Beyond Mother’s Day: Continuing the Commitment to Working Mothers and Families

Published on May 14, 2012 in Debra Ness. 0 Comments

Debra Ness, President, National Partnership

Cross-posted from the Huffington Post.

As families throughout the country were making their Mother’s Day plans, some lawmakers were similarly focused on America’s women. But unlike the short-lived events of Mother’s Day weekend, their attention was on the kind of support and family friendly policies mothers and working families need year round. We applaud the lawmakers who took action, and urge their colleagues to join them in advancing the kinds of meaningful paid leave, paid sick days, anti-discrimination and fair pay policies the nation urgently needs.

The sad truth is that becoming a mother in this country too often means the loss of a job and/or the beginning of financial hardship. That’s because women still suffer from rampant pregnancy and wage discrimination and enormous challenges that result from our failure to adopt 21st century workplace policies. And it’s not just women who suffer. All working families pay a price when women are without fundamental equality in the workplace.

Women are nearly half the workforce and the primary caregivers and sole or co-breadwinners in the majority of families today. So when women are fired, forced out of their jobs, and denied employment and promotion opportunities just because they become pregnant, families’ financial stability suffers – as does our productivity and our economy. Yet, despite legal protections for pregnant women having been in place for nearly 35 years, pregnancy discrimination is alive and well.

That’s why we were so pleased that the Pregnant Workers Fairness Act – an effort to stem rising pregnancy discrimination – was introduced in the House of Representatives. We applaud its sponsors. The bill would put in place the same workplace protections for women with pregnancy-related limitations as the protections already in place for similarly abled workers, and it would help ensure employers provide reasonable accommodations to pregnant women who want to continue in their jobs. It is a badly needed measure that would promote the kind of equality working women need and deserve.

Sadly, discrimination against women in the workplace doesn’t stop there. Wage discrimination is another unacceptable reality in this country – and it has a terrible impact on the economic security of families. The median yearly pay for a woman working full time is $10,784 less than a man’s in the United States. For working mothers, that means years’ worth of basic necessities for their families – such as groceries, rent, health insurance premiums, gas and more – lost each year.

Here, too, there’s a legislative solution. The Paycheck Fairness Act would close loopholes in existing laws, protect women from wage discrimination and promote basic fairness in our workplaces. Given the increasing importance of women’s wages to families and our economy, Congress must recognize what is at stake and prioritize its passage.

But addressing discrimination alone will not eliminate the challenges working mothers and families face. Every day, workers struggle to provide for their families while meeting their responsibilities at work because the nation lacks family friendly workplace policies like paid sick days. More than 44 million workers in the United States don’t have the right to earn a single paid day off to recover from illness or care for a sick child. The consequences for mothers and families can be devastating.

That’s why it was great that a recent Senate hearing focused on the Rebuild America Act. The bill is a powerful legislative package that includes a national paid sick days standard as defined by the Healthy Families Act. Held just in time for Mother’s Day, the hearing addressed the real challenges working people face in managing the dual demands of work and family. It started an important conversation among lawmakers that must continue.

Still, not all solutions have to be at the federal level. The National Partnership just released a new state-by-state analysis that shows how few states have policies that support working people when a new child arrives. While California and Connecticut fared well in the report, it found that most states are doing very little to support new parents and 18 states don’t have a single supportive policy in place that expands upon minimal federal standards. There is much more states can and should be doing to help working mothers and families, even as the findings underscore how badly we need federal solutions.

It was encouraging to see some enlightened members of Congress focus on these issues as Mother’s Day approached, but it was only a start. The nation needs real progress and we need it now. It’s time for lawmakers to prioritize and pass the kind of anti-discrimination protections and family friendly policies working families need. Doing so would be a Mother’s Day gift that makes a difference all year long, and much-needed evidence that our nation truly values families.

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On Mother’s Day: Expecting Better for All Mothers and Working Families

Published on May 8, 2012 in Debra Ness. 0 Comments

Debra Ness, President, National Partnership

Cross-posted from the Huffington Post.

On Sunday, millions of mothers will be celebrated and honored — some for the first time, and others as part of a fun family ritual. But when the family fun and gift giving ends, we should all take a moment to think about the kind of help and support that would make a real difference for mothers year-round.

The sad truth is that millions of working mothers in this country find themselves without the support they need to care for their families and hold onto their jobs. A new state-by-state analysis from the National Partnership shows just how bad it is, particularly for new mothers and fathers.

