WAWH Submits Comments Related to Nondiscrimination in Health and Health Education Programs or Activities
The Wisconsin Alliance for Women’s Health (WAWH) submits these comments in response to the Department of Health and Human Services’ (“HHS”, “Department”) and the Center for Medicare and Medicaid Services (“CMS”) Notice of Proposed Rulemaking (“proposed rule,” “NPRM”) to express our concerns with the proposed rule entitled “Nondiscrimination in Health and Health Education Programs or Activities,” published in the Federal Register on July 14, 2019.
WAWH is a Wisconsin-based non-profit that advocates on behalf of women and girls. Our vision is for every Wisconsin woman - at every age and every stage of life – to be able to reach her optimal health, safety and economic security. We are deeply concerned with the proposed rule that seeks to remove nondiscrimination protections that would have a direct effect on women and girls.
Section 1557 is the law; however, this proposed rule attempts to change the administrative
implementation in ways that are contrary to the plain language and intent of the law to protect against discrimination. The NPRM’s proposed changes could impose wide ranging harm, particularly falling hardest upon underserved populations, who already struggle to access health care.
We recognize that this proposed rule is just another way for the Trump-Pence Administration to reduce access for people seeking reproductive health care, including abortion, LGBTQ individuals, individuals with limited English proficiency, including immigrants, those living with disabilities, and people of color. People across our country need access to healthcare, and cruelly putting up hurdles and intentionally allowing room for increased discrimination takes healthcare in the wrong direction. The proposed rule is dangerous and contravenes the plain language of Section 1557, specifically, and the ACA broadly.
The ACA’s clear intent and its overriding purpose is to reduce and ultimately eliminate discrimination in health care. This proposed rule should not be used to narrow the scope of Section 1557 to allow for more discrimination. Such a change is illegal and morally abhorrent.
For the reasons detailed above, HHS and CMS should not finalize the proposed rule and should instead redirect their efforts to advancing health care access and equity for all.
Thank you for the opportunity to submit comments.
The Wisconsin Alliance for Women’s Health
Sara Finger, Executive Director/Founder
Important Healthcare Investments Eliminated from Budget
Statement from Sara Finger, Executive Director of the Wisconsin Alliance for Women’s Health (WAWH):
“GOP leaders approved a woefully insufficient budget and blocked healthcare investments we deserve and need. The Republican approved budget fails to fully expand Medicaid, and prevents our state from attracting $160 million a year in federal funds which could be invested in maternal and child health, mental health, and education.
“70% of Wisconsinites in a recent poll support Medicaid expansion, yet the vast majority of GOP legislators oppose it, and pushed through a budget that removed full expansion and left hundreds of millions of dollars on the table. This is what extreme gerrymandering looks like, and the will of the people will continue to be obstructed until Wisconsin solves our gerrymandering problem.
“Republicans leaders have once again played politics to score political points with their funders and base and have stripped our communities from the opportunities outlined by Governor Evers in his refreshing budget.
“State budgets are moral documents that offer a powerful reflection of our leaders’ collective priorities. We are grateful to Governor Evers for putting forth his positive policy vision for women’s wellbeing in his bold budget proposal. His budget priorities reflected the values and needs of Wisconsin women and families after eight long years of blatant disregard for the public’s health and economic security. We understand why the Governor is accepting this budget, but since healthcare polices needed by women in girls were largely cut out and he must work with us to find ways to support and move these policies forward.
“We remain committed to working the Evers Administration and champions in the Capitol to advance our shared policy vision outside of the budget process. Wisconsin women deserve to be heard and we won’t stop holding our leaders accountable for their failures to invest in our health, safety and economic security.”
Taken from materials from FamiliesUSA:
On July 9, 2019, the Fifth Circuit Court of Appeals in New Orleans will hear oral arguments in the case Texas v. United States. This case threatens access to health care and financial security for millions of Americans with 153,000 people estimated to lose coverage in Wisconsin.
The case before the Fifth Circuit is based on an appeal of the dangerous ruling of U.S. District Court Judge Reed O’Connor in December 2018 that would strike down the entire Affordable Care Act (ACA), including provisions that:
This case is an extremely overt form of health care sabotage. Millions of Americans rely on the ACA and if it hadn’t been for the ACA, many Americans would not be alive today.
While the case is under appeal, it is important that consumers and their advocates know that the ACA is still law of the land!
To learn more, link here. And stay tuned for more updates on this case.
Legislature Prioritizes Politics over People
MADISON - Statement from Sara Finger, Executive Director of the Wisconsin Alliance for Women’s Health (WAWH):
“When Governor Evers released his budget early this year I felt so hopeful that our state would invest in the needs of real people. From doula reimbursement to infant mortality prevention to affordable child care, Evers’ budget included investments to tackle tough issues that had been long neglected. Governor Evers’ budget plan included a full expansion of Medicaid to cover 82,000 more Wisconsinites while saving the state hundreds of millions of dollars to invest in program like the Healthy Women Healthy Babies initiative.
