lack access to healthy food choices and have limited time or ability to access safe environments for physical activity. In effect, these programs will make health coverage less affordable to the very people who need it the most.

Employers can help everyone prioritize their health by providing a supportive environment for health and wellness in the workplace.  But, if Congress adopts the language in the Senate’s health reform bill on workplace wellness programs, we’ll see employers and insurance companies using this loophole as a way to discriminate.  That’s not good for anyone, and it undermines the promise of reform.

To learn more about workplace wellness programs under health reform, please see our recent Issue Brief:

Protect Women and Families From Discrimination: Prevent Employer “Wellness” Programs From Unfairly Increasing Health Insurance Premiums

Pregnancy Discrimination On Wisteria Lane!

Desperate Housewives

Desperate Housewives

If you haven’t seen the latest episodes of Desperate Housewives, you have missed more than just the usual melodrama swirling around the residents of Wisteria Lane. A new storyline may be all-too-familiar to many viewers — a woman facing pregnancy discrimination on the job.

Lynnette, a working wife, mother of four, and “desperate housewife” chose not to reveal her pregnancy to Carlos, her boss and longtime friend and neighbor. When Lynnette received a promotion over a coworker who was pregnant, it became clear to her that she would be discriminated against as well if Carlos found out about her pregnancy.

Her fears were confirmed in a recent episode. Once Carlos discovered that Lynnette was pregnant, she was quickly fired. Although Carlos claimed that she was fired because she refused to take a promotion and relocate, it was clear to her — and to the audience — that the real reason was her pregnancy. Can this happen in real life, or is it just another outlandish plot?

Statistics show that the Desperate Housewives pregnancy discrimination storyline is neither exaggerated nor rare. In 2008, pregnancy discrimination charges rose to their highest level in the history of the Equal Employment Opportunity Commission (EEOC), which saw an almost 13 percent increase in claims over the previous year. And the most recent increase is part of a trend; since 1992, pregnancy discrimination charges to the EEOC and its companion agencies have skyrocketed by 86 percent. Read about the increase here.

Some cases rival the drama on Wisteria Lane. In 2004, the Department of Justice joined a lawsuit against the Washington D.C. Fire and Emergency Medical Services Department, claiming that women in training for the program were required to take pregnancy tests and told that they could lose their jobs if they became pregnant. As a result, two women said they chose to terminate their pregnancies for fear of losing their jobs. The complaint the U.S. Department of Justice filed against the employer is here. The case was eventually settled and the women received $100,000 each.

In 2007, the EEOC settled a case of pregnancy discrimination for $350,000 against Mothers Ware Inc., which sells maternity clothes. According to the EEOC, the store refused to hire pregnant women and discriminated against a supervisor who complained about the policy. Read the EEOC’s press release about the case here.

In August, the EEOC brought a pregnancy discrimination suit against a New Jersey trucking company, Decker Transport. According to the EEOC, when one of the women working at Decker informed her boss she was pregnant, she was immediately put on leave and told she should not come back until she got “rid of the problem.” When she refused, she was fired.

Those are women who spoke up and complained. Many more may be afraid to do so, or may not even know that discrimination against pregnant women is illegal.
Find out more about your rights here.

Given the economic crisis, it is especially important that women have secure employment. For those outside of Wisteria Lane, pregnancy discrimination truly can create a desperate situation. Not only does it cause emotional suffering, but it also threatens the economic security of working families who rely on women’s income.

Learn more about the Pregnancy Discrimination Act and what protections it provides.

Historic Milestone Reached! Bill Needs Improvement…

Debra Ness

Debra Ness

Today, the Senate took a historic step to fix our nation’s broken health care system by passing comprehensive reform that will cover 31 million more people, prohibit insurance practices that undermine meaningful, affordable coverage, help contain costs, and put us on track to improve the quality and coordination of care.

But this flawed bill must be improved. The anti-choice provisions in the Senate and House bills are bad and worse, and represent a step the nation simply should not take.

It is a sad day when the price of reform is undermining access to a basic health service that America’s women need.

Those of us who spend our lives working to improve women’s health have been deeply shaken as lawmakers allowed reproductive health services to become a political bargaining chip, and as opponents of choice used reform to advance their extreme agenda.