Expecting Better: A State-by-State Analysis of Laws That Help New Parents is a comprehensive look at federal and state laws that provide the kind of support working parents need to stay healthy and protect their economic security when a new child arrives. From access to paid leave to paid sick days to workplace rights for nursing mothers and more, we assessed the laws and graded each state based on the extent to which it has policies that support new parents (beyond the minimal standards set by federal law). The findings are surprising.

Only two states — California and Connecticut — show real leadership, receiving grades of “A-” for having done the most to support working parents.

An astounding18 states don’t have a single law that supports new parents beyond what federal law requires.

Most states are doing something, but not enough, for new parents.

And not a single state has done all it could to provide paid leave and other supportive policies.

Expecting Better paints a picture of a nation that is failing families — and it should be a wake-up call for lawmakers at every level.

What makes the grades in Expecting Better especially striking is that we know from past research, including two recent studies from Rutgers’ Center for Women and Work, that these policies have significant benefits. Paid leave and paid sick days, for example, promote the health and economic security of families, reduce reliance on public assistance, and benefit businesses through improved worker loyalty and reduced turnover. These policies are wise public investments that help working families and save the government and businesses money. They are truly win-win.

That’s why it is great that the Obama administration has proposed a state paid leave fund that would help foster state innovation and support states that want to create their own paid leave programs. And it is very encouraging that some members of Congress are working on a proposal for a national paid leave insurance program, which would greatly increase access to paid leave for America’s families. These are both critically important initiatives that would pave the way for a more family friendly nation.

The birth of a child should be a joyous event for new mothers and fathers — the beginning of many happy Mother’s and Father’s Days — not the cause of health threats and financial hardship or devastation. But that’s the sad reality for too many families in this country.

Our new report sends a clear and timely message: America’s families expect and deserve better. As a nation that claims to value families, we should put in place the state and federal policies that parents need.

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New Study Shows It’s Time to Invest in Paid Leave for U.S. Workers and Families

Published on May 4, 2012 in Vicki Shabo. 0 Comments

Vicki Shabo, Director of Work and Family Programs

It is no secret that millions of women are both breadwinners and caregivers for their families, the country is rebuilding its economy, and – at the same time – many federal and state lawmakers are trying to figure out how to reduce spending. That’s why it couldn’t be timelier that a new study from Rutgers, The State University of New Jersey’s Center for Women and Work, reveals the power that public policies can play in helping families when they need it most, while benefitting businesses and our economy.

The report, Policy Matters: Public Policy, Paid Leave for New Parents, and Economic Security for U.S. Workers, was commissioned by the National Partnership with generous funding from the Rockefeller Foundation. It is the first study to quantify the role that public policies play in enabling new parents to take leave when a child arrives. It shows, quite strikingly, what we have long suspected: New parents are more likely to take leave in connection with the birth of a child when they live in a state where public policies provide access to paid leave; at the same time, access to paid leave through paid leave insurance programs helps reduce workers’ dependence on government assistance.

According to the report, women who live in states that have some kind of paid leave program – either through temporary disability insurance or paid family leave insurance – are twice as likely to take paid leave following the birth of a child than women in states without these policies. In California, where a paid family leave program has provided paid leave to new parents and family caregivers since 2004, both women and men are more likely to take paid leave following the birth of a child than women and men in other states.

These findings may seem obvious but, when combined with other research results, the impact is considerable. We know from prior research that when workers are able to take paid leave, it leads to positive outcomes for their families, businesses and the economy. Paid leave enables new parents to take the time they need for their health and the health and development of their children while strengthening new mothers’ attachment to the labor force and their post-birth earnings. Paid leave also increases worker loyalty and decreases turnover. And, as this study and a prior Rutgers study show, when mothers take a short paid leave following the birth of a child and then return to work, they are less likely than mothers who keep working do not take leave to rely on public assistance and food stamps the year after birth. At a time when state budgets are stretched thin, giving workers access to paid leave offers clear savings for governments and taxpayers.

But in order to realize these benefits, workers must have access to paid leave. Unfortunately, workers in only a handful of states have a guarantee of paid leave in connection with childbirth; only about half of new mothers can take any form of paid leave to recover from childbirth and care for a new child; and only about one-tenth of workers have access to paid family leave through their employers to bond with their babies. That’s why this study is so important. It shows that the positive outcomes of paid leave could be experienced on a much larger scale, by more families, businesses and our economy, if policymakers made access to paid family and medical leave more universal. The study even shows the role that public policies can have in shaping culture by making it more acceptable for workers to take the time they need.

