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RWVoices

Thursday
Oct252018

It’s almost time for open enrollment in ACA coverage!

Open enrollment starts in one week! Get ready!

Open Enrollment for 2019 health plans begins in just one week, on November 1st. This is the sixth year people who otherwise might not have access to health coverage can go to HealthCare.gov and enroll in a high-quality health plan. That’s because all of us have succeeded in keeping the Affordable Care Act (ACA) the law, despite attempts by Congress and the White House to repeal or undermine it.
 
What’s new this year? The good news is that in some states, people will be paying less this year for health insurance. It’s important that anyone interested in enrolling -- or re-enrolling -- in a health plan compare options at HealthCare.gov each year. As the markets have matured, new insurance carriers have entered some parts of the country, expanding choice and competition. In addition, subsidies to people meeting income thresholds rise in proportion to rate increases. So, even if you have heard that rates have gone up in your area, you should still research your options since you may qualify for a money-saving subsidy.
 
Something else new this year is the expanded sale, in some states, of short-term health plans that are not ACA marketplace plans. These plans were originally intended as “stop-gap” health insurance policies for people who are between plans -- such as when changing jobs and waiting to become eligible for a new employer’s health plan.. The short-term plans may appear cheaper than the plans being sold through healthcare.gov, but they are NOT comprehensive coverage! Many omit coverage for maternity care, prescription drugs or mental health care. They have hidden coverage gaps that can leave you stuck with large medical bills, and also can deny coverage to people with pre-existing conditions. That’s why these policies are often referred to as “junk” health plans or “band-aid” plans. We urge you to ask questions about what such a plan would really cover before buying one.
 
For the second year in a row, Raising Women’s Voices is proud to be participating in an outreach campaign designed specifically to reach low-income people, women of color, Latinx people, immigrants, LGBTQ people, people with disabilities and their families. Along with Community Catalyst and other national non-profits, Raising Women’s Voices and our regional coordinators will be using social media to reach our constituencies with messages like those seen here. In addition, Raising Women’s Voices has created flyers for advocates to customize and distribute within their communities. You can find all of these materials here in both English and Spanish.
 
We know that many of the immigrant families we serve are worried that enrolling in health coverage could cause them to be deemed a “public charge,” and become ineligible for visas or green cards. So, it’s important to know that federal subsidies for purchase of an ACA marketplace plan are not included in the Trump administration’s proposed “public charge” rule. Enrollment in a Medicaid plan -- except for “emergency Medicaid” --would be considered in deciding whether someone is a “public charge,” but only 60 days after the final rule goes into effect. The proposed rule won’t take effect until sometime next year, and it will not be applied retroactively. So, there is no reason to drop coverage now, or fail to enroll if you are an eligible immigrant. 
 
In most states, Open Enrollment will last just six weeks, ending December 15. However, people who become uninsured at other times of the year due to certain life events including job loss, marriage, divorce, a move or domestic violence can apply for aSpecial Enrollment Period outside of Open Enrollment. People who qualify for Medicaid based on their income do not need to wait for Open Enrollment. Similarly, children can be enrolled in CHIP (Children’s Health Insurance Program) at any time of the year. Learn more about Medicaid and CHIP here.

Thursday
Oct182018

Who will really protect people with pre-existing conditions?

Voter beware! Don’t believe all the candidates’ claims

With the midterm elections just weeks away, candidates on both sides of the aisle are rolling out campaign ads claiming to support protections for people with pre-existing conditions. But that doesn’t mean that the Affordable Care Act, Medicaid and Medicare are safe. As the New York Times reported this week:

"For months, Democratic candidates have been running hard on health care, while Republicans have said little about it. In a sign of the issue’s potency, Republicans are now playing defense, releasing a wave of ads promising they will preserve protections for Americans with pre-existing health conditions.

The ads omit the fact that the protections are a central feature of the Affordable Care Act and that the Republican Party has worked unceasingly to repeal the law, through legislation and lawsuits.

Republicans in Congress have recently come forward with limited legislative proposals to ensure some pre-existing conditions protections if the health law is overturned. One, a House resolution, would have no force of law, even if adopted. The other would contain a significant loophole: Insurers would have to cover those with pre-existing illnesses, but would not have to cover care for those particular illnesses." [emphasis ours]

In Missouri, for example, Attorney General Josh Hawley (R-MO) has been running ads touting his support for people with pre-existing conditions even as he has signed the state onto the lawsuit that would gut them. As the Times reports, “If his lawsuit invalidates the entire health care law, it would return the country to a time when people with prior illness sometimes couldn’t buy coverage at all. Republicans could pass a law restoring Obamacare’s consumer protections, but Mr. Hawley has not yet explicitly endorsed such a strategy.”

