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Peek @ Policy Blog

GOP Proposal Doesn't Go Far Enough to Protect Health Coverage

1/16/2019

 
Prior to the passage of the ACA, insurance companies were allowed to discriminate against women due to our unique health needs. Insurers could deny coverage to women if they had been pregnant, had fought and survived cancer, or even if they had suffered domestic violence. In many cases, health plans didn’t even cover maternity care.

If the ACA is overturned, then women could be denied coverage based on their medical history, their age, and their occupation, among other factors. As a result, women could be charged more, or priced out of the insurance market altogether. Insurance companies could also try to reinstate gender rating, a common pre-ACA practice in which insurance companies charged women higher premiums than they did men, even though other parts of the ACA protect women from discrimination in the health care system.
 
The gravity of what the loss of coverage for women and girls would look like, should ACA be repealed, makes it paramount that we speak out against our state legislature supporting anything that could lead to reduced coverage. That's why this week, we weighed in on a GOP authored bill - Assembly Bill 1 - that claims to addresses coverage of preexisting medical conditions in our state.
 
It's important to note that under the direction of former Governor Scott Walker, Wisconsin joined this multi-state lawsuit to overturn the ACA. In December, a Texas District Court judge held that the ACA is unconstitutional in Texas v. Azar. As this case makes its way through the appeals process, the ACA remains the law of the land.

Despite Wisconsin’s voters speaking out loud and clear in November by electing state-wide officials who campaigned on a promise to withdraw Wisconsin from the ACA lawsuit, the Republican-led Legislature rejected the outcome of the November elections and voted to force the state to remain as plaintiffs in Texas v. Azar, threatening coverage for many Wisconsinites.

And with recent actions and actions taken over the past eight years to sabotage the ACA while the GOP has held a super majority in our state, now the Republican controlled legislature is attempting to show interest in protecting coverage for Wisconsinites.
 
Unfortunately, their proposal, AB1, does not guarantee insurance for people with preexisting conditions in the same capacity as the ACA, nor does it address other very important issues of coverage -- including essential health benefit mandates such as maternal care. AB 1 does not address lifetime coverage limits, preventative care, consumer protections, or bar discrimination based on gender. During the Assembly Committee on Health’s January 15, 2019 hearing, the bill authors testimony made it clear that they were not interested in expanding the scope of AB1 to include expanded coverage. Without the broader protections and subsidies of the ACA, AB1 does not protect enough people—and could actually lead to harmful unintended consequences, including higher costs.
 
Northern District of Texas Judge Reed O'Connor's December ruling didn't just put protections for preexisting conditions at risk, it attempts to throw out the entire law, including the subsidies that help Wisconsinites afford coverage. AB1 would not close the gap in coverage that will open up should ACA be repealed through the courts.
 
Our state legislative leaders are in a unique position to work to ensure that Wisconsinites continue to be covered and protected in an affordable and comprehensive manner. Rather than enact this inferior talking-point bill, the Assembly should instead focus on withdrawing Wisconsin from the lawsuit and join the numerous attorney generals seeking to uphold the ACA's framework. Such action would allow the Assembly to proudly take ownership for protecting coverage for Wisconsinites and would have the full support of the Wisconsin Alliance for Women’s Health.  AB1 is no substitute for the ACA.

5 Steps To Take Charge of Your Health!

1/14/2019

 
Make 2019 the year you take charge of your health! Here are 5 Steps to get started:
1) Learn how to use your insurance card

Your insurance card has your I.D. number and other important information. You will need it when you go to:
  • the doctor's office
  • a lab for a medical test
  • a drug store or pharmacy to get your prescription filled
  • a hospital
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If you did not receive your insurance card yet and you need to go to the doctor, call your health plan first.

2) Choose your primary care provider who takes your insurance

A Primary Care Provider or PCP is a doctor, physician assistant or nurse practitioner you can go to for check-ups and if you are sick.

It’s important to find a Primary Care Provider you will feel comfortable with. For example, do you want a doctor who speaks your language? Ask people you trust for recommendations.

Make sure your Primary Care Provider is “in network” with your health plan.

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If you go to a doctor who is "out of network", you may have to pay more - or all - of the doctor's bill yourself.

3) Make an appointment to see your new Primary Care Provider right away

It’s best to get to know your new doctor before you get sick. Call to make an appointment for a check-up. Ask if they take your insurance. Feel free to ask about their experience with patients with disabilities, LGBTQ people and people of different ethnic or racial groups. If you have any problems, call your health plan.