Policy Matters makes a strong case for public policies that improve access to paid leave. Fortunately, lawmakers and leaders are beginning to recognize the benefits and power of adopting such policies.

The Obama administration, for example, has proposed a state paid leave fund that would award competitive grants to states interested in establishing paid family and medical leave programs. The fund would foster state innovation, and could spur the enactment of more state paid leave programs and increase workers’ access to paid leave. It would be a great step forward for the country… but still only a start.

What the country really needs is a national standard to ensure that all workers have access to paid leave, no matter where they live. And that’s why we are so pleased that key members of Congress are working on a proposal to create a national paid leave insurance program. This would be a powerful, lasting way to increase access to and use of paid leave for working families – and the nation would benefit in many ways.

This study and others like it make a compelling case to establish a national paid leave program for parents and other family caregivers. It should be a priority now. It’s time for lawmakers to take note and take action on common sense policies that will help families, businesses and our economy.

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Eliminating Disparities in Maternal Health

Published on April 26, 2012 in Kalahn Taylor-Clark. 0 Comments

Christine Monahan, Health Policy Advisor

Kalahn Taylor-Clark, Director of Health Policy

How does race and ethnicity intersect with other identities (including sex, gender identity, etc.) in ways that compound barriers to health care and lead to health disparities?

Every mother and every infant deserve high-quality maternity care.  Yet despite the fact that the United States has many of the best medical professionals and facilities in the world, our health care system is failing to meet the maternal health care needs of millions of women, and Black women are at particular risk.

The statistics are striking.  According to the Centers for Disease Control and Prevention (CDC), Black women are more than three times more likely than White women to die from pregnancy-related causes.  Infants born to non-Hispanic Black mothers are more likely to be born preterm and nearly twice as likely to have low birth weights as infants born to White mothers.  And the preliminary infant mortality rate in 2010 for Black infants was more than twice that of White infants.  Further, only 54 percent of Black babies have ever been fed breast milk, compared to 74 percent for White babies, 80 percent of Latino babies, and 81 percent of Asian American babies.  So what’s the cause behind such troubling disparities and what is being done to combat them?

First, the problem of infant mortality among Black women cannot be dismissed as a result of lower educational attainment.  College educated Black women also suffer an infant mortality rate that is more than double that of their White counterparts – 11.5 deaths per 1,000 births for Black mothers compared to 4.2 per 1,000 for White mothers. White women who dropped out of high school have a lower rate of infant mortality than college-educated Black women – 9.1 deaths per 1,000 births compared to 11.5, according to the National Center for Health Statistics.

Rather, health researchers suggest that a lifetime of stress related to navigating systems plagued by race and gender bias has the additive effect of wearing on the body.  That is, when the body is stressed it produces a hormone called cortisol, which can work to induce labor.  Beyond equalizing access to health care services, more must be done to combat these stressors for Black women.

Over the past eight years, The March of Dimes’ Prematurity Research Initiative has provided nearly $22 million to address these issues broadly, and in 2012 alone has provided grants totaling nearly $3 million for this work. Targeting funding through these types of initiatives could do a lot to address, head on, this troubling disparity.

Second, more than 22.4 percent of Black women – compared to 12.7 percent of White women – have no health coverage. Black women are also more likely to be without a usual source of care than White women.  Consequently many Black women don’t have access to the health care they need before, during, and after pregnancy.  Many are without:

1) Community resources and health care services that can help them stay healthy before pregnancy (for example, 7.5 percent of Black women compared to 3.3 percent of White Women have been diagnosed with diabetes – a condition associated in pregnant women with greater risk of pregnancy complications, birth defects, and spontaneous abortions or miscarriages);

2) Contraception to help them plan families and appropriately and safely space pregnancies (Black women face a significantly higher rate of unintended pregnancies);

3) Preconception and prenatal care to allow doctors to identify and treat any health issues early (Black women are more than twice  as likely as White women to receive prenatal care starting in the 3rd trimester or not receive prenatal care at all); and

4) Postpartum care to assist mothers with breastfeeding (as noted earlier, Black babies are less likely to be breastfed.  Research has shown that breastfeeding can reduce the rates of a range of chronic conditions, including obesity, type 2 diabetes, and asthma. Further, Black adults are likely to suffer from all of these conditions at higher rates than are Whites.  Thus, it is possible that encouraging breastfeeding may help to alleviate some of the disparities that Blacks disproportionately face later in life.