“Yet, our Republican-led legislature just threw Evers’ budget and vision for healthier Wisconsin women out the window. Rather, they enthusiastically voted to replace it with a watered down version that spends more state money, helps fewer people, and leaves more than $1 billion in federal funds on the table. From a fiscal stance, this make zero sense; from a moral position this is a repugnant.
“Governor Evers listened to the people of Wisconsin and crafted a budget to reflect our needs and values. Republicans have drawn a line and have refused to invest in our health, our lives, and our economic security.
Shame on Republicans legislators for denying women and families a budget we need and deserve and for playing politics with our health and our lives.”
Statement from Sara Finger, Executive Director of the Wisconsin Alliance for Women’s Health (WAWH):
“We are so proud to have Governor Evers standing strong with us, fighting for women’s access to abortion care at a time when we see governors across our nation slamming that door shut. Abortion care is about respecting women to make their own healthcare choices, not erecting onerous hurdles for them to make decisions about their own bodies. We are grateful that Governor Evers recognizes this fundamental right and trusts women.
Wisconsinites across our state are fed up with and appalled at how women’s health is being used as a political game piece. It is a grave and blatant display of misogyny that a body of mainly white male legislators believe they are entitled to dictate a women’s personal healthcare decisions to score political points.
Wisconsin Alliance for Women’s Health strongly supports the right of all women to make their own health decisions. We will continue to work to ensure access to healthcare, including abortion, and access to medically accurate information for all who need it. We will continue to track votes and ensure legislators are held accountable by their constituents.”
During this extremely busy week in Wisconsin, it was easy to blink and miss something big that happened in the healthcare and abortion access policy world. Here’s a recap of this week’s moving pieces.
On Tuesday morning (6/4) WAWH proudly stood with legislative champions and advocates to support Rep. Lisa Subeck (D-78), Sen. Fred Risser (D-26) and Sen. Latonya Johnson’s (D-6) introduction of the Abortion Access Protection Act. This proposed legislation repeals Wisconsin’s 1849 laws that make performing an abortion a felony criminal offense. Unless we repeal this archaic language, the only thing in between Wisconsin and an abortion ban is Roe v. Wade. With the appointment of Justice Kavanaugh, Roe v. Wade is under serious attack.
We need to repeal Wisconsin’s abortion ban and ensure women are able to control their bodies and their healthcare decisions.
Late Tuesday, Republicans on the Joint Finance Committee (JFC) removed Medicaid expansion from the state budget. They voted against against accepting $1.6 billion in federal funding for additional healthcare investments which is needed to fund crucial programs. Under Governor Evers’ plan, Wisconsin taxpayers would save $324.5 million over the biennium and expand Medicaid eligibility to an additional 82,000 people.
JFC Republican’s actions also made deep cuts to funding for Wisconsin’s communities of color. The funding for doula reimbursement, included in Evers’ Healthy Women Healthy Babies initiative, was removed as well as funding that would have expanded postpartum eligibility services from 60 days post birth to one year. This removal of funding is indefensible; Wisconsin has some of the worst health disparities in the nation and the highest black infant mortality rates in the nation.
The very next day the Senate took up and passed along party lines a batch of bad anti-abortion bills, several not even based on reliable scientific evidence, that restrict access to abortions and impede a woman’s ability to consult with her physician and make the best decision for her and her family. What is particularly repugnant about the passage of these bills is that they were purely politically motivated. The timing on Wednesday was strategic, and meant to distract from and absorb the pushback from JFC Republicans removing Medicaid expansion and funding for crucial programming included in Governor Evers’ budget.
Even those of us that work on health policy work professionally are struggling to keep up with all the moving pieces, and this is absolutely intentional.
Please take a moment to contact your legislators to let them know that you support Medicaid expansion in Wisconsin, access for abortion and funding for the Healthy Women and Healthy Babies initiative. If your legislator is supportive take another moment to thank them and let them know you are there to support them.
We are so proud of the legislators that are in the Capitol working tirelessly to make Wisconsin a better place for women and families. We are all in this together so let’s keep our focus and remember to breathe!
The state legislature, however, never removed the 1849 law from its criminal code. With Justice Brett Kavanaugh’s recent appointment to the Supreme Court, Roe v. Wade is under serious threat of being overturned and without its protection, doctors could face felony charges under this law for performing abortions in Wisconsin.
We applaud Rep. Subeck and Sen. Risser for introducing a bill that would repeal the Wisconsin abortion ban. We urge our legislators to support this bill and immediately take action to repeal this ban and ensure all women are able to control their bodies and their healthcare decisions. The threat to Roe v. Wade is very real and thus the threat to Wisconsin women’s access to abortion is on the line. The time to take action and make sure abortion care is available in our communities, is right now.
Republicans Pass Extreme Policies While Denying Health Care Coverage
MADISON – Statement from Sara Finger, Executive Director of the Wisconsin Alliance for Women’s Health (WAWH):
“Women across our state are fed up with and appalled at how women’s health is being used as a political game piece. It is a grave act of misogyny that a body of mainly white male legislators believe they are entitled to dictate a woman’s personal healthcare decisions to score political points.
