Archive for the 'Health Care' Category

Keeping “Wellness” from Turning into Discrimination

Published on May 8, 2013 in Health Care, Judith Lichtman, Reform and Workplace Fairness. 0 Comments

Judith L. Lichtman, Senior Advisor

Today, I had the honor of testifying before the U.S. Equal Employment Opportunity Commission (EEOC) on a topic of critical importance to our nation’s workers: employer wellness programs. These programs can offer women and families meaningful avenues for improving and maintaining their health. And, as part of the Affordable Care Act, employers will soon have new incentives to establish them. But they can also open doors to discrimination.

Employer wellness programs are aimed at promoting healthier lifestyles and improving health outcomes by encouraging health-related activities like signing up for gym memberships, taking health education classes, getting health risk assessments and more. They come in two basic forms: “participatory” wellness programs, which are available to employees regardless of a person’s health; and “health-contingent” wellness programs, which are tied to certain health benchmarks or targets. It’s the latter that cause concern.

There is no one-size-fits-all approach to individual health, wellness and life circumstances, and employer wellness programs must reflect that. That’s why they should be voluntary, carefully designed, and not tied to health indicators. Groups like women, older adults and racial minorities experience significant health disparities. Tying wellness program penalties to their health situations can cause them disproportionate harm and, as I argued today, violate nondiscrimination laws.

Health-contingent wellness programs that increase health care costs for certain workers aren’t about wellness; they are about shifting costs to working people, especially those with health problems. And there’s no scientific evidence that shows they do anything to improve health outcomes. That’s why the National Partnership is recommending that the EEOC:

  1. Issue specific and thorough guidance to employers to inform them of best practices in designing and implementing wellness programs, as well as potential legal implications;
  2. Engage in outreach and education to employers to help ensure compliance with nondiscrimination laws;
  3. Enforce the law by challenging employer wellness programs that are discriminatory; and
  4. Work with other agencies – including the Departments of Treasury, Labor, Justice and Health and Human Services, and the Office of Personnel Management – to provide the assistance employers need to prevent discrimination in the implementation and regulation of employer wellness programs.

At the National Partnership, we know that access to affordable, quality health care is essential for women and families. We also know the importance of ensuring people can work free from discrimination. Today, I made clear that, with proper oversight, wellness programs can do both: They can help women and families achieve meaningful improvements in their health, without running afoul of our nation’s civil rights laws. We will do all we can to ensure this happens.

You can read my full written testimony here.

Why Health IT is Truly the Cat’s Meow

Published on April 16, 2013 in Elina Alterman, Health Care and HIT. 0 Comments

Elina Alterman, Health IT Policy and Outreach Coordinator

Those of us who work in the health IT world spend our days analyzing policies, creating advocacy strategies, and talking about meaningful use criteria, quality improvement, and care coordination till we’re blue in the face. But how does that play out when we leave the office? More often than not, we bring our work home.

I am the sole caregiver to Lorelai and a member of Betty’s1 care team. I have been in the caretaking role with both Lorelai and Betty for about five years. Really, I’m the secondary caregiver to Betty — if the primary caregiver is unavailable for any given reason, the job falls to me.

Lorelai and Betty have similar health histories. Both have chronic conditions that require them to take a variety of medications on a specific schedule. Both experience side effects from their respective medications that require monitoring and management. Both have dietary restrictions and weight management issues that negatively affect their health. And most importantly, neither is able to speak for herself and represent herself during encounters with the health care system.

Three years ago, I took Lorelai to a new primary care provider, who was great. What really amazed me though, was the online patient portal that the office provided. Not only did the office staff tell me about it when I was filling out paperwork, but they immediately sent me an email with the link to the portal and a more detailed explanation of the portal’s services. The portal was private and secure and would help me manage Lorelai’s health by allowing me to view and download her health records, request an appointment, refill her prescriptions, search the practice’s extensive health library, and access both her medication schedule and vaccination history. What’s more, the portal was bi-directional, meaning that I could edit any incorrect information, upload a picture of Lorelai so the staff could recognize her and correctly identify her, and email myself medication reminders.

