As a longtime proponent of health care reform, I truly wish that the
National Organization for Women could join in celebrating the historic
passage of the Patient Protection and Affordable Care Act. It pains me
to have to stand against what many see as a major achievement. But
feminist, progressive principles are in direct conflict with many of
the compromises built into and tacked onto this legislation.
The health care reform bill passed by Congress today offers a number
of good solutions to our nation’s critical health care problems, but
it also fails in many important respects. After a full year of
controversy and compromise, the result is a highly flawed, diminished
piece of legislation that continues reliance on a failing,
profit-driven private insurance system and rewards those who have been
abusive of their customers. With more than 45,000 unnecessary deaths
annually and hundreds of thousands of bankruptcies each year due to
medical bills, this bill is only a timid first step toward meaningful
reform.
Fact: The bill contains a sweeping anti-abortion provision. Contrary
to the talking points circulated by congressional leaders, the bill
passed today ultimately achieves the same outcome as the infamous
Stupak-Pitts Amendment, namely the likely elimination of all _private_
as well as public insurance coverage for abortion. It imposes a
bizarre requirement on insurance plan enrollees who buy coverage
through the health insurance exchanges to write two monthly checks
(one for an abortion care rider and one for all other health care).
Even employers will have to write two separate checks for each of
their employees requesting the abortion rider.
This burdensome, elaborate system must be eliminated. It is there
because the Catholic bishops and extremist abortion rights opponents
know that it will result in greatly restricting access to abortion
care, currently one of the most common medical procedures for women.
Fact: President Obama made an eleventh-hour agreement to issue an
executive order lending the weight of his office to the anti-abortion
measures included in the bill. This move was designed to appease a
handful of anti-choice Democrats who have held up health care reform
in an effort to restrict women’s access to abortion. This executive
order helps to cement the misconception that the Hyde Amendment is
settled law rather than what it really is — an illegitimate tack-on
to an annual must-pass appropriations bill. It also sends the
outrageous message that it is acceptable to negotiate health care
reform on the backs of women.
Fact: The bill permits age-rating, the practice of imposing higher
premiums on older people. This practice has a disproportionate impact
on women, whose incomes and savings are lower due to a lifetime of
systematic wage discrimination.
Fact: The bill also permits gender-rating, the practice of charging
women higher premiums simply because they are women. Some are under
the mistaken impression that gender-rating has been prohibited, but
that is only true in the individual and small-group markets. Larger
group plans (more than 100 employees) sold through the exchanges will
be permitted to discriminate against women — having an especially
harmful impact in workplaces where women predominate.
We know why those gender- and age-rating provisions are in the bill:
because insurers insisted on them, as they will generate billions of
dollars in profits for the companies. Such discriminatory rating must
be completely eliminated.
Fact: The bill imposes harsh restrictions on the ability of immigrants
to access health care, imposing a 5-year waiting period on permanent,
legal residents before they are eligible for assistance such as
Medicaid, and prohibiting undocumented workers even to use their own
money to purchase health insurance through an exchange. These
provisions are counterproductive in terms of controlling health care
costs; they are there because of ugly anti-immigrant sentiment, and
must be eliminated.
Fact: The bill covers only 32 million of the 47 million uninsured in
this country, does not contain a meaningful public option and provides
no pathway to a single payer system like Medicare for all. Democratic
negotiators crumpled before powerful business interests and right-wing
extremists, and until they get a spine there will be no true
competition to help rein in costs.
The bottom line is that everyone — citizen and non-citizen,
undocumented immigrant and visitor — has a fundamental human right to
health care. This right has been denied in the U.S. for far too long,
while the rest of the industrialized world moved ahead to assure
universal and affordable care for their people.
We call upon President Obama and elected officials in both houses to
commit to a process of steady improvement of our health care system
that will result in true reform with universal coverage, realistically
affordable rates and no discrimination. We still have a lot of work to
do before we can genuinely celebrate.
Terry O’Neill is NOW President