White House Health Care Plan Fails Women

February 23, 2010

"The president's proposal to revive health care reform from its current state of paralysis needs major revision," according to Terry O'Neill, president of the National Organization for Women. "Although his proposal is an improvement over the status quo on issues such as affordability and accountability of insurers, the effort fails because it embraces the same harmful provisions that are in the Senate health care bill."

The worst feature of the president's proposal -- a real poison pill as far as NOW is concerned -- is retention of the Senate bill's Reid-Nelson anti-abortion language. Forced upon the Senate in order to reach the crucial 60th filibuster-proof vote, this provision requires any exchange-based health insurance plan that covers abortion care to segregate funds by charging separate premiums each month for abortion and all other services. In practice, everyone in a plan that covers abortion care would have to write two checks each month and health experts have predicted that these restrictions would lead to the end of private as well as public insurance coverage for abortion care. Since about one-third of women in this country have abortions, and nearly 90 percent of private health plans currently cover abortion procedures, the President's plan, like the Senate's, would deprive millions of women of insurance coverage they currently have.

This offensive, discriminatory provision bows to the grandstanding of those who would overturn Roe v. Wade. We had hoped that President Obama -- as a supporter of a woman's right to decide -- would have upheld that right and the notion that abortion is to be treated like all other kinds of health care.

The president's proposal also lets stand a Senate bill provision that permits insurers to charge women more because they are women. Although we have been repeatedly told that gender rating would be prohibited -- and President Obama even stated in a major health policy address that gender rating would be banned in reform legislation -- his proposal leaves this costly and discriminatory provision in place. As a result, women who get insurance through the new health insurance exchange could be paying as much as 48 percent more than men -- as is currently the case in the discriminatory individual health insurance market.

Another damaging feature is the retention of age rating -- the practice of charging older individuals more for their insurance coverage. The Senate bill allows insurance companies to charge as much as three times more than they charge a younger person. For many middle-aged women who have modest incomes, this is an unacceptable burden.

There is no public option in the president's proposal. Given that a substantial number of House members have refused to accept the Senate bill because of its lack of a public plan, this is a curious omission. Some White House spokespersons have asserted that there is a public plan in their proposal, but they are referring to Medicaid and the Children's Health Insurance Plan (CHIP) as being the "public plans" where states are encouraged to innovate.

We need a strong public option in both the Senate bill and the president's proposal. Without a strong public plan -- which according to numerous polls is very popular with the general public -- there can be no true competition and very little incentive for private insurers to control their premium rates. NOW supports a single-payer approach similar to that in Canada, which would bypass the need to generate billions in profits to private insurers and bring our health care expenditures in line with what many other industrialized nations pay. At a minimum, health care reform should allow states to adopt their own single-payer plans.