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4) Be prepared for your first visit to your new Primary Care Provider

Write down any questions you may have ahead of time. Get ready to answer questions about your health and your family health history. Find out if anyone in your family has had diabetes, asthma, heart disease, stroke or cancer. It’s okay to bring a friend or family member with you for support.


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5) Visit your Primary Care Provider and take follow up action

During your visit, don’t be afraid to ask all the questions you have about your health. You have the right to feel comfortable and be treated with respect, no matter who you are. If you do not like this primary care provider, you can choose a different one. Call your health plan.
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Meet the Cabinet Members of the Evers Administration

1/11/2019

 
Department of Health Services Secretary: Andrea Palm
Superintendent of Public Schools: Carolyn Stanford Taylor
Dept of Safety & Professional Services Secretary: Dawn Crim
Commissioner of Insurance: Mark Afable
Department of Children & Families Secretary: Emilie Amundson
Department of Veteran Affairs Secretary: Mary Kolar
Department of Natural Resources Secretary: Preston Cole
Department of Workforce Development Secretary: Caleb Frostman
Department of Corrections Secretary: Kevin Carr

Trump-Pence Administration Issues Proposed Rule Designed to Eliminate Insurance Coverage of Abortion in the ACA Marketplaces

1/4/2019

 
From the National Women's Law Center
All health insurance plans should cover all basic health services for women, including birth control, abortion, pre-natal care, childbirth and post-partum care. Yet, merely a day after voters made clear that health care is a top priority, the Department of Health and Human Services released a Proposed Rule designed to take abortion coverage away from individuals who get their insurance through the ACA marketplace.

The Proposed Rule is designed to eliminate coverage of abortion altogether.
  • The Proposed Rule would drastically expand the burdensome and arbitrary accounting requirements imposed on qualified health plans that cover medically necessary abortion. This would impose significant barriers on insurance companies and on consumers who need a comprehensive health plan that covers abortion.
  • These proposed barriers are likely to cause insurance companies to stop providing insurance coverage of abortion. Indeed, insurance issuers have said that barriers like the ones being proposed would be onerous and act as a strong disincentive to covering abortion.
  • The impact of the Proposed Rule could reach well beyond the marketplace, causing insurance companies to drop abortion coverage in other markets as well.
  • The Proposed Rule is the latest attempt by the Trump-Pence Administration to eliminate private insurance coverage of abortion altogether.
The Trump-Pence Administration’s Proposed Rule is targeting states where abortion coverage is available in the marketplaces.
  • Already, 26 states prohibit insurance coverage of abortion in the ACA marketplaces. Women in those states do not have the comprehensive reproductive health coverage they need.
  • With this rule, the Trump-Pence Administration is seeking to eliminate abortion coverage in the remaining states. The Proposed Rule could result in 1.3 million women who purchase their health plan on the ACA marketplace in those states losing critical coverage of abortion
The Proposed Rule would endanger women’s health, economic security, and future wellbeing.
  • Coverage for medically necessary abortion is critical to women’s health and economic well-being.
  • A woman who has to pay for an abortion out of pocket may be forced to delay the procedure to raise the necessary funds.
  • Women denied insurance coverage of abortion may face high out-of-pocket costs that create severe financial strain. More than half of women who get abortions without coverage spend the equivalent of more than one-third of their monthly income on the procedure and its associated costs.
  • Studies show that the Hyde Amendment’s denial of abortion coverage in Medicaid forces one in four lower-income women seeking an abortion to carry an unwanted pregnancy to term.

Get the Most From Your New ACA Health Coverage

1/3/2019

 
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As we start 2019, the Affordable Care Act (ACA) remains the law! Recently, the federal judge in Texas who ruled last month that the law should be struck down declared that the ACA will remain in effect as his decision is appealed to higher courts by 17 state Attorneys General. U.S. District Court Judge Reed O’Connor stayed the effect of his own ruling, writing that otherwise, "many everyday Americans would otherwise face great uncertainty during the pendency of appeal.

That means millions of women, LGBTQ people and families are starting 2019 with health insurance they purchased through healthcare.gov and state-based marketplaces during the 2018 ACA open enrollment period. If you’re one of them, here are six insider tips from the pros at Raising Women’s Voices on how to get your money’s worth from your insurance.

