Independent Women's Forum RSS feedhttp://www.iwf.orgThe RSS feed for the IWF. News, Commentary and Blog posts from the Independent Women's Foundation.(...)IWF RSS of the people who will 'lose coverage' under Obamacare repeal will choose to do so<p> The Congressional Budget Office has released <a href="">an analysis of the American Health Care Act,</a> the House-passed legislation to repeal and replace Obamacare. The CBO says the bill would reduce the federal deficit by $119 billion, result in 23 million fewer Americans being insured, and lower insurance premiums in the next 10 years.</p> <p> The Left have already predictably seized on the coverage effect: 23 million fewer Americans insured than projected under current law. This figure from the CBO is no surprise, but it needs some context.</p> <p> The CBO predicts 14 million fewer insured through Medicaid, 6 million fewer insured in individually-purchased plans, and 3 million fewer insured through employer-based plans.</p> <p> Like all budget projections, the CBO isn&#39;t just considering changes from today, but changes from what they believe will happen in the future. Therefore, the projected decrease in Medicaid coverage includes not only people who are currently in the program, but is based on the assumption that, if Obamacare remained law, more states would expand the program. Today, 31 states have expanded Medicaid; 19 states have not.</p> <p> It&#39;s worth remembering that the CBO can be wrong: The agency was <a href="">about 12 million off</a> on its projection of how many people would enroll in Obamacare&#39;s exchanges.</p> <p> The CBO is likely right that fewer people will have insurance coverage under any Republican plan that repeals Obamacare. After all, while the projection about individual policies attempts to take several variables into account, much of the change due to repeal would be people choosing to go uninsured in the absence of Obamacare&#39;s penalty. Lawmakers should keep in mind that the number of people with coverage, while an important metric<a href="">, isn&#39;t necessarily the right one to gauge the success</a> of any health reform law.</p> <p> For projections related to premiums, the CBO divided states into three categories: 1) states that would not seek waivers for major regulations on what insurance policies must cover or how they may be priced to different consumers based on health status, 2) states that would waive some of the regulations for what plans cover, and 3) states that would waive both the regulations on benefits and health- or risk-based pricing.</p> <p> The CBO says that premiums would be 4 percent lower in the first group and 20 percent lower in the second group. For the third group, they predict that &quot;average premiums for people who did purchase insurance would generally be lower than in other states &mdash; but the variation around that average would be very large.&quot;</p> <p> Wednesday&#39;s score was released just hours after <a href="">a new study from the Department of Health and Human Services</a> showed that Obamacare resulted in an average premium increase of 105 percent since 2013.</p> <p> Obamacare has failed to control costs. It certainly failed to deliver on the repeated promise of lowering the average family premium by $2,500. And while the list of covered services in plans today might be longer than before, we should recognize that not everyone wants or needs such robust (and costly) coverage.</p> <p> The majority of states (62 percent) saw average premium increases between 2013 and 2017 of more than 100 percent, meaning average premiums in most states have more than doubled. In two states (Alabama and Alaska), the average premium increase is more than 200 percent, meaning rates more than tripled.</p> <p> What did the CBO say would happen to premiums in 2009, when the agency was projecting the effect of Obamacare? Well, they got the direction right: They said <a href="">average premiums would be 10 to 13 percent higher in 2016</a>. Even this projection, though, failed to accurately predict that average premiums would in fact double.</p> <p> Considering all this, it&#39;s no wonder that Obamacare has been so politically divisive. Some families credit the law with helping them, but others are paying premiums as high or higher than their mortgage payments. It&#39;s a deeply personal issue for people.</p> <p> But the CBO score is just that: a score, a projection, a best guess from mathematicians who are working under a certain set of assumptions. It&#39;s an important part of the debate, but given the complexity of health insurance markets, may fail to accurately predict what changes lie ahead.</p> HeathThu, 25 May 2017 09:05:00 CSTen-usIndependent Women's ForumYes: Replacement would afford women better options, lower costs<p> Women make the majority of decisions about care and insurance for our families and we generally consume more health care than men. As a result, women have a lot at stake when it comes to the laws that govern American health care and insurance.