Deep Disregard For Women’s Health

Recently, a leaked document confirmed that the Trump Administration may soon move to dismantle one of the most effective aspects of the Affordable Care Act – no cost access to contraceptive coverage. If this leaked rule becomes final, our patients, the women of this country, will be greatly harmed.

This move, coupled by House passage of the American Health Care Act, exhibits a deep disregard for women’s health.
I became the 68^th President of ACOG, I knew our voice was urgently needed to cut through political talking points that minimize the importance of – and try to chip away at — women’s health care.

Women and families – in fact our whole Nation — have benefited from no-copay contraception coverage. This landmark protection has helped our Nation to achieve a 30-year low in its unintended pregnancy rate, and improved the health of women and babies. Contraception is an integral part of medically necessary preventive care.
This week, I’m joining 15 ob-gyn leaders from 14 states who will meet with Members of Congress to press this important issue. All women, like men, deserve the ability to make personal health care decisions without intrusion from bosses and the government. We must – and will – do everything we can to protect women’s health.

• 23 million more people would be left uninsured over the next decade;
• 14 million more in year after enactment;
• women seeking maternity coverage in states that do not include maternity care as an essential health benefit (EHB) could spend more than $1000 per month;
• elderly individuals could see their premiums rise between 700 – 800 percent; and
• premiums would increase for people with pre-existing conditions.

ACOG firmly opposes the AHCA, and has asked the Senate to work with us on a better approach. ACOG urges Republicans and Democrats to come together for the benefit of patients and physicians to ensure health care reform is done right. Tell Congress: Don’t Turn Back the Clock on Women’s Health!

ACOG is urging Senator Orrin Hatch (R-UT), Chairman of the Senate Finance Committee – the committee in charge of funding the Medicaid program – to preserve Medicaid, the vital safety net program. Deep cuts, as proposed by the White House budget, along with calls for block granting and/or providing per-capita caps incorporated into the AHCA would have a devastating impact on the health of women and children throughout the country.
Of those currently covered by Medicaid, two-thirds are women, and 48 percent of all births in the US are covered by the program.
Cuts Could Worsen Zika Threat
Concern is also mounting over the impact that cuts to the Medicaid program could have concerning the spread of the Zika virus. In a press release, Representative Frank Pallone (D-NJ) stated, “funding for Puerto Rico’s Medicaid program through the Affordable Care Act is on track to be exhausted as early as this October. And despite the $295 million allocated for Medicaid funding in Puerto Rico as part of the recent Continuing Resolution, up to 900,000 people remain at risk of losing their health coverage at the end of this year.”
ACOG is highlighting that more than 36,000 people, including nearly 3,800 pregnant women throughout the country and its territories, have been infected with the virus since 2015.

Reduce the National institutes of Health’s (NIH) budget 18 percent from 2017 spending levels;

• Cut 17 percent from the Centers for Disease Control and Prevention (CDC);
• Cut domestic HIV prevention and research by $147 million;
• Cut $400 million from the Substance Abuse and Mental Health Services Administration ;
• Reduce the Substance Abuse Prevention program by $73 million;
• Bars Planned Parenthood from receiving any federal funds;
• Eliminate the Agency for Healthcare Research and Quality (AHRQ);
• Shrink the Health Resources and Services Administration (HRSA) by $460 million;
• Cut $56 million from the Indian Health Service (IHS);
• Decrease funding for the Food and Drug Administration (FDA) by 31 percent;
• Eliminate the Office of Adolescent Health’s Teen Pregnancy Prevention Program (TPPP);
• Bar Planned Parenthood providers and clinics from not only Medicaid reimbursements, but HHS programs as well; and
• Eliminate the International Family Planning Program.

Chairman of House the Subcommittee on Labor, Health and Human Services, Education and Related Agencies, Representative Tom Cole (R-OK), called the proposed cuts to NIH “penny-wise and pound-foolish.”

And while the Budget calls for legislation capping non-economic damage awards to $250,000, a 3-year statute of limitations, and a safe harbor for clinicians, medical liability reform legislation doesn’t have the votes to pass the US Senate.

President Trump’s Mothers’ Day message asserted that “ensuring affordable, accessible, and quality health care is critical to improving women’s health and ensuring that it fits their priorities at any stage in life.” ACOG released a “Facts are Important” document reminding the President of the importance of maternity, preventive, and reproductive care coverage to women’s health.
ACOG is eager to work with the White House and Congress to ensure that health care reform is done right. Tell Congress: Don’t Turn Back the Clock on Women’s Health.

The Texas Health Department is taking public comments on a controversial Medicaid reform proposal that is expected to advance to the federal government next month. If approved, the proposal could start a dangerous domino effect and threaten the safety net across the country.
The Healthy Texas Women program lost federal Medicaid funds when, in 2011, the state excluded all organizations that perform or “promote” abortions, including Planned Parenthood, from participating in the program. Texas’ exclusion violated Medicaid’s “any qualified provider,” or “free choice of provider,” requirement. Tens of thousands of low-income Texas women have lost access to family planning and other preventive services.
Today, the state of Texas is asking the feds to restore funding, despite its continued exclusion of Planned Parenthood. CMS approval would set a dangerous precedent, giving a green light to other states to eliminate Planned Parenthood and other family planning providers from Medicaid. Already 11 states have attempted to do this—the any qualified provider requirement has been a legal backstop in preventing them from succeeding.
The any qualified provider requirement is an essential tenet of the Medicaid program, protecting both patients and physicians.

Washington State Governor Jay Inslee signed legislation requiring insurers to cover a 12-month supply of birth-control pills at one time, as well as a bill to create accommodations for pregnant workers.

ACOG Washington Section Legislative Chair Dr. Judy Kimelman praised its passage, saying “Passing a bill allowing women to get 12 months of birth control pills just makes sense because it gives women control over when and if they want to be pregnant. Whether it is because they are working two jobs or they lack good transportation many women are not able to consistently make the monthly trip to get their birth control pills filled. Having reliable birth control for a year at a time decreases unintentional pregnancies allowing women to have healthier well-spaced pregnancies and more career and educational opportunities.”
Insurance coverage of an extended supply of oral contraceptives— rather than at a 1- to 3-month interval—can improve adherence and reduce unintended pregnancy. A fiscal analysis of California’s 12-month-supply proposal confirms substantial cost savings from reduced spending on coverage for maternity care and delivery, and subsequent health care coverage. The legislation was a Section priority and a focus of its state lobby day. Section representatives attended the Governor’s bill-signing.
Washington will also now ensure that pregnant workers receive flexibility for scheduling prenatal doctors’ visits, accessible drinking water, food and seating, as well as manual labor accommodations. The new law also establishes a healthy pregnancy advisory committee to develop strategies for improving maternal and infant health outcomes.
ACOG applauds the advocacy of ACOG Washington’s Section!