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Need new health insurance NOW?

If you experience certain life changes, you don’t have to wait for Open Enrollment in November to enroll in affordable health coverage on healthcare.gov or your state’s marketplace. You have 60 days after the following events to apply for a Special Enrollment Period and enroll:

• Moving to a new zip code or county
• Getting married or divorced
• Having a baby, adopting or becoming a foster parent
• Becoming a U.S. citizen or getting a green card

You have 60 days before or after the following to enroll: 

• Losing your health insurance from your job
• Turning 26 and aging off your parent’s health plan

And if you are experiencing domestic violence and want to apply for your own health plan, you can do so at any time.

Learn more about Special Enrollment Periods at healthcare.gov or call 1-800-318-2596.

 

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RWVoices

Thursday
Jun202019

Don't let Trump take coverage away from thousands of people!

Trump Wants to Lower the Definition of Being Poor...

...because if you aren’t called “poor,” then you aren’t anymore. Right?

Wrong. Last month, the Trump administration proposed changes to the Census Bureau’s poverty guidelines, which would leave fewer low-income people with the designation they need to qualify for life-saving federal benefits. More specifically, millions who currently rely on public health coverage (think Medicare, Medicaid, and CHIP), housing support, or food assistance would increasingly become ineligible for those programs--and it’s going to get worse over time

This change would affect you even if your income is above the Federal Poverty Line. Many people who get ACA subsidies currently won’t qualify for that same support if this change goes unchallenged. The Coalition on Human Needs wrote, “It is estimated that by the 10th year, more than 150,000 ACA marketplace consumers would lose cost-sharing assistance and be required to pay higher deductibles. Tens of thousands of people would lose premium tax credits.”

The Office of Management and Budget is accepting comments up until Friday, June 21st on how this switch to a “shrinking inflation adjustment” would affect you, your organization, or your community. If those numbers sound as bad to you as they do to us, you can send your own comment to the OMB here or comment on behalf of your organizationhere. Don’t worry, they have template comments for the writing-wary.

Thursday
Jun132019

Good news, for a change, about state abortion laws!

Progress in state legislative work

We’re thrilled to report real progress this week by some of our regional coordinators in two important areas of health policy: enshrining Roe v. Wade-type protections at the state level, to protect against potential undermining of Roe by the U.S. Supreme Court, and extending Medicaid coverage for 12 months postpartum.

States take action to protect access to abortion care

Illinois and Maine recently took steps to protect and expand access to abortion care, in contrast to the recent wave of state laws banning all or nearly all abortions.  Illinois’ Legislature passed, and its governor signed into law, the Reproductive Health Act, which ensures that abortion will remain legal even if Roe v Wade is overturned.  Input from advocates, including RWV regional coordinator EverThrive, ensured that the law goes beyond protecting abortion and includes contraception, sterilization, and pregnancy and maternity care as fundamental rights in the state of Illinois.

Maine took another approach to protecting and expanding access to abortion care when its new Governor Janet Mills (below), signing a law permitting nurse practitioners and physicians assistant to perform abortion.   According to a new analysis, more than 11 million women nationwide live more than an hour from the nearest source of abortion care.

“The limited number of professionals providing termination services has burdened women in rural areas of Maine,”  RWV’s regional coordinator Consumers for Affordable Health Care said in an official statement. Expanding the pool of medical professionals who are able to provide abortion care is an important way to make it less difficult to obtain.  The Act to Authorize Certain Health Care Professionals to Perform Abortions is set to go into effect in September.

States Make Progress on Postpartum Health Coverage

Strikingly high rates of maternal mortality in the United States, particularly among women of color, have alerted a wide range of stakeholders to a maternity care system in crisis. Across the country, advocates at the state level have demanded action on maternal health and have highlighted the particular importance of support for new mothers in the postpartum period following delivery.

During 2019 legislative sessions in Illinois, Texas, New Jersey and California, policy makers have started to pursue postpartum support as one critical way to address our national maternal health problem. Among these efforts, Illinois became the first state to take steps to extend Medicaid coverage for pregnant women beyond the federal requirement of 60 days in their public health code. However, the path to implementing the new policy is unclear, as no funds were specifically appropriated for it in the state budget. Meanwhile, a bill to extend Medicaid coverage to one year postpartum passed one house of the Legislature in Texas, a major step forward in that state.