The Affordable Care Act (ACA) contains a number of important provisions that will help us tackle these barriers.  It makes significant investments in prevention (in both the health care and community settings) and expands affordable health coverage to millions of women.  The ACA also specifically aims to improve conditions for pregnant women and new parents by providing comprehensive maternity coverage and supports for low-income mothers, and improving the infrastructure for breastfeeding.  In addition, through the Strong Start Initiative, providers, states, and others have the opportunity to build public-private partnerships to reduce early elective deliveries, and to test innovative approaches to provide access to high-quality prenatal care.  Targeted efforts through these programs will be imperative to reducing disparities in access to needed care services.

The National Partnership for Women & Families is committed to making sure the ACA delivers on these important protections, by working closely with both federal and state officials as they implement the law and combating efforts by opponents in Congress to undermine it.

By Christine Monahan, Health Policy Advisor and Kalahn Taylor-Clark, Director of Health Policy, National Partnership for Women & Families

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Medicare Matters to Older Women

Published on April 24, 2012 in Health Care and Kirsten Sloan. 1 Comment

Kirsten Sloan, Vice President

The Medicare Trustees announced this week that the program will remain solvent until 2024 – the same projection as last year.  While this finding is reassuring, it doesn’t mean we can afford to be complacent. Millions of American women – mothers, grandmothers, and aunts – rely on this program every day for affordable health care coverage.  In fact, more than half of the roughly 49 million Medicare beneficiaries are women.  And the numbers continue to grow as our nation ages.

 

For these women, Medicare provides access to essential preventive care, physician and hospital services, prescription drugs, and home health care.  Often this is care women could not otherwise afford; nursing home care alone can cost roughly $75,000 per year.

 

Medicare also offers guaranteed protection.  There is no gender rating – women pay the same Medicare premium as men; there is no exclusion for pre-existing conditions – an eligible woman diagnosed with breast cancer will not be turned away from the program; Medicare coverage is never rescinded – women can be confident that the coverage will be there when they need it; and there are no annual limits that restrict coverage when a woman needs it most.

 

Medicare’s promise of affordable coverage has become one of the most important pillars of retirement security.  Women age 65 and older have average incomes of only around $22,000 – an amount easily wiped out by one serious illness.  Without Medicare, millions of older women would be left to shoulder unmanageable health care costs, forego the critical health care services they need, or be forced to rely on their children for assistance.

 

There is no question that refinements that reduce health spending and make Medicare more sustainable for the long-term are necessary.  There are also improvements in the program – like a sorely needed cap on total out of pocket expenses – that need to be made.  But any refinements must be done thoughtfully and carefully.  Changes that simply push more costs onto Medicare beneficiaries or cut provider payments in ways that deter physicians from accepting Medicare patients are short-sighted.

 

The Trustees report indicates there is some time to make the right changes – changes that strengthen the program for current and future generations of women and protect Medicare’s promise of affordable, quality health care.  We owe it to these women to get it right.

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Women’s Work: A Political Flashpoint and an Urgent Policy Imperative

Published on April 16, 2012 in Debra Ness and Workplace Fairness. 1 Comment

Debra Ness, President, National Partnership

Cross-posted from the Huffington Post.

Women’s work. Last week, when Hilary Rosen used words she quickly admitted were poorly chosen, we were all reminded that it remains a huge flashpoint in our society. But there are some truisms that will hold even after the media frenzy and politically-motivated discourse subside.

First, America’s moms aren’t at war with each other. For a good part of our lives, most women are in the workforce. At other times, many women are stay-at-home caregivers. Most of us assume both roles at various points in our lives — and for several decades, many of us fill both of these roles, breadwinners and caregivers, at the same time. We all need and deserve respect.

Second, in this tough economy, women’s work is about not just family economic security over the long term, but also basic family economic survival right now. In 2010, nearly 40 percent of women were the primary breadwinners for their families, bringing home as much or more than their husbands — or providing solely for their families as single parents, and just under one-quarter more were co-breadwinners who brought in at least 25 percent of their families’ income.

Our jobs matter, and our caregiving responsibilities matter. And much more important than the rhetorical war around Hilary Rosen and Ann Romney is the urgent need to finally adopt policies that address the needs of employed women and their families, now and in the future. That means expanding the Family and Medical Leave Act so it covers more workers, adopting paid family and medical leave, and ensuring that all workers can earn paid sick days. And it means finally, once and for all, ending the gender-based wage discrimination that punishes women and families these days.

