Monthly Archive for December, 2010

A Step in the Right Direction

Published on December 17, 2010 in Vicki Shabo and Work & Family. 0 Comments

Vicki Shabo, Director of Work and Family Programs

Our country needs more adequate, reasonable and flexible sick leave policies. Tens of millions of workers in this country don’t have a single paid sick day. Many of those who do can’t use them to meet their family’s health needs. As a result, kids and their parents are forced to go to school or work sick, contagion spreads, and public health suffers. That’s why it is encouraging to see the federal government leading the way by updating its leave policies with a new rule that will make it easier for federal workers to recover from illness and care for their families. It is a welcome step in the right direction.

Under the new rule, which goes into effect January 3rd, federal agencies can grant up to 30 days of advanced leave for employees to deal with their own serious illness, the birth of a child, exposure to communicable disease, or to care for a family member with a serious health condition.

For the federal workers who benefit, the new rule will address some of the key challenges they have been dealing with for years. It represents a significant improvement for more than one million federal employees and their families, but it is just a first (and in some ways, incomplete) step toward acknowledging the realities of our society and the demands on today’s working parents.

Serious illness and family emergencies are unpredictable. None of us can predict when a child will break an arm, the flu will strike, or chemotherapy treatments will be needed. Health needs don’t fit into neat packages and emergencies don’t always occur when a worker has accrued enough sick leave to deal with them. In these cases, the ability to take advanced leave is critical. The new rule will help. It sets an important standard, but advanced leave policies should be required of all agencies—not just allowed.

Paid leave is vital to preventing the spread of communicable disease. Last year, during the H1N1 pandemic, many schools and day care centers closed to prevent the spread of infection. But most parents couldn’t take unscheduled time off to stay home with their children without risking the loss of their job or quickly using up other forms of leave. This new federal rule would allow parents to take up to 13 days to care for a child who needs to be at home, but only if a child is actually exposed to the disease and not when a school or day care center closes to prevent an outbreak of infection.

The new rule also sets a high bar—perhaps too high—for taking leave due to exposure to communicable diseases that could affect the health of others. By its definition, last year’s H1N1 influenza outbreak would not qualify because it wasn’t serious enough to require quarantine. The goal should be to stop the spread of disease, not wait until we have a full blown pandemic to exercise due caution.

As an employer, the federal government is in a unique position to lead by example and set the highest workplace standards. This new rule is a significant and important step forward. It acknowledges the key role of paid sick leave—both short and long term—in caring for our families and protecting our nation’s health. But there is still much to be done. Federal employees still lag behind many private sector employees in access to paid leave to bond with a new child or care for a seriously ill family member. And there are tens of millions of private sector workers who still lack any paid leave to meet their family health needs. It’s time for our nation to take greater steps toward the responsible and family-friendly policies all workers need.

How Far Have We Come When it Comes to Covering Women’s Birth Control? We Shall See.

Published on December 14, 2010 in Marya Torrez and Reproductive Health. 2 Comments

Marya Torrez, Senior Reproductive Health Policy Counsel

Ten years ago today, the Equal Employment Opportunity Commission (EEOC) ruled that refusing to cover prescription contraception in an employee health plan – if other similar preventive services and prescription drugs were covered in that plan –violated Title VII of the Civil Rights Act of 1964 and the amendment to Title VII, the Pregnancy Discrimination Act. It was a monumental victory for women, many of whom spend the majority of their reproductive lives (approximately three decades) trying to avoid an unintended pregnancy.  Women rely on contraception to plan their families, and appropriately and safely space their children.

Before this important ruling, things were pretty bleak on the contraceptive coverage front.  At that time, half of traditional indemnity plans for large groups did not cover any reversible prescription methods of contraception and only 39 percent of health maintenance organizations (HMOs) covered all five leading methods. [i] This meant that many women were paying for contraceptives themselves or – as was often the case – were at high risk for unintended pregnancy because they could not access affordable and effective contraception.

Now we find ourselves, 10 years after the EEOC victory, with an opportunity to expand contraceptive use by ensuring affordable access to contraceptives in all health plans. The EEOC ruling did much to advance women’s equality in health coverage, but cost still leaves many women without access to birth control. But now, the Affordable Care Act (ACA) requires that preventive services be covered by insurers at no cost. The Women’s Health Amendment to the ACA specifically requires coverage of preventive services for women.

There’s one catch.  The law didn’t specify which women’s health services qualify as preventive. Instead, a committee appointed by the Institute of Medicine (IOM) has been charged with making a recommendation to the Department of Health and Human Services (HHS) on what services should make the list. Whatever is ultimately decided will have a huge impact on women because, while the EEOC ruling 10 years ago expanded access to prescription birth control for women with insurance coverage, women still bear a significant burden of expense through co-pays and other cost-sharing.  If there’s one thing we know for sure, it’s that cost is a barrier to contraceptive access and use. Studies show that even minimal co-pays for preventive services deter consumers from obtaining the care they need.[ii]

Health reform has the potential to expand affordable access to prescription contraceptives to women in all 50 states and the District of Columbia.  Not surprisingly, this potential expansion of contraceptive coverage breathed new life into the attacks on family planning in this country.  At a recent IOM hearing on the issue, anti-choice organizations lined up to testify – without any  real evidence – that “birth control poses serious health risks to women and adolescents” and that mandating coverage would violate the rights of employers and insurers.  (These claims don’t pass the laugh test, and the only silver lining to this debate is that it exposes the real agenda of these groups.  The public generally knows them only as anti-abortion.  They try to hide their anti-contraception views, because birth control has such overwhelming public support.)