Why the focus on postpartum care?

The majority of maternal deaths do not take place in the delivery room. Rather, they happen during the postpartum period – sometimes months after a woman has a baby. During this medically vulnerable phase, new mothers can face a range of medical conditions, such as complications from childbirth, chronic conditions, or postpartum depression all while caring for a newborn. Given these challenges, advocates and clinicians alike have named this period the “fourth trimester” and are calling for equal medical attention and supportduring this crucial time period.

However, many American mothers, and particularly those on Medicaid during pregnancy, lack adequate health insurance during this critical period after birth. States are federally required to provide Medicaid to low-income pregnant women through 60 days postpartum, in order to make prenatal care accessible. But immediately after that 60 day period, hundreds of thousands of mothers are kicked off the program and in states without Medicaid expansion often do not have other options for coverage. This Medicaid system exposes new mothers to a health insurance “cliff” and can leave them without access to medical services that are essential for their well-being, as well as the health of their infants.

So, what are states doing to address this problem?

During state legislative session so far this year, a handful of states have taken action on this issue by pushing forward legislation that would extend pregnancy Medicaid coverage through the full 12 months postpartum, instead of only 60 days.

Illinois’s legislature amended the state’s public health code to extend coverage for pregnant women on Medicaid through the first year after delivery. The change was written into the budget implementation plan language, but without specifically-dedicated funding,  so there will likely be robust discussion on implementation.

Raising Women’s Voices Regional Coordinator EverThrive was a key advocate for this legislation, which was one of its 2019 policy priorities. In an interview with Public News ServiceKathy Waligora, Executive Director of EverThrive, described the long-term benefits of this initiative for both mothers and children: "Things like maternal-depression screening and treatment, treatment for substance-use disorders, smoking cessation – all of those are benefits that Medicaid can and does cover. So, those are likely to have really positive, two-generational impacts." This initiative was part of a larger maternal mortality package that was not voted on, but the house sponsor of the wider bill was able to push postpartum coverage specifically into the budget implementation plan.

A proposed bill in Texas would have similarly amended the state’s Human Resources Code to require that women on Medicaid during pregnancy remain covered for at least 12 months postpartum. The Afiya Center, our Dallas-based regional coordinator, had a powerful impact in pushing the bill forward. Afiya leadership worked closely with representatives to provide language for the bill and Policy Director Deneen Robinson (below at the podium) testified at the hearing. The bill ultimately passed in the House, but didn’t make it to a vote in the Senate. Instead, the legislature agreed to a narrower and less expensive two-year initiative to address postpartum depression and substance abuse treatment for some low-income women.

The bipartisan bill to extend Medicaid coverage was the top recommendation of a taskforce convened by the state to tackle high levels of maternal mortality. This initiative was particularly critical in Texas, which has the highest rate of uninsured women of reproductive age. Advocates have expressed disappointment that the state missed the opportunity to reduce gaps in coverage, and are eager to see the legislature build on the progress made in the house to achieve lasting policy on this issue.

In New Jersey and California, similar bills have made progress on the legislative floor and are still being reviewed. New Jersey Governor Murphy signed a robust four bill package to address maternal health into law, but extended postpartum Medicaid coverage was not included.

The legislative action across these states has the potential to fill gaps in maternal health coverage and lead to healthier mothers and babies. A recent report from Georgetown University Health Policy Institute shows that states that increased health coverage for women of reproductive age through general Medicaid expansion have reduced adverse maternal health outcomes and maternal mortality rates. Illinois’ success and other states’ progress are major steps in the right direction for supporting America’s mothers and tackling our maternal health crisis. 

