“To be sure, no group is doing well under our network of private insurers,” but “women fare particularly badly in terms of health, being more likely than men to leave a prescription unfilled; forgo seeing a needed specialist; and skip a medical test, treatment or followup,” author Sharon Lerner writes in an opinion piece in The Nation. “Despite the fact that they skimp on their care to cut costs, three in five women are still unable to pay medical bills,” Lerner continues. She adds that such statistics “make it surprising that men and women support health reform in almost equal numbers” 38% and 40%, respectively according to a recent Kaiser Family Foundation poll. “Odder and ickier still is the sight of Sarah Palin, Betsy McCaughey and other women leading, or sometimes blindly following, the wacko townhall movement against reform,” Lerner says.

Lerner goes on to explain how “[m]any of womens problems stem from the fact that to get anything close to decent private insurance, you usually need a fulltime job.” Women without fulltime employment “have become a sort of medical underclass, stuck without insurance, paying dearly for it out of their own pockets or … begging desperately, and unsuccessfully, for the opportunity to pay dearly for it outofpocket.” Private insurers can legally reject uninsured women who become pregnant and apply for individual policies because they consider pregnancy a preexisting condition, even though federal law prohibits group health plans from doing so, Lerner explains. For women seeking health insurance before conception, Lerner notes that the “vast majority of individual plans dont even offer maternity coverage” and that those that do charge women up to 140% more than men for the same plans, according to a 2008 study by the National Womens Law Center. Lerner says that some pregnant women who cannot afford insurance often “take their chances” and forgo some prenatal care, including physician visits. “Other women spend down, forgoing income to qualify for Medicaid,” according to Lerner, who notes that some women who do this “can wind up without prenatal care for long periods, since 20 states lack laws allowing pregnant women to receive timesensitive coverage while waiting for approval of their Medicaid applications.” Lerner adds that some pregnant women “spend their money on the bogus health companies that have slithered onto the scene to exploit uninsured pregnant women,” which “should be Exhibit A in whats wrong with our current system.” These companies, advertised on sites like pregnancyinsurance.org, do not actually offer insurance for pregnant women and have been the target of legal action for making fraudulent claims. According to Lerner, health care reform “would put a knife through the hearts of the bottomfeeding companies that prey on uninsured pregnant women.”

Reform “should eliminate pregnant womens desperate search for coverage” by “forbidding real insurers from denying coverage on the grounds of preexisting conditions,” Lerner writes. “The biggest question of all, of course, is still whether any version of health reform will pass,” she says, adding that the answer will depend in part on “whether women remain silent or, worse, contribute to the twisted version of events offered by groups like Concerned Women of America” and Conservatives for Patients Rights. According to Lerner, “The best hope for the more than half of women who are uninsured or underinsured would be to lend their support to groups like the National Partnership for Women & Families, NWLC and Moms Rising, who are actively fighting for reform and against the misrepresentation of womens experience.” She concludes, “If they dont, womens prognosis for escaping the medical underclass and the sleaze that comes with it is grim” (Lerner, The Nation, 8/21).

Reprinted with kind permission from nationalpartnership.org. You can view the entire Daily Womens Health Policy Report, search the archives, or sign up for email delivery here. The Daily Womens Health Policy Report is a free service of the National Partnership for Women & Families, published by The Advisory Board Company.

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