Both the Senate and House bills contain anti-choice provisions that betray the promise of reform for women and would, in practical terms, cost millions of women coverage for basic reproductive health care. This should not stand.

We will work tirelessly to improve the final bill, including by urging conferees to provide more support to the low- and moderate-income families that will now have to purchase coverage.

We must strengthen the final bill by maintaining strong delivery and payment reforms, ensuring greater affordability and meaningful benefits, and guaranteeing effective market reforms that prohibit the discriminatory practices that have put affordable, quality health coverage out of reach for millions of women and families.

We see today’s vote, and the eventual enactment of this bill, as a beginning rather than an end.

The true test of reform’s success will depend on whether it delivers on the promise to expand access to high quality, affordable care; dramatically improves quality and care coordination; gives us better value for our health dollars; and puts us on track to get costs under control. We see implementation as key, and making our health care system work for the most vulnerable patients is essential.

And we look forward to the day when women’s health is no longer bargained away.

Our elected leaders’ work will not be done until those goals are achieved. And we will count on you to stand by our side.

It’s a resolution for the new year that we must all keep!

Wal-Mart’s Demerit Practice Makes Me Sick

blog.photo.steffany.stern

Steffany Stern

Given the recent news about Wal-Mart’s sick days practice, we all may want to think twice about shopping there this holiday season—which regrettably overlaps with cold and flu season.

Because the breaking news on Wal-Mart’s practice is, well, sickening: as The New York Times recently reported, “At Wal-Mart, when employees miss one or more days because of illness or other reasons, they generally get a demerit point. Once employees obtain four points over a six-month period, they begin receiving warnings that can lead to dismissal.”

The article goes on to quote workers who felt pressured to go to work even when they were sick, including one who was sick with—you guessed it—the dreaded H1N1 virus!

Unfortunately, that makes complete sense: in this economy, with family budgets stretched to the breaking point and scores of workers vying for every job opening. Workers are simply too anxious to do anything that could jeopardize their paychecks or their jobs.

Wal-Mart’s practice is indefensibly bad for workers, their families, and our public health.

That’s why the National Partnership for Women & Families is joining with our allies at MomsRising.org, and our other partners, in the Demerit Wal-Mart campaign. We’re helping build a movement of thousands and thousands of people who are standing up to Wal-Mart until the company changes its short-sighted practice. It’s Wal-Mart and its executives who need a demerit badge, not its workers.

>>Give Wal-Mart a demerit badge of its own by clicking here!

Now, I know that Wal-Mart seems like an all-too-easy target for complaints from workers’ rights advocates. But really, they’re making it tough to ignore their actions.

Beyond our concerns for Wal-Mart’s workers, and our public health, we’ve got our eyes on Wal-Mart because it’s one of the largest private employers in the country. With about 1.4 million employees, and locations all across the nation, Wal-Mart often sets the standard for other employers. Which means we can’t let them off the hook when they’re not doing right by their workers or their customers. We have to urge Wal-Mart to fix this practice—sooner rather than later. And we have to let not only Wal-Mart, but all employers know that this kind of practice is unacceptable.

The National Partnership is particularly alarmed about the impact Wal-Mart’s practice has on women.

Women make up 72 percent of Wal-Mart’s workers, and since women still perform many of the caregiving duties for their families, they are disproportionately at risk for punishment or even firing under policies like this one.

The National Partnership is working to pass a national standard of paid sick days that workers can access without fear of punishment: the Healthy Families Act. But until the day we win that national standard, we are calling on standard-bearing employers like Wal-Mart to step up and change their ways.

To learn more and send Wal-Mart its own demerit badge, visit www.demeritwalmart.com.

Health Care Reform Matters to Older Women

Debra Ness

Debra Ness

Let’s be clear. As both caregivers and patients, women bear the brunt of shortcomings in our health care system – high costs, poor quality, and fragmented, uncoordinated care. 

That’s because women are the primary users of health care, and we continue to use more health services as we age.

It’s also because, in most cases, we are primary caregivers for our families.  We coordinate care for our spouses, parents and children, and often, at great cost to ourselves, we fill in the gaps when the system fails and care is poor quality or uncoordinated.

With the finish line in sight on health reform, everyone needs to take a close look at what the House and Senate bills will do, not only to expand coverage and contain costs but also to improve the way care is delivered.  We should look particularly closely at whether these bills will provide higher quality care for older women, who are more than half of Medicare beneficiaries and 70 percent of those aged 85 and older.