 

Thursday
Jun062019

Louisiana activists speak out against abortion ban

Louisiana passes copy-cat abortion ban

Last week, John Bel Edwards, the governor of Louisiana, signed the latest legislation banning abortion ban.  Similar to laws passed in five other states, the act would ban abortion when electrical activity is detected in embryonic cells, referred to by its supporters as a “heartbeat bill”.  If it were to go into effect, the law would ban abortions at around six weeks of gestation, typically two weeks after a missed period.  There would be no exceptions for rape or incest. 

In a sign that state policymakers want to be seen as opposing abortion, but realize that the law is unconstitutional, the Louisiana law will only go into effect if a similar Mississippi law is upheld in federal appeals court.  The Mississippi law is temporarily blocked by Federal Judge Carlton Reeves, who wrote that the law “prevents a woman’s free choice, which is central to personal dignity and autonomy.”

Lakeesha Harris, Director of Reproductive Justice and Health of Women With A Vision (our New-Orleans based regional coordinator), told Rewire.News that Democrats in Louisiana often mirror Republicans when it comes to issues like abortion. They will say one thing and vote another way, or they will “take a walk” and be absent.  The bill passed the Louisiana House with an overwhelming 79-23 vote.

Earlier last month, Lakeesha Harris (standing in center) put herself on the line to protest the draconian proposed abortion ban in Louisiana. “I wish I were surprised that when so many people are struggling, state Sen. John Milkovich and other lawmakers choose to waste their time and our tax dollars denigrating the decisions of women who seek abortion.” said Lakeesha in her op-ed piece for The Advocate.

“We haven’t been a part of the national conversation, so today was about claiming our rights but also letting people know that we fight in Louisiana,” said Deon Haywood, Executive Director, WWAV. “Southerners stand up, and we are always fighting. We’re always on the front lines.”

Medicaid expansion supports housing stability

In case you need another reason to support Medicaid expansion (we don’t, but if you’re trying to convince a recalcitrant policymaker, you might), a new study demonstrated that expanding Medicaid helped low-income people avoid being evicted.  How can a Medicaid card help you pay your rent?  By covering health care costs that you could otherwise have to pay out of pocket, leaving you without enough money to pay rent. 

Researchers Heidi Allen, Erica Eliason and Naomi Zwede at Columbia University and Tal Gross at Boston University looked at all evictions in fourteen states from January 2009 through December 2013, which is roughly two years before and after California expanded Medicaid coverage.  They found that in the California counties that expanded Medicaid in 2011-2012, there were 59 fewer evictions per month - a 25% drop in the number of families that experienced eviction.  Medicaid expansion helps women and their families maintain stable housing, which is a crucial underpinning to good health.  Reason number 3,427 to support Medicaid expansion.  But, who’s counting?

Thursday
May302019

Trump's new rule would allow even more discrimination

Trump's new rule would allow even more discrimination

Late last week, the Trump administration issued a proposed rule undermining the nondiscrimination provision of the Affordable Care Act (ACA). Section 1557, also known as the Health Care Rights Law, prohibits any health program or activity that receives federal funding from discriminating against individuals on the basis of race, color, national origin, sex, age, or disability. The Trump proposal seeks to eliminate protections against discrimination for LGBTQ people and for individuals who have had or are seeking abortions, while simultaneously doubling down on religious exemptions that allow health care providers to deny care on the basis of their personal beliefs.

This proposed rule would likely subject members of the LGBTQ community to renewed, and possibly intensified discrimination in health care, such as in denial of gender transition services, purposeful misgendering, improper hospital room assignments and improper or hostile treatment by health care providers. It could also mean that patients could be denied medically-indicated terminations of pregnancy, such as in cases of reproductive emergencies.

In May 2016, the Obama administration issued final regulations implementing Section 1557 that interpreted “sex” in such a way as to bar discrimination against people based on pregnancy, gender identity, sex and gender stereotypes, or abortion. However, in December of that year, Texas federal court judge Reed O’Connor issued a nationwide injunction blocking key portions of the rule, including discrimination on the basis of gender identity or termination of pregnancy. (If O’Connor’s name sounds familiar, that’s because he’s the judge behind the “bananas” ruling in late 2018 striking down the entire ACA. That case is still pending.