Hawley’s ad—called “ridiculously dishonest” in the Washington Post—and those of other candidates raise questions about what to make of so many competing claims this year and how health care advocates can speak up for truth about the ACA.

How to tell which candidates will protect people with pre-ex conditions?

Last week, our allies at Families USA rolled out a simple three-part test to cut through the noise:

Questions 1 and 3 are critical because none of the replacement proposals put forward by the ACA’s opponents have ever come close to providing the full consumer protections guaranteed under current law. In fact, these replacement plans would once again makerape and domestic violence pre-existing conditions.

Question 2 gets to the heart of the Trump administration’s efforts to impose Trumpcare by executive fiat. The full-year “junk” plans allowed under a new Trump rule are not required to cover essential health benefits and they can discriminate against people with pre-existing conditions, charge limitless out-of-pocket expenses and reinstate annual and lifetime coverage caps. These plans are coming on the market this month, and we’ve urged consumers to carefully compare them with the comprehensive ACA marketplace plans for which open enrollment starts Nov. 1.

A Kaiser Family Foundation analysis from April found that none of these junk plans cover maternity care and only 29% cover prescription drugs. Kaiser’s analysis concluded that encouraging healthy people to switch to these junk plans “would raise the cost of coverage for people with health conditions who remain in the ACA-compliant market.”

Yet the Senate voted 50-50 last week to uphold these junk plans, with many of the senators who claim to support people with pre-existing conditions nevertheless voting to drive up the cost of health care coverage for those conditions.

With so many candidates running and so many health care issues at stake in federal, state, and local races, Families USA has pulled together a nonpartisan toolkit to help evaluate candidate claims.

Meanwhile, this week Senate Leader Mitch McConnell (R-KY) promised to take up another ACA repeal effort in 2019 if conservatives retain control of both chambers. In a separate interview, he also confirmed what we have long predicted: that conservatives hope to use the massive deficits triggered by their tax bill—“a 77 percent increase from fiscal 2015, when McConnell became majority leader”—as a reason to cut Medicare, Medicaid, and Social Security. McConnell called the deficit “disappointing” but “not a Republican problem” before tarring public health and anti-poverty measures as the “real drivers of the debt.”

More Community Conversations with Black Women's Health Imperative

The Black Women's Health Imperative continues its Real Talk Real Women community conversation series, this time with events coming up in Atlanta and Maryland. The Atlanta event will take place on Oct. 22, 7 PM at the Gathering Spot, and will be focused on galvanizing black women voters ahead of the crucial midterm elections. The Maryland event will at the Rising Sun First Baptist Church in Gwynn Oak at 2 PM on Nov. 3, and will feature a discussion on health topics relevant to Black women today. For more information, check out the Facebook event page for the Atlanta event here, and for the Maryland event here

Friday
Oct122018

Post-SCOTUS reflection: Speaking up still matters!

Post-SCOTUS reflection: Speaking up still matters!

Brett Kavanaugh joined the Supreme Court this week, after the Senate voted on near-party lines late last week to confirm him. That vote hurt, and undoubtedly will endanger women’s health and rights, as we had warned. But we want to thank all of our Raising Women’s Voices supporters for your incredible #SaveSCOTUS advocacy and send you this message: Speaking up still matters!

One female Republican Senator heard our messages. Sen. Lisa Murkowski (R-AK) was the lone Republican to vote no and she explained, “The Code of Judicial Conduct Rule 1.2 requires that a judge ‘act at all times in a manner that promotes public confidence in the independence, integrity, and impartiality of the judiciary, and shall avoid impropriety and the appearance of impropriety.’ … After the hearing that we all watched last week, last Thursday, it became clear to me… that that appearance of impropriety has become unavoidable.”

In contrast, Sen. Susan Collins (R-ME) gave a lengthy speech in support of Kavanaugh in which she railed against the groups that had opposed him, while disingenuously ignoring the overwhelming spending advantage of the groups supporting him. Collins dismissed Dr. Christine Blasey Ford’s testimony that she was “100 percent certain” that Kavanaugh was her attacker. Collins also expressed confidence that Kavanaugh would be a moderating force on the Court, leading to fewer 5-4 decisions. That assertion was immediately undercut by Kavanaugh’s second day on the bench this week, when he argued in support of“harshness” for immigrants detained without bail hearings.