</p> <p> In 2010, the Affordable Care Act, also known as Obamacare, made it illegal for insurers to charge women more than men and mandated that insurance plans cover women&#39;s preventive care, including birth control, with no copay.</p> <p> Therefore, some now suggest repealing the Affordable Care Act would be detrimental for women&#39;s health. But the opposite is true: Repeal will afford women greater choice and lower costs when it comes to insurance plans, doctors and care.</p> <p> ? The supposed benefits of the ACA have been oversold. No copay birth control sounds like a gift, but savvy shoppers know the difference between what&#39;s truly free and what&#39;s simply included in a larger cost.</p> <p> Rather than actually making birth control free, this provision forces women to pay for birth control without seeing the price. It&#39;s rolled into the cost of insurance premiums, which have increased dramatically due to the law &ndash; even if men and women now both pay equally high rates.</p> <p> The group that has seen the largest increase in costs under the ACA are women ages 55-64.</p> <p> Before the ACA, these women &ndash; outside their childbearing years &ndash; paid lower premiums and didn&#39;t have to buy costly maternity coverage.</p> <p> But now these women suffer from the flipside of the gender-equity coin; they are averaged with 55-64-year-old men, many of whom have high health costs.</p> <p> Further, some ACA plans provide coverage in name only: Oftentimes, the out-of-pocket costs are too high and the doctor&#39;s networks are too restrictive, meaning women and men in these plans don&#39;t always have access to the services they need.</p> <p> And importantly, the ACA took away women&#39;s choice in plans: Not only have the many regulations in the law limited what types of plans can be bought and sold, but overregulation has led to financial losses and insurer exits, leaving few choices for consumers. In one in three U.S. counties, ACA customers have only one option.</p> <p> Women deserve better. Repeal would entrust women with the choice to determine what coverage they want &ndash; or don&#39;t want &ndash; for themselves and their families. And removing Obamacare&#39;s regulatory burdens would reduce costs and entice more insurance companies to compete for our business, giving consumers more power.</p> <p> It should also be noted that support for repeal of the ACA does not equate with a desire of returning to the previous status quo.</p> <p> We would still need further health reform. For example, we need to move beyond our employer-centric insurance system to allow for greater portability in plans, lower costs and more choice.</p> <p> Women in particular need a strong market for individually purchased insurance plans as we are less likely than men to get insurance through work.</p> <p> Many women suffer from expensive health conditions and some may fear that without the protections in the ACA, they will be harmed. But no one wants a policy where people die for want of care and no one wants to see compatriots face financial ruin due to health costs.</p> <p> That&#39;s why the proposed replacement plan includes additional funding and protections to help people with pre-existing conditions. There are better ways to address this issue than the ACA approach.</p> <p> The fatal flaw in the ACA&#39;s treatment of women, like so many other big-government schemes, is its misguided premise that all women are the same and want the same things. This is wrong.</p> <p> Women and their families have unique, individual needs and preferences for health care and insurance. Repealing the ACA is the best first step to offering women &ndash; and men &ndash; the freedom to find and afford what they want in a robust, competitive marketplace.</p> HeathThu, 25 May 2017 09:05:00 CSTen-usIndependent Women's ForumPodcast #82 Cathy McMorris Rodgers on how the AHCA will affect citizens with pre-existing conditions<div> <div> <div> <p> IWF policy director Hadley Heath Manning interviews Rep. Cathy McMorris Rodgers, chair of the House Republican Conference on the plan to repeal and replace the Affordable Care Act, or ObamaCare. Hadley and the Congresswoman discuss the legislation that the U.S. House passed recently, the American Health Care Act, and specifically, they discuss how the plan would affect people with pre-existing health conditions.