Following release of the rule and before O’Connor’s injunction, victims of gender identity discrimination were briefly able to file complaints with the U.S. Department of Health and Human Services (HHS) Office of Civil Rights (OCR). Analysis of those complaints by the Center for American Progress (CAP) reveals just how critical those protections are. CAP found that “transgender patients who filed complaints were often denied [health care] in general, unrelated to transition-related treatments, solely because of their gender identity. … [H]ealth care providers most often discriminate against transgender people simply for being who they are.”

The Trump administration’s refusal to defend the rule or appeal O’Connor’s ruling, combined with separate court cases upholding protections for gender identity directly under the statutory language of 1557 itself, have left protections for trans health care in legal limbo ever since. Trans people may still be able to sue in the courts but unable to use the administrative remedies available through OCR.

On Friday, the Trump administration framed their current 1557 rewrite as necessary for complying with O’Connor’s ruling. In fact, HHS is simultaneously ignoring those contradictory decisions from other courts while going far beyond O’Connor in attempting to unwind longstanding protections written across a host of federal laws. For example, the Trump rule would erase such protections from all HHS health care regulations including those governing ACA marketplaces, Qualified Health Plans, Medicaid, and the Program of All-Inclusive Care for the Elderly. Even the ability of patients with limited English proficiency to receive information in their native languages is under attack in the proposal, spun as a way for insurers to cut costs.

Although the proposed rule may never go into effect and does not change the underlying law regardless, that may not be necessary to harm trans people and people seeking abortion care. Many patients will be afraid to seek health care in the first place or to speak up if they are turned away. Many biased providers will feel emboldened to discriminate free from consequence.

Furthermore, the rule is the latest in a series of extremist policies being pushed through the U.S. Department of Health and Human Services by Vice President Mike Pence and what Politico labeled his “Indiana mafia.” Women’s and LGBTQ health advocates have long feared a Pence presidency but the truth is that it’s already here.

As the Washington Post reported, “the proposal is part of a broader effort by religious conservatives in the Trump administration” to attack protections for transgender people beyond health care and across the entire federal government. “The Department of Housing and Urban Development on Wednesday proposed a rule that would allow federally funded shelters to turn away transgender people for religious reasons or force them to use bathrooms and sleeping areas that do not conform to their gender identity. A March 12 memo from the Defense Department outlined a policy that bans enlistment by anyone with a gender dysphoria diagnosis who is taking hormones or has transitioned to another gender. In addition, troops already in the military would have to serve according to the sex stated on their birth certificates.”

What can you do?

Before the proposed rule can be finalized, the administration must accept comments from the public and explain why each unique criticism, grouped by theme, is addressed in the final rule. The more comments they receive, the longer the delay before they can finalize the rule.

It is a critical time for you to voice your opinions about the repercussions of these proposed changes. (However, individuals should be aware that comments submitted to HHS are public, which may impact the kinds of stories or details individuals are comfortable sharing.)

Once the comment period is open, we will be writing with ways that you can speak up and be counted.

Thursday
May232019

Despite attacks, ACA and abortion supporters move forward

Good news from Washington State

Northwest Health Law Advocates (NoHLA), our Seattle-based regional coordinator, celebrated a the recent passage of SB 5602, the Reproductive Health Access for All Act. The bill, which was signed by Governor Jay Inslee (D) last Monday, aims to eliminate barriers to reproductive health care faced by young people, immigrants, rural residents, transgender and gender non-conforming people, and people of color. Senate Bill 5602, sponsored by Senator Emily Randall (D-26) and championed by Representative Nicole Macri (D-43), enhances anti-discrimination policy to address the discrimination and denials of services many transgender and gender non-conforming people face in receiving reproductive health care services; requires student health plans to cover reproductive health services; mandates hospitals be transparent about policies related to admission, nondiscrimination, and the reproductive health services available at the hospital; and requires the Bree Collaborative to identify guidelines and develop clinical recommendations to improve reproductive health care for people of color, immigrants and refugees, gender-based violence survivors, and people with disabilities.

While the final bill passed without the provision that created a state-funded program to cover comprehensive reproductive health care services for immigrants who currently cannot access state medical services due to federal restrictions, this program will effectively be funded in the budget for two years.