1. Breathe a sigh of relief! You have quality insurance that complies with the ACA’s high standards. That means you’re covered for pre-existing conditions, hospitalizations, maternity care, prescription drugs and all the basics you’d expect a health plan to cover!
2. Pay your monthly bill on time! It’s especially important to pay that first bill--it was due December 31--so that your coverage actually goes into effect. If you haven’t paid it yet, call your health insurance company right away to work it out.
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3. Schedule a FREE check-up! You get preventive care at no additional charge to you. So, make that appointment now with your primary care provider and/or ob/gyn. A woman’s annual check-up is called a “Well-Woman Visit.” If you need to see two different providers (such as a primary care provider and an ob-gyn) to get all of the needed preventive care, it’s still covered 100%. If you have children, schedule their preventive check-ups, too.
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4. Find doctors you trust. The key to getting the most value out of your health plan is finding doctors and other health care providers you trust who take your insurance. A good way to start is by calling your health plan for help. Tell the representative what is important to you in a doctor, such as office location, languages spoken, gender, hospital affiliation or office hours. If you are looking for an LGBTQ-friendly doctor, try searching the glma directory. You can also ask friends, family or colleagues for recommendations. If you try a new doctor and you do not like him or her, you do not have to go back. You are entitled to try someone different next time.
5. Get FREE birth control. While you are at your Well-Woman Visit, discuss your options with your doctor and make the choice that's best for you. All FDA-approved forms of birth control must be 100% paid for by your health plan. Some brands may not be covered by your particular health plan, so discuss it with your provider before she writes the prescription.
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6. Take care of your mental health. The ACA requires health plans to cover mental health care the same way they cover physical health care. You will pay a deductible or co-payment. After that, your insurance will pay the rest, without limits on the number of visits or cost, as long as you see a mental health provider participating in your health plan.
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Need more help getting started with your new health insurance?  Raising Women’s Voices has created a website where you can learn much more. It’s called My Health, My Voice. There you can learn five important steps to getting started using your health plan, and understand the four types of costs you may pay to use your coverage (your monthly premium, co-pays, deductibles and co-insurance.) You can also download free copies of our publications: A Woman’s Step-by-Step Guide to Using Health Insurance and My Personal Health Journal.

    Authors

    Sara Finger, Executive Director

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  • Home
  • About
    • Our Initiatives >
      • PATCH
      • ECCHO WI
      • ECCOS
      • Wide Awake in Wisconsin
      • Policy Rx: Our Policy Vision
      • Wisconsin Women's Health Advocacy Summit
      • Health Professionals at the Forefront >
        • Unbiased Care in Women's Health
      • Women Win With the ACA
    • News
  • Take Action
    • Vote! >
      • Vote Early!
      • OutreachCircle
    • Census 2020
    • Know Your Legislators >
      • Meeting with Legislators
    • Media Advocacy
    • Policy Watch >
      • Peek at Policy Blog
      • Democracy & Accountability
      • 2021 Legislative Session Review >
        • Legislator Vote Record 2021-22
      • 2019 Legislative Session Review >
        • Legislator Vote Record
      • Executive Blueprint
      • Health Programs >
        • WI Well Woman Program
      • Economic Security >
        • Paid Family Medical Leave
      • Violence Against Women
      • Reproductive Health >
        • Post Roe Abortion Access
        • SCOTUS
        • Truth
        • Timeline of Reproductive Health Threats in WI
        • RESPECT Women Act
        • "Personhood"
        • Pelvic Exam Consent
      • Maternal & Child Health >
        • Momnibus Act
        • Postpartum Medicaid Coverage Expansion
        • Black MCH Justice
        • Healthy Women Healthy Babies
        • Community Based Doulas
        • WI "Cocaine Mom" Law
        • Patient Privacy & Confidentiality
      • State Budget
      • Health Care Reform >
        • Medicaid Expansion
  • Resources
    • Health Care Coverage
    • Resources to be a White Warrior
    • COVID-19 Resources
    • Public Charge Rule
    • Reproductive Justice
  • Connect
    • Events >
      • WI Women United for a Better Budget
      • Belly of the Beast Film Discussion
      • WI Women's Health Congress
  • Support Us
    • Why Support Us?
    • Donate >
      • Foster the Future
    • Shop & Support
    • Workplace Giving
    • Good Night Stories for Rebel Girls
    • The Big Share
    • Day In My Shoes
  • #KindnessIsEverything
  • Shop
    • Kindness Is Everything Wholesale