The National Partnership for Women & Families testified at the hearing (as did a number of other women’s health experts) that family planning is basic health care for women and should be treated like any other preventive service under ACA.  Period.

In its ruling ten years ago, the EEOC rectified a long-standing inequity for women. The only forms of FDA-approved prescription contraceptives available today are for women –and pregnancy is a condition unique to women.  So the failure to cover contraceptives, when other prescription drugs are covered, has a disproportionate and discriminatory impact on women.

As the IOM considers whether to recommend to HHS that prescription contraceptives be included in the menu of preventive services that health plans are required to cover without cost sharing – and as HHS makes its final decision – let’s hope we take the next step in promoting contraceptive access and use.

Health reform promises a giant step forward for the country. For women, that step forward must include affordable access to contraception. But that will only happen if the IOM and HHS continue the progress begun by the EEOC ten years ago.

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[i] Dailard, Cynthia. (March 2003). Special Analysis: The Cost of Contraceptive Insurance Coverage. Retrieved from http://www.guttmacher.org/pubs/tgr/06/1/gr060112.pdf.

[ii] Solanki, G and Schauffler, HH. (1999) Cost-sharing and the utilization of clinical preventive services. American Journal of Preventive Medicine, 17, no.2, 127-133.

Paid Sick Days: An Important Step toward Economic Security for Women of Color

Published on December 10, 2010 in Portia Wu and Work & Family. 2 Comments

Portia Wu, Vice President

We often talk about the importance of a paid sick days standard for families’ economic security and our public health—but paid sick days are also an issue of basic fairness. That was a key topic at Monday night’s panel discussion on the disproportionate impact the lack of paid sick days has on low-income communities and women of color. The event was hosted by the Women of Color Policy Network at New York University.

It was a lively discussion that underscored the appalling fact that tens of millions of workers in the United States don’t have a single paid sick day. These workers risk their economic security when illness strikes or family emergencies occur. Women of color have it even tougher. They’re more likely to hold jobs that don’t have paid sick days. In addition, women of color are consistently paid less than the national average—and are more likely to be both the primary caregiver and the main breadwinner for their families.

Particularly in this economy, with unemployment high and money and jobs scarce, women of color simply can’t afford to take time off work to meet their families’ health needs without the protection of paid sick days.

Monday night’s discussion made clear that for women of color, who already face economic inequality and health disparities, paid sick days are more important than ever. We need to do more to highlight the real-world effects of our nation’s failure to adopt paid sick days on these communities. We’re excited to see the results of important research the Women of Color Policy Network is doing on this issue.

We face a lot of challenges, but we must continue the fight for economic security and justice for all American families.

It’s Politics v. Science. Again.

Published on December 1, 2010 in Judith Lichtman and Reproductive Health. 1 Comment

Judith L. Lichtman, Senior Advisor

It’s a fact: Contraceptive use improves overall health. It enables women to plan and space their pregnancies. It has contributed to dramatic declines in maternal and infant mortality. And it has been a driving force in reducing unintended pregnancies and the need for abortion.

But things don’t always work out as planned. Emergency contraception (EC) is a safe, effective way to prevent pregnancy after contraceptive failure or unprotected sex, such as when women are sexually assaulted. Although EC is not a substitute for regular contraceptive use, it can help reduce unintended pregnancy if women are able to access it in a timely manner. At the National Partnership, we want EC to be accessible to all women who need it.  That’s why we’re so disappointed by a recent decision by the Food and Drug Administration (FDA).

Here’s some background: In 2006, after years of delay in making a decision on whether to make the emergency contraceptive Plan B available without a prescription, the FDA decided to limit over-the-counter sales to women ages 18 and older. It was a highly controversial decision because it directly contradicted an independent panel of experts who voted unanimously in 2003 that Plan B was safe for non-prescription use. That expert panel also voted 23-4 to recommend that Plan B be available without prescription or age restriction.

Thanks to a lawsuit filed by the Center for Reproductive Rights, a U.S. District Court finally ruled in 2009 that the FDA’s decision to limit access of Plan B was politically-motivated and scientifically-flawed. The Court ordered the FDA to lower the age limit and re-examine whether Plan B should be available to women of all ages without prescription.

However, the FDA merely reduced the age limit for accessing Plan B to 17 – and it recently announced that it does not plan to reconsider expanding its availability. Read the entire timeline here (link to RHTP timeline).

We are disappointed by that announcement. As FDA officials know, reproductive health services – including easy access to emergency contraceptives – are basic health services for women of all ages.

Politics should never get in the way of meeting women’s health care needs. Please contact the FDA and ask its leaders to make emergency contraception available without a prescription to women of all ages.

Unintended pregnancy does not discriminate- women of all ages need access to emergency contraception so they can prevent unintended pregnancy.

Take action today. Make your voice heard.