</p> </div> <div> <div> &nbsp;</div> </div> <div> <div> <div> &nbsp;</div> </div> </div> <div> <div> &nbsp;</div> </div> </div> </div> <p> &nbsp;</p> HeathTue, 23 May 2017 16:05:00 CSTen-usIndependent Women's ForumGlobal hack attack: It's time to safeguard systems to protect our information HeathSat, 20 May 2017 20:05:00 CSTen-usIndependent Women's ForumClear message to American allies in the mideast to unite and fight terrorism HeathSat, 20 May 2017 20:05:00 CSTen-usIndependent Women's ForumWhy do we need tax cuts in America? HeathSat, 20 May 2017 20:05:00 CSTen-usIndependent Women's ForumWhat needs to happen to address the core problems in our government spending? HeathFri, 19 May 2017 19:05:00 CSTen-usIndependent Women's ForumHadley Heath Manning On Health Policy, Medicaid Reform, And Miss USA<p> Hadley Heath Manning is a senior policy analyst and director of health policy at the Independent Women&rsquo;s Forum. Manning shares her insights on Medicaid, the recent healthcare debate, and common sense ways conservatives can improve their health policy messaging.</p> <p> Manning explained alternatives to the current incentives for spending at the state level. &ldquo;Medicaid needed reform before Obamacare. Obamacare made it worse in some sense,&rdquo; Manning said. &ldquo;What [the AHCA] would do is limit the Medicaid expansion that now states &lsquo;get money for spending money&rsquo; on Medicaid.&rdquo;</p> <div> <div> Ivanka Trump has brought working women and issues like paid maternity leave to the forefront of issues at the White House. &ldquo;I hope that Republicans can change their reputation as being stone-cold on these issues, only concerned about cost,&rdquo; Manning said.</div> </div> <p> <iframe frameborder="no" height="166" scrolling="no" src=";color=ff5500" width="100%"></iframe></p> HeathWed, 17 May 2017 19:05:00 CSTen-usIndependent Women's ForumAnother ObamaCare exit = fewer options = bad for consumers<p> <strong>Lawmakers need to pay attention to Aetna&#39;s latest decision involving ObamaCare. That&#39;s the advice of a senior health policy analyst with the Independent Women&#39;s Forum.</strong></p> <p> Aetna, the nation&#39;s third-largest health insurer, says <a href="">it won&#39;t participate in ObamaCare exchanges</a> in Nebraska and Delaware next year. The insurer had pulled out of several other states after losing nearly a half-billion dollars in 2016; this decision comes after projecting a $200 million loss this year.</p> <p> Hadley Heath Manning of the <a href="">Independent Women&#39;s Forum</a> points out Aetna has been reducing its participation in state-based exchanges &ndash; and not just because of financial losses.</p> <p> &quot;They announced a while ago they wouldn&#39;t participate in Virginia&#39;s exchange, and that time they cited some of their concerns related to the current legislation under consideration that just passed the House,&quot; says Manning, IWF&#39;s director of health policy. &quot;And of course this puts insurance companies in a difficult position because they&#39;re going to have to reconsider how they do business and what kind of plans they can offer depending on a variety of decisions that lawmakers at the federal and state level are making.&quot;</p> <p> That said, when Aetna announced this week it would no longer participate in any of the exchanges, it didn&#39;t cite uncertainty related to the law, but rather financial losses the company has experienced.</p> <p> &quot;If an insurance carrier can&#39;t make money in the exchanges, then it&#39;s not in their best interest to participate,&quot; Manning adds. &quot;We have to recognize that reality if we want to consider the best laws that are going to give consumers the most options and at the best prices.&quot;</p> <p> Other insurers have said as much in recent months. Some have also been fleeing exchanges, including Humana, UnitedHealth, and even Blue Cross Blue Shield in some cases.</p> <p> Over the two years, Aetna wanted to merge with Humana &ndash; and Anthem sought to merge with Cigna. <a href="">Both those mergers were blocked</a> by federal judges. OneNewsNow asked Manning if things would be different today had one or more merger been approved.</p> <p> &quot;The companies who suffered the financial losses were looking at mergers as a potential way to ward off some of their financial problems, and some people speculated that Aetna pulled out of some of the exchanges earlier as sort of revenge against the Obama administration for denying their merger request,&quot; answers Manning.</p> <p> &quot;I don&#39;t know that that&#39;s so much the case because when you&#39;re a customer, whether we have the big five or the big three or a handful of options,&quot; she continues. &quot;It really depends on where you live and what&#39;s available to you &ndash; and when you have consolidation in the health insurance market, that&#39;s another way that consumers face fewer options.&quot;</p> <p> So whether it&#39;s insurers exiting the exchanges altogether or merging with other big insurance companies, the bottom line for consumers is the trend toward fewer choices.