Today during National Women’s Health Week, Assembly Republicans showcased their true priorities by passing a batch of anti-abortion bills along party lines. Rather than focus on real policy solutions like full Medicaid expansion that would advance women’s health in Wisconsin, GOP leaders fast tracked a series of politically motivated bills that threaten women’s wellbeing, patient-physician relationships and health care delivery in Wisconsin.
Wisconsin Republicans are far too eager to pull pages from conservative playbooks to advance an all –out assault on abortion access. As seen in Georgia and Alabama, Wisconsin’s GOP majority is shoring up support from their extreme base for next year’s critical election year with these inflammatory and irresponsible policies.
The timing of the Republican push for these bills is transparent. With recent polling demonstrating extremely high support for the Governor’s proposal to expand Medicaid Wisconsin, GOP leaders rush a floor vote on these bills to distract from last Thursday’s Joint Finance Committee party-line vote to remove Medicaid expansion and other good policy items from the budget.
Wisconsin Alliance for Women’s Health strongly supports a woman’s right to make their own health decisions. We will continue to work to ensure all women have access to healthcare and access to medically accurate information. We will continue to track votes, and advocate on women’s health to ensure legislators are held accountable by their constituents.”
WAWH's Press Release in response to committee hearings on 5 anti-abortion bills:
MADISON – Just as the Republican controlled Joint Finance Committee (JFC) is getting ready to make some very unpopular decisions related proposals made in Governor Evers budget, the Republican controlled legislative committees rush to hold hearings on four politically motivated bills on abortion in attempt to draw some attention away.
“These bills represent a thinly veiled effort by Republican state legislators to advance their anti-abortion agenda under the guise of protecting women’s health and anti-discrimination legislation,” notes Wisconsin Alliance for Women’s Health Executive Director Sara Finger. “Sadly their obsession with interfering with the patient-physician relationship, pushing inflammatory rhetoric, and threatening women’s health is nothing new in our state.”
Today, four separate Republican led committees are dedicating hearings to amplify their extreme agenda. Even knowing that Governor Evers has vowed to veto these and other dangerous bills, committee chairs are choosing to expend significant time and energy to score political points with their base.
As healthcare proposals in Governor Evers’ Budget continue to gain momentum and popularity, these hearings are being strategically scheduled to draw attention away from Medicaid Expansion which seventy percent of Wisconsinites support.
“It’s no coincidence that these bills are getting hearings at the same time as GOP JFC members are declaring war on the Governor’s Budget,” adds Finger. “But try as they may to distract us, we are focused on advocating for policies and programs in the budget that can make a powerful and positive difference in the health, lives and economic security of Wisconsin women and their families.”
With the Joint Finance Committee scheduled for a critical conversation this Thursday, the Wisconsin Alliance for Women’s Health and many of our partner organizations and health care allies are applying pressure to decision makers to maintain the Governor’s proposals around health care, transportation, public education, mental health, infant mortality and economic security for all Wisconsinites.
“If our leaders truly want to improve the health of moms and babies in this state, we expect them to fully support the Healthy Women Healthy Babies initiative and to fully Expand Medicaid,” Finger added. “Wisconsinites deserve real solutions and real opportunities to improve their health and lives.”
Did you know that our of 131 current state legislators, only 3 of them have a health care background?
On April 10th Republican legislators released a package of 4 bad bills* aimed at chipping away at a woman’s access to abortion in Wisconsin. These bills represent a thinly veiled effort by Republican state legislators to advance their anti-abortion agenda under the guise of protecting women’s health and anti-discrimination legislation.
It’s no surprise that Republican leaders chose to release these bills now in an attempt to distract from the proactive healthcare proposals in Governor Evers’ Budget gaining momentum and popularity. The latest Marquette Law School poll, (released on the same day as the four bad bills) found that 70% of voters believe our state should accept federal funds and expand Medicaid. Support is also growing for Governor Evers’ Healthy Women Healthy Babies initiative in the budget, which invests in programs that support healthier pregnancies and births to address our state’s infant mortality and black healthcare disparities. If the goal is to take attention away from popular policies led by those on the other side of the aisle, it makes perfect sense that GOP leaders are desperate to change the conversation and refocus the public’s attention.
It’s important to note that the communities these 4 bad bills directly affect, have not asked for these bills to be crafted or advanced. On the contrary, these advocacy groups are actively engaged in the budget process and are focused on lifting up evidence-based proposals in Governor Evers’ budget around transportation, education, social supports and healthcare access.
Because our vision is that every Wisconsin woman - at every age and every stage of life - is able to reach her optimal health, safety and economic security, we will continue to fight to advance the evidence-based policies that can improve the well-being of women and families. We will never shy away from calling out the political games GOP leaders continue to play at the expense of the health and well-being of Wisconsin women.
*AB 179, AB 180, AB 181, AB 182, AB 183
Sara Finger, Executive Director