Now let’s compare Betty’s situation at that same point in time. Though Betty sees a variety of health care providers, three years ago, none of them had online patient portals. Betty, her primary caregiver, and I had to keep track of her medications on a piece of paper. I can’t tell you how many times we argued with her doctors because her prescriptions were sent incorrectly or weren’t ready when she needed them. When Betty got hit by a car and broke her leg, the ER didn’t notify her primary care provider — we did. And when Betty needed to travel internationally and wanted to bring a copy of her medical records with her in case of an emergency, her doctors resisted so vehemently and took so long to comply that we had to pick up the records on our way to the airport.

Now here’s the kicker: Betty is my grandmother. Lorelai is my cat.

Three years ago, my cat’s veterinarian offered a secure online portal that made my role as the person responsible for her health easier. However, none of the providers treating my 80-something year old grandmother, who doesn’t speak English and is fully dependent on our family, provided that convenience.

Luckily, meaningful use is changing all of that. Since my grandmother is a Medicare recipient, my father and I were able — with my grandmother’s permission — to download her health records and print a copy for my grandmother in case she has a medical emergency and goes to the hospital without us. Over Christmas break, we downloaded the iBlueButton app that allowed my father and me to have my grandmother’s medical records and medication schedule on our smartphones in a clear, organized fashion. And since my grandmother’s prescriptions are now filled electronically, we no longer have screaming matches with her doctors or pharmacists — a relief for all parties involved.

We’re all caregivers — we take care of our parents, grandparents, siblings, significant others, friends, pets, and — let’s not forget — ourselves. And we’re all busy and we’re all human — we forget things, we get overwhelmed, and we make mistakes. Meaningful use is helping to make being a caregiver more manageable and easier. The health care system should afford the same benefits to my grandmother and me as it does to my cat, and now, thanks to meaningful use, it finally is.

1 Names have been changed.

It’s All in the Details: Employer Wellness Programs Can Help or Harm

Published on March 22, 2013 in Health Care, Kirsten Sloan, Reform and Workplace Fairness. 0 Comments

Kirsten Sloan, Vice President, National Partnership

As health care purchasers, consumers, and decision makers for ourselves and our families, women are keenly interested in wellness and preventing illness.  So the new wellness programs some employers are offering have some appeal.

These programs are intended to provide a convenient way for employees to improve and maintain their health.  And there are some benefits.  If designed and implemented properly, wellness programs can offer flex-time for walking or other physical activity, provide education about healthy lifestyles and other valuable health-related workplace initiatives.  The programs can also help workers achieve their wellness goals by providing activities at a time and location that fits the time constraints associated with responsibilities at home and in the workplace.

But done badly, employer wellness programs can become a back door way of discriminating by circumventing the market reforms and protections put in place by the Affordable Care Act (ACA).

The National Partnership for Women & Families is working to ensure that wellness programs are not used to undo the progress made by the ACA. In a recent letter to the U.S. Department of Labor, the National Partnership outlined some of the specific steps that need to be taken to ensure that employer wellness programs help — not hurt — women. These steps include:

  • Preventing employers from using workplace wellness programs to tie health insurance premium costs to conditions like weight, cholesterol, and blood sugar levels.  Programs that do this could be used by employers to avoid the ACA’s prohibition on medical underwriting.
  • Ensuring that employers cannot dramatically vary employee premiums so that employees who are unable to satisfy their workplace’s wellness targets face substantially higher premiums.  These employees could find themselves priced out of employer-sponsored coverage, a development that would undermine the intent of many of the ACA’s key insurance reforms.
  • Ensuring employees are fully informed about any financial responsibility associated with wellness programs.  No employee should have to wonder if there is a financial obligation that comes with participating or choosing not to participate in an employer wellness program.

To read the National Partnership’s full letter on the proposed rules for designing and implementing employee wellness programs, go here.