</p> <p> &quot;And fewer choices means not only do we have fewer options in terms of plans, but our networks depend on what plans we get, our doctors are dependent on those networks, and for us it&#39;s about accessing care and the prices that we pay,&quot; Manning concludes. &quot;The trend has been bad for consumers regardless of what would have happened with those mergers.&quot;</p> HeathFri, 12 May 2017 10:05:00 CSTen-usIndependent Women's ForumWomen’s Mags need to stop fear-mongering mothers on AHCA<p> Parents Magazine wants you to freak out about the prospect of the AHCA becoming law. If you&rsquo;re a mom, ever hope to become a mom, or may someday be the partner to a mom, the AHCA is about to make your life more complicated and expensive&hellip; if you believe the mainstream media narrative.</p> <p> Boston Medical Center OB/GYN <a href="">Dr. Kristyn Brandi told Parents</a>, &ldquo;Things that are incredibly common for women, including C-sections, pregnancy and postpartum care, will all be considered preexisting conditions.&rdquo; Social media lit up with the rumor that sexual assault might even count as a preexisting condition.</p> <p> This &ldquo;information&rdquo; is a stretch at best. The AHCA still requires insurance companies to offer plans to everyone. No insurance company can turn you away outright.</p> <p> <a href="">Reason</a> explains that under the AHCA, &ldquo;states can apply for waivers&nbsp;that will allow insurance companies, under certain limited circumstances, to charge higher premiums to people based on their personal medical histories&hellip; [those states] must also set up special high-risk insurance pools to try and help defray costs for these people.&rdquo;</p> <p> For any medical condition to count as a preexisting condition, two criteria must be met:</p> <p style="margin-left:.5in;"> &bull;&nbsp;&nbsp; &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; The patient must have had a lapse in coverage (a period of being uninsured before buying a new plan.) If you have continuous coverage, you&rsquo;re in the clear.</p> <p style="margin-left:.5in;"> &bull;&nbsp;&nbsp; &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; The patient must live in a state that has applied for and received a federal waiver. This waiver allows insurance companies to look at preexisting conditions <a href="">if and only if the person has recently been uninsured</a>.</p> <p> Oh, and by the way? For any of this to go into effect, the AHCA would have to pass the Senate in its current form. Senate Democrats want the bill struck down because it strips some of Obamacare&rsquo;s major provisions. Under the AHCA, the individual mandate is abolished. In other words, you can choose to remain uninsured without paying that $695 tax penalty. However, should you choose to have a gap in coverage, insurance companies can charge you more when you buy insurance later on.</p> <p> Senate Republicans are cautious about the AHCA for different reasons. As soon as President Trump signs a GOP healthcare bill, the Republican Party effectively &ldquo;owns&rdquo; that issue &ndash; for better or for worse. When Democrats passed Obamacare in 2010, the electoral consequences were devastating: <a href="">Democrats lost 83 seats in Congress during the Obama presidency</a>.</p> <p> Republicans are rightly concerned that passing &ldquo;Trumpcare&rdquo; could similarly erase their Congressional majorities, if the law is anything less than a drastic improvement over the current system.</p> <p> Millions of people lost their insurance plans under the Affordable Care Act. The AHCA seeks to fix that problem by allowing states to waive the &ldquo;essential health benefits&rdquo; requirement that Obamacare put in place. Right now, you cannot legally purchase a plan that only covers catastrophic care. The AHCA could allow you to purchase a bare-bones plan &ndash; which is an appealing option for people who are young, healthy, and not exactly flush with cash.</p> <p> <span style="font-size:14px;"><strong><span style="color:#ffffff;"><span style="background-color:#ea425b;">If you were one of the lucky ones who kept your plan under the ACA, you still might be feeling the brunt of rising premiums. Here, too, the AHCA steps in. According to the Independent Women&rsquo;s Forum&rsquo;s Hadley Health Manning in&nbsp;</span></span><a href=""><span style="color:#ffffff;"><span style="background-color:#ea425b;">The Federalist</span></span></a><span style="color:#ffffff;"><span style="background-color:#ea425b;">, &ldquo;The Parents article fails to mention that the AHCA includes a universal, advanceable, refundable tax available to anyone making under $75,000 annually.&rdquo; If you shell out for a monthly premium, you get to save that money on your taxes.</span></span></strong></span></p> <p> Still, misinformation about the AHCA persists. Does ungrounded fear count as a preexisting condition?