How bad is it? America’s women are paid just 77 cents for every dollar paid to men, which results in $10,784 in lost income each year. For women of color, the gap is even worse. African American women are paid 62 cents and Latinas are paid just 54 cents for every dollar paid to men, which means they lose $19,575 and $23,873 in critical income each year, respectively. And these gaps exist regardless of industry, education or personal choices.

The wage gap in this country is diminishing so slowly that it will take more than four decades for it to close. Yet, if it were eliminated, a woman in the United States could afford 13 more months of rent, 2,751 more gallons of gas, seven more months of mortgage and utility payments or nearly three years’ worth of family health insurance premiums. The loss of these basic necessities is no small matter for America’s families.

To paint a clearer picture of what these lost wages look like for households throughout the country, the National Partnership has released a state-by-state analysis of the wage gap. Although some states are closer to closing the gap than others, in no state are women paid equally. And the disparities for women of color are significant and often appalling.

In Wyoming, Louisiana and Utah the gap between men’s and women’s wages is more than 30 cents for every dollar. They make up the bottom states in our ranking of state wage gaps for all women. An analysis of the state gaps for African American women and Latinas shows that Wyoming, Rhode Island and Alabama have the worst gaps — more than 50 cents. The fact that women of color in these states are being paid half, or even less than half, as much as their male counterparts is truly appalling.

This week, we recognize Equal Pay Day — the day that marks how far into 2012 women have to work to match the total wages paid to men in 2011. You read that correctly: it takes women four extra months of work to catch up in wages to their male counterparts — and it’s hurting the nation’s families and our economy terribly.

That’s why we need Congress to pass the Paycheck Fairness Act, which would help fight wage discrimination and establish stronger workplace protections for women in all states. It is critically important legislation that has been introduced in the current Congress. Its passage must be a priority for anyone who cares about women’s work and families’ well-being.

It’s time to move beyond posturing and political dust-ups to real policy changes that will help real families. We cannot afford to wait.

 

 

 

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Older Women’s Stake in Health Reform

Published on April 3, 2012 in Debra Ness, Health Care and Reform. 4 Comments

 

Debra Ness, President, National Partnership

Cross-posted from the Huffington Post.

This week, all the talk in Washington has been about handicapping the outcome of the Supreme Court health reform cases, and identifying winners and losers. What did the justices mean with each question? Which way are the potential swing votes leaning? Will the Court reach consensus of any kind? What are the likely political/electoral consequences of the upcoming rulings?

There’s been painfully little attention to the impact of the rulings for patients, and one group has been just about totally ignored throughout this debate: older women. But as one of the most vulnerable segments of our population, older women have a tremendous amount at stake as the future of reform is decided.

Why, when most seniors are covered by Medicare? Because older women tend to have low incomes and poor health — and because nobody suffers more in our fragmented, incoherent health care system.

Let’s get specific. Older women are more likely than others to have chronic conditions and, consequently, they bear the brunt of shortcomings in our health care system — among them high cost, poor quality and uncoordinated services that often generate additional cost, burden and sometimes serious harm. Older women also are more vulnerable than men to high costs, due to the lower wages and savings that result from time spent out of the workforce to meet family caregiving responsibilities.

That means older women gain a lot from the Affordable Care Act, because the law does so much to improve both the affordability and quality of health care.

It is closing gaps in Medicare coverage. Annual wellness visits are now covered, as are some preventive benefits older women need, such as mammograms and bone density tests, without co-pays. This benefit includes time for health care providers to conduct comprehensive health risk assessments and create personalized prevention plans for their patients.

Older women will save millions of dollars as reform closes the current gap in Medicare prescription drug coverage known as the “donut hole.” Beneficiaries who fell in this gap have already received a $250 rebate. Beginning last year, they benefited from 50 percent off brand-name drugs in the “donut hole.” By 2020, the donut hole will be closed, and beneficiaries will only have to cover 25 percent of the cost of their drugs until they hit the catastrophic cap, after which they will only have to pay 5 percent.

Health reform also created the Center for Medicare and Medicaid Innovation, to test, evaluate and rapidly expand new care delivery models that improve quality and care coordination. It encourages the use of health information technology in these models to help improve coordination and communication among health care providers and patients. It puts more resources into making sure older women get the follow-up support they need when they transition from a hospital stay back to the community. It supports new medication management services that will help patients and caregivers understand their medications and avoid dangerous interactions and medical errors. It supports better primary care and a team-based approach that will help older women avoid unnecessary hospitalizations and link them to community services that can help them maintain their health and live better quality lives. And the reform law establishes Geriatric Education Centers to support training in geriatrics, chronic care management and long-term care issues for family caregivers, as well as for health professionals and direct care workers. Read even more about the benefits for older women in health reform here.