NoHLA, along with partners from the Health Equity Reproductive Rights Organizations (HERRO) Coalition, took the lead in drafting the bill, working with state agency staff to iron out technicalities and conduct outreach to impacted communities. Huma Zarif, NoHLA’s Staff Attorney, testified in support of the bill in the Senate Health and Long Term Care committee, and is pictured below (middle right) at the bill’s signing.

The HERRO Coalition released the following statement after the bill’s signing:
“We are thrilled to see stronger protections for transgender and gender non-conforming people signed into law today. The RHAA takes important steps to dismantle unjust barriers to care and ensure comprehensive, affordable, discrimination-free reproductive health care is within reach for Washingtonians of all gender identities and expressions.

“However, we are concerned that by relegating the state-funded program to a time-limited budget allocation, the Legislature did not fully commit to covering reproductive health services for immigrants on a par with other Washington residents. Immigration status should not be a barrier to accessing health care. We are committed to continuing our work with legislative champions next session to secure meaningful reproductive health care access for all.”

Week of Solidarity to Defend Abortion

Across the country, we have seen an alarming increase of extreme bans on abortion. These bans are diminishing reproductive freedom for thousands and leaving others under attack. Eight abortion bans have passed in Alabama, Arkansas, Georgia, Kentucky, Mississippi, Missouri, Ohio, and Utah.

Supporters of abortion rights organized two defense efforts this week-- a national Day of Action, and a Week of Solidarity to Defend Abortion.  The week is being organized by women of color-led organizations, including three RWV regional coordinators:  Feminist Women’s Health Center (FWHC), WV FREE and New Voices for Reproductive Justice. The Day of Action was organized by NARAL & other large national organizations in collaboration with hundreds of local and state organizations.

During the Day of Action people gathered in every state to speak out and fight back against the latest attacks on our reproductive rights. “These doors will remain open!” said Kwajelyn Jackson, Executive Director, FWHC (center above). Kwajelyn was joined by many organizations and reproductive advocates who showed their support for abortion at the Georgia state capital. Just two weeks ago, Georgia’s Governor Brian Kemp signed the state’s extreme ban of nearly all abortions, which is set to go into effect in 2020.

WV FREE hosted a Facebook live chat with the Women's Health Center of West Virginia and the American Civil Liberties Union of West Virginia to discuss abortion access in West Virginia and what their constituents can do to protect reproductive rights. The live stream already has over 1,000 views. WV FREE and other organizations also across the country participated in the national twitter storm. “Abortion is still legal in Alabama, Georgia, and every other state the US. These bans will be challenged in court, and we hope they never take effect -- but it’s going to be an uphill battle, and abortion care providers need you.” WV FREE shared via Twitter.

“Cisgender women, trans folk & nonbinary folk must have the freedom to decide when they will have children. Body autonomy is a human right. New Voices stands with the thousands fighting nationally for abortion access and full reproductive rights for all.” said New Voices for RJ.

All week long, we’re spotlighting the folks defending abortion in our states and communities. Follow #AbortionSolidarity to learn more, lift up this crucial work, and plug in.

Elections make a difference, part 2
House passes bill to shore up ACA & tackle high drug prices

In an attempt to undo some of the ways the Trump administration has weakened the ACA, the U.S. House of Representatives passed the MORE Health Education Act last week.  The bill passed with a vote of 234 to 183.  Every “no” vote came from a Republican, despite the fact that the bill also included three drug pricing provisions that will rein in anti-competitive behaviors by pharmaceutical companies.  The measures addressing high drug prices had previously won bipartisan support, which disappeared when the drug pricing provisions were combined with the ACA provisions.  The bill restores funding for enrollment outreach, and rolls back Trump actions to allow skimpier health insurance plans.  The MORE Health Education Act also restores protections for people with preexisting coverage, an important issue for people who might be tempted by the less expensive premiums for skimpy plans, only to discover that the insurance company won’t cover health care they need.  The bill goes next to the Senate, where it faces a difficult road to passage.