If Budgets Reflect Priorities…

Published on March 19, 2013 in Debra Ness, Health Care, Medicaid, Quality, Reform and Reproductive Health. 0 Comments

Debra Ness, President, National Partnership

If our budgets reflect our priorities, what does Paul Ryan’s budget say about our country, how much we value women and our compassion for the most vulnerable among us? Nothing good, I am afraid.

The Ryan budget that the House of Representatives will vote on tomorrow is driven by misplaced priorities, short-sighted goals, and callous disregard for women and everyone who relies on government programs. It targets close to two-thirds of its cuts to programs that support those with low or moderate incomes, most of whom are women.

The Ryan budget would undermine Medicare’s promise of affordable, quality health care by turning Medicare into a premium support “voucher” program that shifts costs onto beneficiaries, the majority of whom are women who live on less than $22,000 per year.

It would block-grant Medicaid and cut Medicaid funding, endangering health care for millions of women and their children. It would jeopardize care for older women living in nursing homes, putting even greater burdens on family caregivers, most of whom are women. And since Medicaid is the largest source of family planning funds, it would make it harder for millions of women to access the birth control they need.

And the Ryan plan to repeal the Affordable Care Act would cause grave harm to millions of women and their families. Repealing the law would eliminate women’s access to essential preventive services like breast cancer screening, take away young women’s ability to stay on their parents’ health insurance plans until age 26, and eliminate critical protections against gender-based discrimination in insurance coverage and pricing. It would reverse our progress in improving care coordination, which reduces costs for family caregivers and millions of women who suffer from multiple chronic conditions.

The Ryan budget would also devastate nutrition assistance programs, denying millions of families living in or near poverty – many headed by women – the ability to put food on the table. It would put school lunch, child nutrition, job training and child care tax credit programs on the chopping block. It would devastate the safety net.

Rep. Ryan named his budget the “Path to Prosperity,” but it is a path to poverty for millions of women and families. Every representative should vote to defeat this callous budget bill.

The ‘With Model’ of Patient and Family Engagement

Published on November 27, 2012 in Debra Ness and Health Care. 1 Comment

Debra Ness, President, National Partnership

Cross-posted from NAPH’s “SafetyNet Matters” Blog.

As our national debate over health care reform continues, with its future, at least in part, likely to be shaped by the election, one thing is clear: There is consensus that we need to move to a more patient- and family-centered health care system. But the key question is how to do it and make it work.

As a leading advocate for health care consumers and families, the National Partnership for Women & Families is, of course, pleased to see health leaders commit themselves and their institutions to putting patients first. We worked hard to make that a central tenet of the historic Affordable Care Act, which is helping to reform the care delivery system to make it more efficient, effective and patient-centered.

But a lot of work to make that happen lies ahead because true collaborative consumer engagement, implemented broadly, would amount to nothing less than culture change for our health care system—and culture change is never quick or easy.
There are two models of patient-centered care. I like to call them the “To Model” and the “With Model.”

The “To Model” of patient-centered care is familiar to most of us. To keep patients healthy or restore their health, well-meaning doctors, hospitals, insurers, and others decide what a patient needs and then find ways to do those things “to” or “for” them. And then we try to figure out how to get patients to comply.

The “With Model,” on the other hand, is more difficult to create but much more meaningful. In this model, providers and patients jointly set care goals and work together to determine the approaches that will yield the best possible results. Patients are involved in decision-making and in the design of their treatment plans. In other words, it’s about getting patients to tell providers and others what they need us to do.

In both models, the training, skills and experience of caring health care professionals is essential to success. But the “With Model” involves the patient from the beginning and is much more likely to lead to better outcomes. To make it work, we need the involvement of patients, families, and consumer representatives in reshaping the way we deliver care. We can’t design patient-centered care without the patient. Patients and families need to be part of a collaborative engagement that drives genuine transformation in attitudes, behavior, and practice. They need to be partners in defining, designing and assessing the care practices and systems that serve them. This model engages patients and families at all levels—from policy to governance, to redesign of care practices, to individual/family engagement, to community involvement.