But even now, the fight over Kavanaugh is far from over. This week, Sen. Kamala Harris (D-CA) questioned FBI Director Christopher Wray about why the investigation had ignored dozens of witnesses, confirming on the record that the White House had strictly limited the scope. In the House, Democratic Leader Nancy Pelosi (D-CA) filed a Freedom of Information Act (FOIA) request for records related to the investigation. And Democrats have promised that if they win control of either chamber, they will conduct investigations into the assault allegations and the possibility that Kavanaugh committed perjury.

In the near-term, however, it’s easy to feel despair. A president accused of sexual assault won the confirmation of a judge accused of sexual assault. Along with another justice accused of sexual harassment, these men are certain to make the Court much more hostile to women’s health and autonomy. For millions of survivors who watched Dr. Blasey Ford painfully testify about her experiences, it may feel like their voices have been silenced again.

But even now, we find hope in this moment. When Professor Anita Hill bravely testified to the Senate Judiciary Committee in 1991, it was in front of an all-white, all-male panel of senators, many of whom were guilty of the same conduct as Clarence Thomas. In 2018, some of the committee’s most effective senators are women of color. Inspired by the MeToo movement—the brainchild of Tarana Burke, a Black woman activist—and by the heroic examples of Hill, Blasey Ford, and others, women and men who’ve never shared their stories before have been talking openly about their experiences. And it is working! More Americans believe the survivors who spoke up than believe Kavanaugh’s denials. More Americans opposed his confirmation than supported it. Speaking up still matters. Fighting back still matters.

Thursday
Oct112018

Public charge: Another attack on immigrant families!

Public charge: Another attack on Immigrant Families!

The Trump administration has released the long-awaited full version of the proposed changes to the “public charge” rule. The impact of the rule would be to force immigrant families to choose between receiving vital federally-funded health, food and housing assistance or being eligible to apply for green cards or visas.

How would the rule operate? A public charge is defined as an individual who is “likely to be primarily dependent” on the government for subsistence. Being considered a public charge is especially troubling for immigrants, as it could be grounds for the government to deny immigrants visas or green cards. In the past, immigrants could only be considered a public charge if they had received government cash benefits, such as Temporary Assistance for Needy Families (TANF) and Supplemental Security Income (SSI).

The Trump administration’s proposed changes would widen the definition of public charge to include four additional types of public benefits: non-emergency Medicaid coverage, premium and cost-sharing assistance for low-income people receiving Medicare Part D prescription drug coverage, SNAP food assistance and housing assistance (i.e. Section 8 voucher and public housing). In addition, the proposal includes a new income requirement; to overcome the public charge test, immigrants must make at least 125% of the Federal Poverty Level.

The proposed rule would disproportionately harm women and children. Women are the heads of 80% of single parent households, which means they are more likely to have incomes below the required minimum income. Children are also more likely to receive SNAP, which makes them more likely to be considered a public charge. Moreover, many states make an exception for pregnant women and children to the usual five-year bans on non-emergency Medicaid coverage for immigrants. So, those immigrant pregnant women who do enroll in that needed coverage would be deemed a public charge, and thus ineligible to apply for a green card. Do we really want to discourage pregnant women from getting health coverage?
 
It is worth noting that the final proposed version is not as harmful as previously leaked versions. A lot of the provisions that were most detrimental to women and children have been removed, such as including WIC and children’s health insurance (CHIP) as determinants for public charge consideration. Additionally, the final proposal removes an especially damaging provision that would have penalized immigrants for having other family members, including US-born children, enrolled in public benefit programs. This means that immigrant families can still continue to enroll in WIC and CHIP, and people with citizenship or green cards can enroll in any public benefit programs without endangering members of their families.

However, it is still worth noting that this is an unprecedented change. Public charge has been a long-standing rule that has remained the same for decades. Though this proposal is not yet in effect, it has already created a chilling effect in health care, with many immigrants preemptively dropping out of essential public health programs for fear of being deported. These changes are estimated to impact as many as 24 million immigrants, including 9 million children.

So what are our next steps? The 60 day public comment period is open, and it is a critical time for you to voice your opinions about the repercussions of these proposed changes. The Protecting Immigrant Families coalition has created an action page with guidance and a template that you can use to submit your comments, which can be accessed here.