Health reform is the greatest advance for women’s health in a generation. Access to affordable, quality health care is central to the well-being of older women. It is a key determinant of their quality of life, their economic security and their ability to thrive, prosper and participate fully in our society. Losing reform would have grave consequences for women and families, and older women have a particular stake. Nobody wins when we lose sight of that.

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10 Things to LOVE About the Affordable Care Act

Published on March 21, 2012 in Debra Ness, Health Care, Reform and Reproductive Health. 0 Comments

Debra Ness, President, National Partnership

This week, the Affordable Care Act (ACA) turns two. Let’s not mince words: This law is the greatest advance for women’s health in a generation. Here are just a few things we love about the law:

1. Being a woman is no longer a pre-existing condition.

For the first time in history, gender discrimination will be prohibited in all federally funded health care. This basic protection means that any insurance companies receiving federal funds (including tax credits, subsidies and contracts) will be prohibited from discriminating against women.

2. The ACA helps to make health insurance more affordable for women.

Health care we can afford? Sign us up! The ACA establishes protections to make private health insurance options more affordable for women purchasing coverage on their own or through small businesses.  This is due to new rules to keep premiums in check and prohibitions on charging higher premiums based on gender and health status or history.  Beginning in 2014, lower-income women and families who don’t receive insurance through their employers will be able to access financial assistance to help them buy insurance in the individual market.

3. Women will be guaranteed preventive services such as birth control, mammograms and cervical cancer screenings, with no deductibles or copays. Need we say more?

New private insurance plans will be required to cover a wide range of recommended services without cost-sharing, including well-women visits; screenings for gestational diabetes, osteoporosis, and colon cancer; pap smears and pelvic exams; STI and HIV screenings and counseling; all FDA-approved contraceptive methods; breastfeeding support, counseling, and supplies; and screenings and counseling related to interpersonal violence.  Private plans also must cover screenings and vaccinations critical to children’s health without out-of-pocket costs. The ACA also requires Medicare to waive cost-sharing for many of these services as well provide a free annual, comprehensive wellness visit that includes personalized prevention planning services.

4. Young adults can stay on their parents’ insurance policies until age 26

To ensure that recent high school and college graduates aren’t without coverage as they search for work and start their careers, the ACA allows young adults to stay on their parents’ insurance plans until they are 26 years old. This provision is already benefitting 2.5 million young adults, including an estimated 1.1 million young women.

5. Universal maternity coverage

Currently, most individual health plans fail to provide any insurance coverage for maternity care. This means that even without complications, women face expenses that average $10,652 or more. Beginning in 2012, plans offered in the individual and small group market will be required to cover maternity and newborn care – ensuring better health for mothers and babies.

6. Closing the “donut hole”

Senior women will save thousands of dollars as reform closes the Medicare prescription drug coverage gap. Each year, about 16 percent of Medicare beneficiaries hit the “donut hole” in their prescription drug coverage, meaning that they are responsible for paying 100 percent of drug costs up to the point when Medicare begins to pay again. Under the ACA, a typical Medicare beneficiary who hits the donut hole could save more than $3,000 by 2020, when the donut hole will be closed completely.

7. Expanded Medicaid coverage for lower-income women

Restrictive state eligibility rules have long kept many women from accessing the benefits of Medicaid, which provides essential care over the spectrum of women’s lives. In 2014, the ACA will close this gaping hole in the nation’s safety net by expanding Medicaid eligibility to individuals and families with household family incomes up to 133 percent of the Federal Poverty Level (FPL). With this change, ten million more women will qualify for Medicaid’s comprehensive health coverage with strong out-of-pocket cost protections.

8. Pre-existing condition? The ACA has you covered.

Today, it can be nearly impossible to access health insurance on the individual market without a blemish-free medical history. Health plans deny or drop women from coverage for conditions ranging from acne to C-sections to breast cancer. The ACA already prohibits private health insurers from retroactively canceling coverage when a person incurs high health care costs.  Beginning in 2014, new private health plans will no longer be able to turn away women and families applying for or renewing coverage.  Nor will they be able to exclude services from coverage on the basis of a pre-existing condition. These protections went into effect for children under age 19 in September 2010. To help uninsured adults with pre-existing conditions access coverage before 2014, new Pre-Existing Condition Insurance Plans (PCIP) are available in every state.