Many hospitals and other care institutions are working to redesign their care delivery systems. The National Partnership for Women & Families is leading the “Campaign for Better Care,” which encourages consumers, patients and families to partner with health care providers across the country to create the kind of change we all want. But for this to happen, providers have to embrace such a partnership, and move beyond the mindset that they always know best what patients want and need.

We talk with patients, families, and consumer advocates every day to get a first-hand understanding of what they want from a redesigned health care system. Time and again we hear four key concepts:

  • “Whole-person”care.
  • Better coordination and communication.
  • Information and support to help them manage their health.
  • Ready access to their providers.

The foundation for whole-person care is a strong patient-clinician relationship built on trust. But today, too many patients are viewed as a collection of body parts. We need care systems that take into account all the factors affecting a patient’s ability to get and stay well. And we need treatment recommendations that align with a patient’s values, preferences, and life circumstances.

The biggest complaint we hear from patients and their families is the lack of consistent communication and coordination of care. This is particularly—but not only—true for older women and men, because many of them are living with multiple chronic conditions. Older adults with five or more chronic health conditions have an average of 37 physician visits a year, see 14 different physicians, and fill an average of 50 separate prescriptions each year. These patients urgently need their providers to talk to each other and they urgently need better-coordinated care.

There is overwhelming data that the failure to coordinate care causes harm and costs all of us more. That’s why patients and their families want and need a “go-to” person who is available to answer questions, help navigate the system, and help them understand their conditions and how best to take care of themselves. They want help choosing specialists and getting timely appointments. They need their providers to have complete information at the point of care and a system that tracks referrals and results. They want their providers to work as a team, ensuring smooth transitions across settings and providers.

To truly feel like a partner in their care, patients and their families need tools and services that help them manage their conditions. They need to know they will be treated with trust and respect for their preferences, comfort and privacy. And they need to be able to communicate in a system where language, culture, and literacy barriers, as well as physical limitations and cognitive impairment, are taken into account and addressed.

Finally, patients and their families want to be able to get the right care, at the right time, and in the right place—the kind of care that keeps people from getting sicker and prevents medication errors, trips to the emergency department, and unnecessary hospitalizations. That means 24/7 access to care team members. It also means prompt appointments and short waiting times, and access beyond traditional office visits, including e-visits, secure messaging and, when appropriate, telemedicine.

When we truly ask and listen to what patients and families want, we realize they want the very things that will help us achieve better care, better health, and lower costs. It’s also time to realize that redesigning care together is the best way to create a system that meets the goals we all share.

Debra Ness is president of the National Partnership for Women & Families, which leads the Campaign for Better Care.

At Long Last, Preventive Care Will Be Affordable for All Women, Thanks to Health Reform

Published on July 31, 2012 in Health Care, Judith Lichtman and Reform. 1 Comment

Judith L. Lichtman, Senior Advisor

The Affordable Care Act is the greatest advance for women’s health in a generation, and tomorrow one of its promises becomes reality for millions of women, who will be healthier and better off as a result.

Tomorrow, on August 1, the Affordable Care Act will ensure that new insurance plans cover preventive health care without the cost sharing and co-pays that for too long have put these critical services out of reach for so many women.  This is one of the most tangible and meaningful benefits from reform.

Thanks to the Affordable Care Act, no longer will women go without birth control because they cannot afford the co-pays.

Thanks to the Affordable Care Act, no longer will women go without the HIV and sexually transmitted disease screening and testing that they urgently need.

Thanks to health reform, no longer will cost prevent pregnant women from being tested for gestational diabetes.

Thanks to health reform, no longer will cost prevent new mothers from getting the counseling, support and supplies they need to breastfeed their infants and give them a healthier start in life.

Thanks to reform, no longer will teens and adults at risk for domestic violence go without potentially life-saving screening and counseling.

It’s about time.

Already, the Affordable Care Act has covered women’s annual breast exams, mammograms and pap tests at no cost.  Tomorrow, the list of the law’s benefits expands dramatically as cost ceases to be a deterrent to the preventive care that millions of women need.  And soon, reform will outlaw gender discrimination in pricing – at long last.