The Trump administration is specifically asking for feedback on possibly including CHIP as a public charge determinant in the final version. Be sure to include your thoughts on this to help prevent this proposal from being more dangerous than it already is.

 

Friday
Oct052018

Senate Clears Way for Final Kavanaugh Confirmation Vote Following Sham FBI Investigation

Senate Clears Way for Final Kavanaugh Confirmation Vote Following Sham FBI Investigation
 
Earlier today, the Senate voted 51-49 to cut off debate and move to a final vote on the Supreme Court Left
nomination of Brett Kavanaugh. Sen. Lisa Murkowski (R-AK) broke with her party to vote No on “cloture” (the procedure for ending debate and moving to a final vote), while Sen. Joe Manchin (D-WV) voted Yes. It is not yet clear whether all of the senators voting Yes on cloture today will also vote for final confirmation, which could happen as early as Saturday afternoon.
 
Since this morning’s cloture vote was procedural, there is still time to call your senators at (202) 224-3121 and let them know how important their final vote against the confirmation of Brett Kavanaugh is to you. Call your senators even if you think there’s no point. Call your senators even if they have already announced their vote one way or the other. If your senators are doing the wrong thing, they need to hear your opposition and know that their constituents are watching. If your senators are doing the right thing, thank them for standing up for women.
 
We don’t advise calling senators from other states, which can be counterproductive since it can block the phone lines and allow those senators to claim that the opposition isn’t reflective of how their constituents really feel. What you can do, however, is call your friends and family members in other states. Explain why this issue matters and ask them to call their senators.
 
At stake in this fight is the future of our country over the course of the next three decades. It’s abortion rights, access to contraceptives, and coverage for pre-existing conditions under the Affordable Care Act. It’s civil rights, free and fair elections, and clean air and water. But it’s also about the legitimacy of the Supreme Court itself.
 
We already know that Kavanaugh is unfit to serve on the Supreme Court because of his blatant partisanship, dishonesty, and uncontrolled temper. And we believe the brave survivors who have come forward to share their stories, even with the full weight of the White House and Congress lined up to silence them.
 
In the days preceding today’s cloture vote, the FBI wrapped up a grossly inadequate background investigation of Brett Kavanaugh. As the Washington Post reported, it "appears to have been highly curtailed" by the Trump White House. 
 
The FBI did not interview Kavanaugh about the sexual assault allegations, even though it’s clear that he lied to the Senate Judiciary Committee about his past drinking and treatment of women, and even though his own calendar shows he attended a small party on July 1very much like the one Dr. Christine Blasey Ford described.
 
In addition, the FBI was not allowed to interview Dr. Ford and Julie Swetnick—two of the three women who have accused Kavanaugh of sexual assault. The FBI was also not permitted to interview  dozens of people who could corroborate Ford's claims or those of Swetnick and Deborah Ramirez. The FBI’s final report is not public, and only a single copy was made available to all 100 senators, locked in a secure reading room. Senators are prevented from revealing what’s in the report but Sen. Elizabeth Warren (D-MA) made clear that they reveal more than Republicans are pretending: “One: This was not a full and fair investigation. It was sharply limited in scope and did not explore the relevant confirming facts. Two: The available documents do not exonerate Mr. Kavanaugh. And three: the available documents contradict statements Mr. Kavanaugh made under oath. I would like to back up these points with explicit statements from the FBI documents — explicit statements that should be available for the American people to see. But the Republicans have locked the documents behind closed doors.”


As the Senate moves towards its final confirmation vote—in spite of the overwhelming evidence of Kavanaugh’s dishonesty and sexual misconduct—we will continue to make our voices heard and let our senators know that #WeBelieveSurvivors.
 
Buyer beware! Band-Aid health plans are risky

Starting this month, insurance companies in many states are starting to sell newly expanded “short-term limited duration” health insurance plans. You may see advertisements for these plans and be tempted, because the prices could be low.  But these are really just “Band-Aid plans” that are good only for short-term coverage of very minor health needs. You shouldn’t consider them if you need comprehensive health insurance, especially if you have a pre-existing condition. Here’s why. 

These plans don’t have to comply with the Affordable Care Act (ACA) comprehensive consumer protections. They are full of fine print excluding coverage for many types of medical care. Moreover, they aren’t required to cover people with pre-existing conditions, and can retroactively drop you from coverage without warning if they think your medical care will cost them too much. 