9. Higher quality, better coordinated care  

It’s about time!  By investing in primary care, patient safety, and the new Center for Medicare and Medicaid Innovation, the ACA lays the groundwork to improve quality and coordination of care. This means older patients will be less likely to experience dangerous drug interactions, duplicative tests and procedures, conflicting diagnoses, and preventable readmissions.

10. Investment in the health care workforce to ensure access to health care providers

The ACA requires insurance plans to contract with essential community providers, including women’s health centers, HIV/AIDS clinics, community health centers, and public hospitals that serve medically under-served and low-income populations. This will mean women who rely on these clinics can continue to receive care from their regular health care providers, and it will help alleviate the shortage of primary care providers, which is expected to worsen as reform increases the number of people with insurance coverage.  In addition, the ACA establishes Geriatric Education Centers (GECs) to support training in geriatrics, chronic care management, and long term care issues for family caregivers, as well as health professionals and direct care workers. The GECs are required to train family care practices into their curricula.

The ACA is already beginning to deliver for women and their families – and some of the best is yet to come. But the health reform law faces challenges in Congress, in the states and at the Supreme Court.  We can’t let opponents distort the facts, control the debate, or take away a law that America’s women need!  So let’s keep talking about all the ways the Affordable Care Act is helping women.  Let’s ensure we can continue the progress.

It’s time to protect our care – and protect the law.

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Supreme Court Erodes State Workers’ FMLA Rights

Published on March 21, 2012 in Judges & Supreme Court, Sarah Crawford and Work & Family. 1 Comment

Director of Workplace Fairness

Cross-posted from the American Constitution Society.

“This grading of Congress’s homework is a task we are ill suited to perform and ill advised to undertake.” 

– Justice Scalia’s concurring opinion in Coleman v. Maryland Court of Appeals

By a narrow majority, the U.S. Supreme Court’s decision in Coleman v. Maryland Court of Appeals has eroded the right of millions of state workers to take job-protected leave under the Family and Medical Leave Act of 1993 (FMLA) when faced with a serious illness, injury, or pregnancy. In these tough economic times of high unemployment, the Supreme Court has dealt another devastating blow to millions of workers – making them vulnerable to losing their jobs if they need time off for medical leave. The Court ruled that states cannot be sued for monetary damages for violating the FMLA’s medical leave provision, leaving state workers with little meaningful recourse if their employers deny the self-care leave guaranteed by the plain language of the FMLA.

The FMLA set an important family and medical leave standard that guarantees eligible workers – both women and men – up to 12 weeks of job-protected, unpaid leave to recover from a serious illness or medical condition, including pregnancy or childbirth, or to care for a newborn, a newly adopted child or a seriously ill family member.

Since its enactment 19 years ago, workers have used the FMLA more than 100 million times. The law has helped workers disabled by pregnancy or recovering from childbirth, workers with new babies and dying parents, workers who have had heart attacks and hysterectomies – in short, workers for whom job-protected leave is of critical importance.

Petitioner Daniel Coleman was one such worker facing a serious illness who sought to exercise his rights to medical leave. He was working for a Maryland court when his doctor ordered bed rest. After requesting medical leave, Coleman was fired the next day. He then filed a lawsuit alleging a violation of the FMLA.

After years of litigation, the Supreme Court rejected his claim for monetary relief. While the Court left the door open for workers like Coleman to seek injunctive relief such as reinstatement, such limited relief provides little incentive for employers to comply with the law from the outset, without the risk of monetary liability for violating the law. Additionally, few workers will have the resources to pursue costly, protracted litigation just to be reinstated.

Justice Kennedy’s plurality opinion was joined by Chief Justice Roberts and Justices Thomas and Alito. Justice Kennedy’s opinion acknowledged that:

[d]ocumented discrimination against women in the general workplace is a persistent, unfortunate reality, and, we must assume, a still prevalent wrong. An explicit purpose of the Congress in adopting the FMLA was to improve workplace conditions for women.

Yet the plurality concluded that the medical leave provision of the FMLA was not directed at gender-based discrimination, and therefore, Congress did not validly abrogate state sovereign immunity under the Eleventh Amendment under the “congruence and proportionality test” developed to analyze legislation enacted under the Equal Protection Clause of the Fourteenth Amendment.