It’s hard to believe that controversy still surrounds a law that is doing so much good, that there are those who still try to argue that it should be repealed or defunded.  As more and more benefits roll out, we should all focus on implementing the law and ensuring that all women – and all Americans – can access these critical advances.

To those who try to argue that repealing reform is right for the country or its families, I say this: You can’t talk fast enough, sow enough confusion, or in any other way deceive the women of America – and the men who care about them – any longer.  Better care for pregnant and nursing mothers; screenings for HIV, sexually transmitted infections, and domestic violence; and no-cost access to birth control and other preventive services will make women and our country healthier.  And starting tomorrow, we have the Affordable Care Act and its champions to thank for that.

The Affordable Care Act improves women’s health.

There’s No Place Like (A Medical) Home

Published on May 23, 2012 in Health Care, Lee Partridge, Quality and Reform. 0 Comments

Lee Partridge, Senior Health Policy Advisor

Today, fully 1/3 of our health care spending is wasted on payments for medical mistakes and poor quality care. We also have a system that values expensive technology over basic primary and preventive care, rewards volume of care over outcomes or appropriate care, and makes no distinction in payment based on quality or health outcome. But thanks to the Affordable Care Act, things are looking up.

The health care reform law is advancing a promising approach to addressing these problems: the “Patient-Centered Medical Home.” At the National Partnership, we consider medical homes to be one of the most promising models for delivering truly patient-centered care — they improve access to primary care, help coordinate patient care across settings and providers, and make patients, family caregivers and providers partners in making decisions about care.

Recently, I spoke with the American Academy of Pediatrics about the potential of patient-centered medical homes, how families can get involved in improving quality, and how practices can support patients as partners in care. Take a look!

 

Medicare Matters to Older Women

Published on April 24, 2012 in Health Care and Kirsten Sloan. 1 Comment

Kirsten Sloan, Vice President

The Medicare Trustees announced this week that the program will remain solvent until 2024 – the same projection as last year.  While this finding is reassuring, it doesn’t mean we can afford to be complacent. Millions of American women – mothers, grandmothers, and aunts – rely on this program every day for affordable health care coverage.  In fact, more than half of the roughly 49 million Medicare beneficiaries are women.  And the numbers continue to grow as our nation ages.

 

For these women, Medicare provides access to essential preventive care, physician and hospital services, prescription drugs, and home health care.  Often this is care women could not otherwise afford; nursing home care alone can cost roughly $75,000 per year.

 

Medicare also offers guaranteed protection.  There is no gender rating – women pay the same Medicare premium as men; there is no exclusion for pre-existing conditions – an eligible woman diagnosed with breast cancer will not be turned away from the program; Medicare coverage is never rescinded – women can be confident that the coverage will be there when they need it; and there are no annual limits that restrict coverage when a woman needs it most.

 

Medicare’s promise of affordable coverage has become one of the most important pillars of retirement security.  Women age 65 and older have average incomes of only around $22,000 – an amount easily wiped out by one serious illness.  Without Medicare, millions of older women would be left to shoulder unmanageable health care costs, forego the critical health care services they need, or be forced to rely on their children for assistance.

 

There is no question that refinements that reduce health spending and make Medicare more sustainable for the long-term are necessary.  There are also improvements in the program – like a sorely needed cap on total out of pocket expenses – that need to be made.  But any refinements must be done thoughtfully and carefully.  Changes that simply push more costs onto Medicare beneficiaries or cut provider payments in ways that deter physicians from accepting Medicare patients are short-sighted.

 

The Trustees report indicates there is some time to make the right changes – changes that strengthen the program for current and future generations of women and protect Medicare’s promise of affordable, quality health care.  We owe it to these women to get it right.

Older Women’s Stake in Health Reform

Published on April 3, 2012 in Debra Ness, Health Care and Reform. 4 Comments

 

Debra Ness, President, National Partnership

Cross-posted from the Huffington Post.

This week, all the talk in Washington has been about handicapping the outcome of the Supreme Court health reform cases, and identifying winners and losers. What did the justices mean with each question? Which way are the potential swing votes leaning? Will the Court reach consensus of any kind? What are the likely political/electoral consequences of the upcoming rulings?