The good news is that the House and Senate bills both contain a number of measures that will improve the way we pay for and deliver health care.  These quality improvement measures are vital to preserving and protecting programs like Medicare for the long term, and containing costs and improving efficiencies overall.

For example, both bills move us toward a system that links payment to better quality and better coordinated care.  This means we can start paying for health care based on value and better health outcomes, rather than paying based on the number of services or tests performed. This is good news for anyone who has a loved one struggling with illness or health problems. People who navigate the health system know that their loved one needs the right test or treatment at the right time – not an abundance of repeat or erroneous services that don’t provide answers or make them better.

Earlier this year, we talked to caregivers around the country about their concerns with our health care system.  Poor care coordination and a lack of communication among doctors were foremost on their minds.  That’s because they’ve seen first-hand how these problems lead to dangers and waste from bad drug interactions, repeat tests, misdiagnoses, and more.

Both the Senate and House bills also introduce new models of delivering health care that are specifically designed to improve coordination and reduce events like preventable hospitalizations and readmissions, which are all too common now.

Because passing legislation only begins the work to fix our broken health care system, these bills allow us to test new models over time so we can find out what works best and continuously build on our success.

Recently a distinguished group of consumer advocates, economists and analysts issued a letter praising the Senate’s Patient Protection and Affordable Care Act for its payment and delivery reforms.  I was proud to coordinate and sign that letter.

Older women have a huge stake in turning our health care system around, and ensuring that it serves them and other vulnerable populations better.  If we can make the system work for them, we can make it work for everyone.

We’re closer than ever to the reforms we need, but victory is not assured.  We need to be certain the final legislation includes the key provisions that will improve care coordination and put patients first.  

Balancing the need for change with ensuring that we do change right is the key to sustainable reform.  As the Senate debates the specifics of reform, we must all fight for policies that will provide higher quality, better coordinated, and more affordable care for everyone.

What Are Lawmakers Afraid Of?

Jody Heymann
Jody Heymann, Founding Director, Institute for Health and Social Policy, McGill University

Ensuring a floor of decent working conditions is crucial for the majority of Americans. 

For decades, we’ve debated whether the United States can afford to provide more family-friendly workplace policies and protections, and whether doing so will increase unemployment and harm our economic competitiveness.  

At the Institute for Health and Social Policy at McGill University, we set out to answer those questions through an eight-year study that examined policies, protections and supports in 190 of the world’s 192 countries. 

Through the study, we learned that the United States lacks many key work protections that are crucial for working adults and their families, and lags behind most of the 190 countries whose labor laws we examined. 

photo.blog.globalfloor.bookThe new study, Raising the Global Floor: Dismantling the Myth that We Can’t Afford Good Working Conditions for Everyone, found that:

• 164 nations guarantee paid annual leave; the U.S. does not.
• 163 nations guarantee paid sick leave; the U.S. does not.
• 157 nations guarantee workers a day of rest each week; the U.S. does not.
• 177 nations guarantee paid leave for new mothers; the U.S. does not.
• 74 nations guarantee paid leave for new fathers; the U.S. does not.

We also found that, globally, none of these working conditions are linked with lower levels of economic competitiveness or employment. In fact, many of these guarantees are associated with increased competitiveness. Of the world’s 15 most competitive countries, 14 provide paid sick leave, 14 provide paid annual leave, 13 guarantee a weekly day of rest, 13 provide paid leave for new mothers and 12 for new fathers.

Similarly, the majority of the 13 countries with consistently low unemployment rates provide paid annual leave (12), a weekly day of rest (12), paid leave for new mothers (12), paid sick leave (11), and paid leave for new fathers (9).

While the implications of guaranteeing decent work have always been important, they are particularly critical during the economic downturn that began in 2008 and that will likely affect United States workers for years to come.

So what are our lawmakers afraid of?  Now we know that the world’s most successful and competitive nations are providing the supports the United States lacks, without harming their competitiveness.  We can – and should – do better.

To learn more about the new study, visit www.RaisingtheGlobalFloor.org.

A Historic Moment…But at Women’s Expense

Debra Ness

Debra Ness

The health reform bill the House passed this weekend had some long-overdue advances — and an eleventh hour amendment so appalling it taints the entire bill.

