By Suzanne York. Original posted at 6degreesofpopulation.org
Last week, at the Women's Policy Summit in Sacramento, promoting women's issues took center stage for a day.
An impressive array of California advocates, activists, legislators and others gathered for a conference dedicated to “Advancing Women's Health, Wealth and Power”. One of the main themes of the day was healthcare – especially the impact of health reform and the federal Affordable Health Care Act (ACA) on women in California.
Susan Berke Fogel, Director of Reproductive Health at the National Health Law Program stressed the urgency of getting the 2.7 million women in California who are currently uninsured into full healthcare coverage. Health reform, Berke Fogel said, “is about reaching out to these women.” Those with the highest rates of not having insurance? Younger women, single women, and lower-income women.
Below are the top three policy recommendations for legislative action at the Women's Policy Summit:
ensure comprehensive health coverage for all of California's women and girls;
ensure access to comprehensive family planning and other preventative services in public and private health insurance;
address reproductive health disparities by bringing a gender lens to HIV and STI prevention, coverage, treatment, and education.
(A gender lens is defined as “assessing the implications and impacts of gender from an initiative's conception through all aspects of design, analysis, piloting, partnership, staffing and implementation through to evaluation, dissemination, taking to scale and assessment of policy implications.”)
One of California's most innovative and successful programs addressing reproductive health and family planning is Family Planning, Access, Care and Treatment (Family PACT). Julie Rabinovitz, CEO of the California Family Health Council, called it the “most successful family planning program in the country”. It was enacted in 1996 to reduce the rate and cost of unintended pregnancy, increase access to publicly funded family planning for low-income Californians, and increase the use of effective contraceptive methods.
The most recent statistics available show that an estimated 286,700 unintended pregnancies were averted in California, which amounted to a savings of $1.88 billion in public sector costs. This program alone serves nearly 2 million low-income women, men, and teenagers.
According to the California Coalition for Reproductive Freedom, a consortium of organizations working on reproductive rights, the components that make Family PACT a model program include the following: on-site enrollment, immediate access to services, a large network of public and private providers, coverage of all FDA-approved contraceptive methods, and reproductive health education and counseling.
Many of the speakers at the session on Reproductive Health, Rights & Justice focused on policy recommendations. One of the main policy objectives of reproductive rights advocates in California is to preserve Family PACT, for the reasons stated above, and to maintain current funding levels. Despite the program's success, Amy Moy of California Family Health Council said that incoming state legislators and all state officials need to know the importance of maintaining it. Even with the Affordable Care Act and Family PACT, it is estimated that between two to four million Californians will be uninsured in 2019.
A second recommended policy action is to pass legislation to protect confidential access to sensitive services (namely sexual and reproductive health care but also treatment for mental health issues and substance use) for insured dependents. Under ACA, an insured dependent is covered up to age 26, certainly considered the age of an adult. If confidentiality is weak or lacking, some minors and young adults may forgo services such as birth control and screening and treatment for sexually transmitted infections, for fear that a parent or guardian may find out.
Current law on sensitive services has gaps and also lacks clarity and clear definitions. The burden is put on the insured dependent to opt-in to confidentiality protections. Moy said that guaranteeing confidentiality “takes the burden off the patient to have to ask for non-disclosure.” Advocates are calling for requiring automatic non-disclosure when insured dependents age 26 or under seek sensitive services.
What is clear is that despite successful program like Family PACT, despite the Affordable Care Act fully coming into force January 1, 2014, despite past great leadership by Californian legislators and others supporting women's rights, empowerment, and access to healthcare, we cannot sit on our hands and assume all is well. We must continue to push for reproductive rights and justice and support healthcare for all. The state of California faces many budgetary hurdles, but all effort must be made that our newly elected legislators understand the importance of reproductive issues so no one gets left behind.
Suzanne York is a senior writer with the Institute for Population Studies
(photo credit: http://www.elephantjournal.com)