There’s been painfully little attention to the impact of the rulings for patients, and one group has been just about totally ignored throughout this debate: older women. But as one of the most vulnerable segments of our population, older women have a tremendous amount at stake as the future of reform is decided.

Why, when most seniors are covered by Medicare? Because older women tend to have low incomes and poor health — and because nobody suffers more in our fragmented, incoherent health care system.

Let’s get specific. Older women are more likely than others to have chronic conditions and, consequently, they bear the brunt of shortcomings in our health care system — among them high cost, poor quality and uncoordinated services that often generate additional cost, burden and sometimes serious harm. Older women also are more vulnerable than men to high costs, due to the lower wages and savings that result from time spent out of the workforce to meet family caregiving responsibilities.

That means older women gain a lot from the Affordable Care Act, because the law does so much to improve both the affordability and quality of health care.

It is closing gaps in Medicare coverage. Annual wellness visits are now covered, as are some preventive benefits older women need, such as mammograms and bone density tests, without co-pays. This benefit includes time for health care providers to conduct comprehensive health risk assessments and create personalized prevention plans for their patients.

Older women will save millions of dollars as reform closes the current gap in Medicare prescription drug coverage known as the “donut hole.” Beneficiaries who fell in this gap have already received a $250 rebate. Beginning last year, they benefited from 50 percent off brand-name drugs in the “donut hole.” By 2020, the donut hole will be closed, and beneficiaries will only have to cover 25 percent of the cost of their drugs until they hit the catastrophic cap, after which they will only have to pay 5 percent.

Health reform also created the Center for Medicare and Medicaid Innovation, to test, evaluate and rapidly expand new care delivery models that improve quality and care coordination. It encourages the use of health information technology in these models to help improve coordination and communication among health care providers and patients. It puts more resources into making sure older women get the follow-up support they need when they transition from a hospital stay back to the community. It supports new medication management services that will help patients and caregivers understand their medications and avoid dangerous interactions and medical errors. It supports better primary care and a team-based approach that will help older women avoid unnecessary hospitalizations and link them to community services that can help them maintain their health and live better quality lives. And the reform law establishes Geriatric Education Centers to support training in geriatrics, chronic care management and long-term care issues for family caregivers, as well as for health professionals and direct care workers. Read even more about the benefits for older women in health reform here.

Health reform is the greatest advance for women’s health in a generation. Access to affordable, quality health care is central to the well-being of older women. It is a key determinant of their quality of life, their economic security and their ability to thrive, prosper and participate fully in our society. Losing reform would have grave consequences for women and families, and older women have a particular stake. Nobody wins when we lose sight of that.

10 Things to LOVE About the Affordable Care Act

Published on March 21, 2012 in Debra Ness, Health Care, Reform and Reproductive Health. 1 Comment

Debra Ness, President, National Partnership

This week, the Affordable Care Act (ACA) turns two. Let’s not mince words: This law is the greatest advance for women’s health in a generation. Here are just a few things we love about the law:

1. Being a woman is no longer a pre-existing condition.

For the first time in history, gender discrimination will be prohibited in all federally funded health care. This basic protection means that any insurance companies receiving federal funds (including tax credits, subsidies and contracts) will be prohibited from discriminating against women.

2. The ACA helps to make health insurance more affordable for women.

Health care we can afford? Sign us up! The ACA establishes protections to make private health insurance options more affordable for women purchasing coverage on their own or through small businesses.  This is due to new rules to keep premiums in check and prohibitions on charging higher premiums based on gender and health status or history.  Beginning in 2014, lower-income women and families who don’t receive insurance through their employers will be able to access financial assistance to help them buy insurance in the individual market.

3. Women will be guaranteed preventive services such as birth control, mammograms and cervical cancer screenings, with no deductibles or copays. Need we say more?

