Health Care

Access to affordable comprehensive healthcare is a human right.

(Please click a topic below)

 

Affordable Care Act

Thanks to the Affordable Care Act (ACA), for the first time ever millions of women now have access to all FDA approved prescription birth control coverage, with no out-of-pocket expenses such as deductibles and co-pays.  The ACA’s mandatory birth control benefit empowers more women to make one of the most important economic decisions possible: whether and when to have children. Yet despite the plan’s popularity with women and men, the Trump administration and conservative members of Congress would like to do away with this comprehensive, affordable coverage.

According to the National Women’s Law Center (NWLC) there is strong evidence for why the benefit is so popular. Before the benefit, costs of birth control amounted to 30-40 percent of women’s out-of-pocket health care costs. For example, the cost of an IUD amounted to a month’s salary for someone working full-time for minimum wage.

Getting rid of the mandatory birth control benefit would mean that once again women would need to make difficult economic choices among methods based on cost rather than what works best for them. Some women would be forced to go without any method if the cost were too high.

For more information on the birth control benefit go to the National Women’s Law Center.

Medicaid and Medicare

Medicaid

Medicaid is a government insurance program run by the U.S. Centers for Medicare & Medicaid Services.  It is also the largest source of funding for medical and health-related services for low-income people in the United States.

Funded by state and federal monies,  Medicaid provides free health insurance to:

– 74 million low-income adults and their children (2017).

– Disabled people of all ages.

– U.S. citizens and legal residents with income up to 133% of the poverty line including adults without dependent children.

Medicaid provides benefits that are not covered by Medicare, the other government health insurance program for older adults. These benefits include nursing home care and personal care services.

Each state manages its own Medicaid program. Individual states have broad leeway to decide who is eligible for the program. States do not have to participate in the program, although all have done so since 1982.

The Affordable Care Act, also called Obamacare, expanded eligibility and federal funding for Medicaid.  However, the Supreme Court of the United States has ruled that states do not have to agree to this expansion. Many states have chosen to continue with pre-Obamacare funding levels and eligibility standards.[4]

Under the Hyde Amendment, federal Medicaid funds cannot be used for abortion except in cases of rape, incest or life endangerment. All state Medicaid programs must cover abortions under these circumstances; however, states have the option to cover other abortions using their own funds.

– Thirty-four states and the District of Columbia follow the federal standard and only cover abortions in their Medicaid program in cases of rape, incest or life endangerment.

– These 34 states and the District of Columbia that restrict public abortion coverage are home to 54% of Medicaid-enrolled women aged 15 to 44—more than seven million women.

– The remaining 16 states use their own Medicaid funds for coverage that extends beyond what the Hyde amendment requires and applies to most or all medically necessary abortions.

Medicare

Medicare is the federal government’s health insurance program for those who are age 65 and over. The program also covers those under 65 who receive Social Security Disability Insurance (SSDI) or who have end-stage renal disease. The Centers for Medicare & Medicaid Services (CMS) is the federal agency that runs Medicare.

Medicare is funded in part by:

– Social Security and Medicare taxes paid on income,

– Premiums that people with Medicare pay;

– The federal budget.

An eligible person can get Medicare benefits from original Medicare, the traditional fee-for-service program. Original Medicare benefits include:

– Part A (Hospital in-patient)

– Part B ( Medical out-patient)

One also can get benefits from a Medicare Advantage Plan. This is an optional alternative to original Medicare and is known as Part C, a type of private insurance offered by companies that contract with Medicare.

To get Medicare drug coverage (Part D) with Original Medicare, you must choose a stand-alone Medicare private drug plan (PDP).

Medicare Advantage Plans, also called Medicare Part C, must cover all the services as Original Medicare does. Each Medicare Advantage Plan must cover all Part A and Part B services but can have different rules, costs, and limits. Most Medicare Advantage Plans also provide Part D coverage. If a person has health coverage from a union or employer when they go on Medicare, they will automatically be enrolled in the Medicare Advantage Plan that they sponsor. One has the choice to stay with this plan, switch to original Medicare, or enroll in a different Medicare Advantage Plan.

Medicare coverage choices can affect out-of-pocket costs and where one can get care. For instance, Original Medicare covers nearly all doctors and hospitals in the country. Medicare Advantage plans, on the other hand, usually have more limited access to doctors and hospitals. However, Medicare Advantage Plans can also have more benefits such as routine vision or dental care. However, the plan can choose not to cover the costs of services that are not considered to be medically necessary under Medicare.

Medicare is different from Medicaid, the other government health insurance program. Medicaid is funded and run by both the federal and state government and covers people with limited incomes. Depending on the state, Medicaid can be available to people below a certain income level who meet other criteria (e.g., age, disability status, pregnancy) or be available to all people below a certain income level. Unlike Medicaid, Medicare eligibility does not depend on income.
Some individuals qualify for both Medicare and Medicaid and are known as “dual-eligibles.”

Title X - Family Planning

When President Nixon signed the Title X bill into law in 1970, he remarked on the strong bipartisan support in the House and Senate.  It has been the only federal grant program dedicated solely to providing individuals with comprehensive family planning and related preventive health services.  It serves low-income families and the uninsured. Overall, it supports individuals in deciding the number and spacing of their children. Title X requires that 90 percent of congressional appropriations be used for clinical family planning purposes.

Forty-one years later, in 2011, abortion opponents challenged the program because 25% of all Title X money went to Planned Parenthood affiliates.  Federal funding regulations prohibit using federal funds to perform abortions. However, abortion opponents argued that any money given to Planned Parenthood from Title X frees up non-federal money that can be used to perform abortions.

A proposal from the Trump administration in 2018 would bar federally funded family planning facilities from providing or referring patients for abortions.  It is aimed at forcing organizations like Planned Parenthood to make the choice: cease offering abortion services or lose some of their government funds.

This proposal jeopardizes the future of Planned Parenthood and other reproductive health organizations that provide both family planning and abortion services.  These organizations have used Title X money to subsidize other women’s health services, such as cancer screenings. Social conservatives seek to make it more difficult for reproductive health organizations to provide comprehensive reproductive health services including abortion.  Without publicly funded family planning services, unintended pregnancies among poor women would nearly double. The natural result would be many more underground, unsafe abortions, as happened before Roe v. Wade in 1973.

 

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