However, as Justice Ginsburg’s forceful dissent makes clear, Congress did in fact collect an enormous amount of evidence of discriminatory workplace policies relating to family and medical leave. Congress found that women continued to face persistent sex discrimination relating to pregnancy and childbirth, even in the wake of the protections against sex discrimination and pregnancy discrimination established by Title VII of the Civil Rights Act of 1964, as amended by the Pregnancy Discrimination Act of 1978.

Justice Ginsburg’s dissent, which was joined by Justices Breyer, Sotomayor, and Kagan, asserts that “the plurality undervalues the language, purpose, and history of the FMLA, and the self-care provision’s important role in the statutory scheme.” The dissent recognizes that Congress enacted the FMLA pursuant to its power to address sex discrimination under the Fourteenth Amendment. Justice Ginsburg’s opinion explains that the FMLA offered leave on a gender-neutral basis rather than creating a special right to self-care leave for medical illness surrounding pregnancy, in part to avoid creating perverse incentives for further discrimination against women.

Notably, the Court refrained from overturning Chief Justice Rehnquist’s 2003 opinion in Nevada Department of Human Resources v. Hibbs. In Hibbs, the Court ruled that Congress validly abrogated state sovereign immunity pursuant to its Fourteenth Amendment authority with respect to the FMLA’s family-care provision. Hibbs made it clear that state workers can sue their employers for monetary damages for violations of the family-care provision of the FMLA. Writing for a 6-3 majority in Hibbs, Chief Justice Rehnquist concluded that Congress clearly intended to protect state workers from sex discrimination by providing job-protected leave to care for a family member.

Contrary to the legislative purpose of the FMLA, the Coleman decision establishes an unintended, unnatural distinction between the FMLA rights of public and private sector workers.  In the absence of additional protections set out by state law, state employers will not be held accountable for violations of the FMLA’s medical leave provisions to the same extent that private employers are held accountable.

The decision also establishes an unnatural distinction between the rights of public workers to take medical leave and caregiving leave. As the dissent points out, “It would make scant sense to provide job-protected leave for a woman to care for a newborn, but not for her recovery from delivery, a miscarriage, or the birth of a still born baby.” But by drawing a distinction between self-care and family care rights, the plurality has opened the door for such a nonsensical framework.

Sadly, the Coleman decision erodes the rights of millions of state workers who need leave to care for their own medical illness, injury, or pregnancy. The decision denies state employees access to a meaningful remedy when their employers violate the FMLA, and could force workers to choose between their health and their jobs. The decision must serve as an urgent call to policymakers to ensure that workers need not make that impossible choice.

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Home Care Workers Deserve Minimum Wage and Overtime Protections

Published on March 1, 2012 in Sarah Crawford and Workplace Fairness. 8 Comments

Director of Workplace Fairness

Every day, nearly three million home care workers in the United States help the elderly and people with disabilities get the daily assistance they need. These workers make it possible for those in need to bathe, get dressed, eat, take medications and more, all while allowing them to stay independent and healthy within the comfort of their own homes and communities.

Yet despite the invaluable assistance home care workers provide, too many are paid poverty-level wages and offered few benefits, which results in undue hardship for them and their families. Ninety percent of these workers are women, and nearly half are forced to rely on public assistance to make ends meet.

These unacceptable circumstances are in part due to a loophole created by the Department of Labor’s regulations interpreting the Fair Labor Standards Act. The existing regulations exclude home care workers from the basic minimum wage and overtime protections that cover most other workers. The exclusion has denied workers fair compensation and threatened families’ economic security for much too long.

That’s why we are so pleased that the Obama administration has proposed a rule that would put an end to the exclusion and provide some welcome and overdue financial security for millions of home care workers. The move will have a profound impact on these families while improving working conditions and the quality of care in an industry that is growing as the country’s population ages.

This is very good news for women, families and our economy, but the details of the rule have yet to be determined. Right now, the Department of Labor is accepting public comments on the rule to help define key provisions and its implementation. The deadline for submitting these comments is Monday, March 12th.

Considering what is at stake for home care workers and their families, it is critically important that the department sees that there is broad-based support for a strong rule that ensures minimum wage and overtime protections for home care workers. The National Partnership will submit comments on the importance of extending these basic rights, particularly for women and families. We urge you to join us by sending your own words of support for the department’s proposed rule here.

Establishing worker protections like this is critical for families and for the future of our country. The home care workforce has been grossly undervalued for much too long. This new rule will help ensure that millions of these women and men, who provide essential care to children, parents, grandparents and others in need, will be more fairly compensated for their critical work. It’s time.

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