New private insurance plans will be required to cover a wide range of recommended services without cost-sharing, including well-women visits; screenings for gestational diabetes, osteoporosis, and colon cancer; pap smears and pelvic exams; STI and HIV screenings and counseling; all FDA-approved contraceptive methods; breastfeeding support, counseling, and supplies; and screenings and counseling related to interpersonal violence.  Private plans also must cover screenings and vaccinations critical to children’s health without out-of-pocket costs. The ACA also requires Medicare to waive cost-sharing for many of these services as well provide a free annual, comprehensive wellness visit that includes personalized prevention planning services.

4. Young adults can stay on their parents’ insurance policies until age 26

To ensure that recent high school and college graduates aren’t without coverage as they search for work and start their careers, the ACA allows young adults to stay on their parents’ insurance plans until they are 26 years old. This provision is already benefitting 2.5 million young adults, including an estimated 1.1 million young women.

5. Universal maternity coverage

Currently, most individual health plans fail to provide any insurance coverage for maternity care. This means that even without complications, women face expenses that average $10,652 or more. Beginning in 2012, plans offered in the individual and small group market will be required to cover maternity and newborn care – ensuring better health for mothers and babies.

6. Closing the “donut hole”

Senior women will save thousands of dollars as reform closes the Medicare prescription drug coverage gap. Each year, about 16 percent of Medicare beneficiaries hit the “donut hole” in their prescription drug coverage, meaning that they are responsible for paying 100 percent of drug costs up to the point when Medicare begins to pay again. Under the ACA, a typical Medicare beneficiary who hits the donut hole could save more than $3,000 by 2020, when the donut hole will be closed completely.

7. Expanded Medicaid coverage for lower-income women

Restrictive state eligibility rules have long kept many women from accessing the benefits of Medicaid, which provides essential care over the spectrum of women’s lives. In 2014, the ACA will close this gaping hole in the nation’s safety net by expanding Medicaid eligibility to individuals and families with household family incomes up to 133 percent of the Federal Poverty Level (FPL). With this change, ten million more women will qualify for Medicaid’s comprehensive health coverage with strong out-of-pocket cost protections.

8. Pre-existing condition? The ACA has you covered.

Today, it can be nearly impossible to access health insurance on the individual market without a blemish-free medical history. Health plans deny or drop women from coverage for conditions ranging from acne to C-sections to breast cancer. The ACA already prohibits private health insurers from retroactively canceling coverage when a person incurs high health care costs.  Beginning in 2014, new private health plans will no longer be able to turn away women and families applying for or renewing coverage.  Nor will they be able to exclude services from coverage on the basis of a pre-existing condition. These protections went into effect for children under age 19 in September 2010. To help uninsured adults with pre-existing conditions access coverage before 2014, new Pre-Existing Condition Insurance Plans (PCIP) are available in every state.

9. Higher quality, better coordinated care  

It’s about time!  By investing in primary care, patient safety, and the new Center for Medicare and Medicaid Innovation, the ACA lays the groundwork to improve quality and coordination of care. This means older patients will be less likely to experience dangerous drug interactions, duplicative tests and procedures, conflicting diagnoses, and preventable readmissions.

10. Investment in the health care workforce to ensure access to health care providers

The ACA requires insurance plans to contract with essential community providers, including women’s health centers, HIV/AIDS clinics, community health centers, and public hospitals that serve medically under-served and low-income populations. This will mean women who rely on these clinics can continue to receive care from their regular health care providers, and it will help alleviate the shortage of primary care providers, which is expected to worsen as reform increases the number of people with insurance coverage.  In addition, the ACA establishes Geriatric Education Centers (GECs) to support training in geriatrics, chronic care management, and long term care issues for family caregivers, as well as health professionals and direct care workers. The GECs are required to train family care practices into their curricula.

The ACA is already beginning to deliver for women and their families – and some of the best is yet to come. But the health reform law faces challenges in Congress, in the states and at the Supreme Court.  We can’t let opponents distort the facts, control the debate, or take away a law that America’s women need!  So let’s keep talking about all the ways the Affordable Care Act is helping women.  Let’s ensure we can continue the progress.

It’s time to protect our care – and protect the law.