Short-term limited duration plans aren’t new. But until recently, short-term plans were more thoroughly regulated by the Obama administration in order to better protect consumers. Under the Obama administration, short-term health insurance plans were intended to cover very short gaps in coverage only, and were limited to just three months. Under new rules from the Trump administration, however, these plans can last for up to 364 days.

Left
Short-term plans often exclude coverage for things like prescription drugs, mental health and substance abuse services and maternity care. Our Chicago-based Raising Women’s Voices regional coordinator, EverThrive Illinois, researched existing short-term plans and discovered a number of alarming fine-print exclusions.For example, one short-term plan sold in Illinois didn’t cover “non-emergency” hospital stays on Fridays and Saturdays.

Some short-term plans may deny coverage for any condition “for which medical advice, diagnosis, care, or treatment was recommended or received” in the two years prior to the start of coverage. For example, a San Antonio man with a short-term plan was denied coverage when he developed a kidney disease because his insurer noticed he had tests conducted eight months earlier. Although his doctor’s didn’t determine the exact diagnosis until later, he was denied coverage for his kidney disease

What else is problematic about the Band-Aid plans? These plans also drive up premiums for everyone with comprehensive health insurance, since they siphon off healthy people who want to take the risk of paying less for Band-Aid health insurance. Gary Claxton, Vice President of Kaiser Family Foundation, sums up the short-term plans by saying that they “draw in healthy people and spit them back into the marketplace when they’re sick.” When that happens, we end up with two separate health insurance “risk pools,” and the one with sicker people will have much higher premiums.

Some states have already acted to protect consumers from the harms of Band-Aid plans by regulating them at the state level. Massachusetts, New Jersey, New York, and most recently California, have prohibited the sale of Band-Aid plans.

But, the Independence Holding Company, one of the largest short-term plan sellers, is selling Band-Aid plans that last up to six months in a number of states, including Delaware, Idaho, Indiana, Kansas, Louisiana, Michigan, Minnesota, Oklahoma, South Dakota and Wyoming. They are also selling Band-Aid plans that last up to 364 days in Alabama, Arkansas, Iowa, Kentucky, Maine, Mississippi, Nebraska, North Carolina, Tennessee, Texas, West Virginia and Wisconsin.

If you’re thinking about buying a Band-Aid plan, just remember that even though may be cheaper up front, they come with some serious long-term costs. These plans often discriminate against people with pre-existing conditions, provide subpar coverage and leave sick people with thousands of dollars in unpaid bills. Make sure to ask questions up front about whether your specific medical needs would be covered. 

If an insurance company asks you to fill out a detailed medical history form, you should realize right away that this is going to be a Band-Aid plan. Companies selling comprehensive  ACA plans are not allowed to ask about your medical history or deny you coverage because of your medical needs. 

Even though the Trump administration recently announced it wouldn’t be promoting Band-Aid plans on Healthcare.gov during the upcoming ACA Open Enrollment Period, individual brokers and insurance agents will still be able to promote them. Consumers may not be given all of the information they need to make an informed decision about what they are buying.

A group of stakeholders – including organizations like the National Alliance on Mental Illness, Little Lobbyists and the National Partnership for Women and Families – is pushing back against the rollout of these harmful plans through a federal lawsuit. They have pointed out that the expansion of short-term plans clearly undermines the ACA and will causeirreparable damage to the individual market. A federal judge in DC recently scheduled a hearing for October 26th on the stakeholders’ motion to suspend the administration’s short-term health plan rule. But in the meantime, the rule remains in effect and short-term plans remain on the market.

You may have seen news reports that a handful of House Republicans up for reelection are strategically promoting a nonbinding resolution in an attempt to demonstrate their commitment to protecting people with pre-existing conditions, as they simultaneously work to undermine those very protections through their sabotage of the ACA. The resolution does not give any details as to how it would, in fact, protect people with pre-existing conditions if the ACA were no longer the law of the land.

A Community Conversation about Black Women's Mental and Brain Health

For those in the Richmond, VA, area, RWV co-ordinating organization Black Women's Health Imperative will be sponsoring a free community conversation at Sarah Garland Jones Center next Wednesday, October 10, from 2 - 3:30 PM. The topic of the conversation will be Black women's mental and brain health, and will feature medical and mental health experts who will tackle the mental health issues concerning Black women today. Special guest speakers will include Stacey Brayboy, a representative from the office for VA Governor Ralph Northam. For more information, check out the Facebook page for this event here.