The U.S. House of Representatives brought the nation one huge step closer to giving all Americans access to high quality, affordable care. We’ve been fighting for decades to get here, and it was an historic moment.

But the outrageous, reckless, and unnecessary restriction on abortion coverage — added at the eleventh hour by opponents of women’s right to choose — threatens to undermine the promise of reform and endanger women’s health and lives. It simply must not stand.

The Affordable Health Care for America Act (H.R. 3962) includes some real advances.   This bill’s greatest strengths include ending gender rating, limiting age rating and prohibiting discrimination on the basis of pre-existing conditions.  It is long past time for these disgraceful practices to end.  We are pleased that H.R. 3962 would extend these new federal rating rules to all individual and fully insured group markets.

The House bill also covers maternity care, well-woman and well-child visits, and cancer screening — and it includes no-cost language to let states expand access to Medicaid-covered family planning services without a cumbersome waiver process.�

We also applaud the provisions that will help lower-income families with the new obligation to buy health insurance, and support the expansion of the Medicaid national ‘floor’ to 150 percent of the Federal Poverty Level. But more must be done to ensure that affordable coverage is within reach for low- and moderate-income families.

But the inclusion of the Stupak-Pitts anti-choice amendment utterly taints this bill. Unless that amendment is removed, the promise of reform will ring hollow for women who will lose coverage for essential reproductive health care that we now have.

This is a historic opportunity that lawmakers must not squander by capitulating to the anti-choice extremists who would deny women coverage for basic reproductive health care.

Rx for Health Literacy

Jennifer Sweeney

Jennifer Sweeney

October is health literacy month and, as Congress debates the widespread challenges in health care, we also need to address the problem of low health literacy — an obstacle people face in doctors’ offices across the country everyday and one that has a big impact on health outcomes.

According to the Institute of Medicine (IOM), 90 million people in the United States, nearly half the population, lack the ability to read, understand, and act on health care information. Low health literacy skills are often a result of limited literacy skills, generally. Consider this daunting dose of reality: One out of five American adults reads at the 5th grade level or below, and the average American reads at the 8th to 9th grade level, yet most healthcare materials are written above the 10th grade level. And while low health literacy affects people of all education and income levels, older people, non-whites, immigrants, and those with low incomes are more likely to have trouble reading and understanding health-related information.

Health literacy is defined as the degree to which someone is able to obtain, process, and understand health information in order to make the best health decisions. These are the skills that everyone needs in order to do things like fill out medical and insurance forms, follow medication instructions, and understand the doctor’s orders for before or after surgery.

Schools and hospitals around the country are raising awareness about health literacy month this October because the impact on individuals and families is considerable and, as usual, any stigma linked to a specific struggle will only exacerbate the problem. In this case, many patients are embarrassed to ask their health care providers to explain health information and, as a result, they are less likely to follow prescribed treatment, more likely to experience medication errors, and often don’t seek preventive care. Beyond the impact on individuals and families, low health literacy takes a toll on our health care system too — adding approximately $50 to $73 billion in health care costs, according to the IOM.

The good news is that positive change is within our reach. Health care providers can help by avoiding acronyms and technical medical terminology when possible. And since one of the biggest barriers to addressing the problem is actually identifying patients who are struggling to understand health information — providers should ask every patient questions to determine if they need help.

And (not that we needed another reason besides improving health to invest in tackling this problem) we’re now seeing that improving health literacy rates could also enhance people’s frame of mind. According to a recent study, researchers from the University of Alabama at Birmingham’s Center for Education and Research on Therapeutics (CERT) and the University of Oklahoma have actually found a positive correlation between health literacy and personal levels of happiness. The study revealed that happiness scores increased steadily with higher levels of health literacy even after controlling for demographic variables, poverty levels, and self-reported health.

As we’ve learned during the course of the current health care debate, the solutions we need in order to improve the health and well being of families across the country come in many shapes and sizes. Broad systemic changes, many of which we’ve seen proposed in Congress in the past year, are going to be necessary. But those changes must be underpinned by strategies — like improving health literacy — that can help ensure patients benefit from health reform. To learn more about what you can do to help tackle the problem of low health literacy, please visit the Department of Health and Human Services’ (HHS) Health Literacy Improvement page.