</p> HeathWed, 10 May 2017 10:05:00 CSTen-usIndependent Women's ForumParents Magazine Needs To Check The Facts Before Scaring Moms About Pre-Existing Conditions<p> A few days ago<em> Parents Magazine</em> published a <a href="">grossly distorted &ldquo;news</a>&rdquo; article on the House-passed American Health Care Act, which misinformed readers about the potential effects of the legislation and the state of health care today. This is extremely disappointing, considering families rely on this publication for factual information, not inaccurate rumors. Here are just a few examples of what they got wrong.</p> <p> Magazines Shouldn&rsquo;t Ignore Obamacare&rsquo;s Detriments</p> <p> First, <em>Parents</em> made no mention of the realities of the current health law&rsquo;s failure. Of course, some people have benefitted from the Affordable Care Act (ACA), also known as Obamacare, but many have also suffered, and more will suffer if the law is unchanged:</p> <p style="margin-left:.5in;"> &bull;&nbsp; <strong>Soaring premiums:</strong> Just this year, premiums increased 25 percent on average for those who buy the ACA plans. More than half (55 percent) of those ACA enrollees are women. Ironically, Parents drives home the point that higher premiums make it harder for people to afford insurance coverage. This is true, and it is already the case under the ACA.</p> <p style="margin-left:.5in;"> &bull;&nbsp; <strong>Cancelled plans:</strong> In fall 2013, 4.7 million Americans&rsquo; health plans were cancelled because they were not compliant with the ACA, and millions more have lost their plans in the years since. Many more will lose their plans if a new health care law is not passed now.</p> <p style="margin-left:.5in;"> &bull;&nbsp; <strong>Death Spiral:</strong> Sadly, one reason more and more Americans will lose coverage under the status quo is that, in the words of Aetna&rsquo;s CEO, the ACA is in a death spiral. Insurers are exiting markets because they can&rsquo;t operate under the ACA&rsquo;s rules. In fact, in one in three U.S. counties, women and families who enroll in the ACA&rsquo;s exchange plans have only one &ldquo;choice&rdquo; of insurer. As more insurers exit, there will be places where enrollees have zero options. Already, 16 counties in Tennessee face this problem for 2018.</p> <p> How the AHCA Helps People</p> <p> The Republican health plan isn&rsquo;t perfect, but it aims to help people who&rsquo;ve been badly affected by the ACA while also protecting those with pre-existing conditions.</p> <p style="margin-left:.5in;"> &bull;&nbsp; In contrast to the <em>Parents</em> article, the MacArthur Amendment does NOT &ldquo;allow states&hellip;&rdquo; to waive &ldquo;pre-existing condition coverage.&rdquo; All 50 states will require that every insurer offer a policy to every customer, regardless of his or her health status or history.</p> <p style="margin-left:.5in;"> &bull;&nbsp; States will be allowed to waive certain regulations. They can waive the &ldquo;essential health benefits&rdquo; required of every policy in the ACA. This means that if people want to buy coverage that is more basic&mdash;plans that also tend to be more affordable&mdash;they will be free to do so. It does not mean that carriers won&rsquo;t also continue to offer plans with ACA features, but it does give people a choice.</p> <p style="margin-left:.5in;"> &bull;&nbsp; States can also waive &ldquo;community rating&rdquo; rules, which would allow insurance companies to offer prices that reflect applicants&rsquo; health status or history that would affect the likelihood of future claims. This waiver program is aimed at lowering premiums, which will result in more people being able to afford to become and stay covered.</p> <p style="margin-left:.5in;"> &bull;&nbsp; In contrast to the Parents article, the AHCA actually WOULD require states to set up a high-risk pool safety net or participate in a federal safety-net program for those who delay applying until they have a high-cost condition. This <strong>is required </strong>of any state that wants to waive the &ldquo;essential health benefits&rdquo; or &ldquo;community rating&rdquo; rules.</p> <p style="margin-left:.5in;"> &bull;&nbsp; The <em>Parents</em> article fails to mention that the AHCA includes a universal, advanceable, refundable tax available to anyone making under $75,000 annually, and it will increase with age (because older people face higher insurance premiums). This means women and families (and men too) who buy insurance on their own will effectively get a reduction in their monthly premiums equal to the size of their tax credit.</p> <p> What &lsquo;Pre-Existing Condition&rsquo; Means</p> <p> The <em>Parents</em> article, like too many criticisms of health-care policies, conflates the concept of &ldquo;pre-existing condition&rdquo; with any factor that might increase insurance costs. There are many factors in insurance that may lead someone to have to pay more than another person, but that does not mean that he or she has a preexisting condition that makes him or her uninsurable.</p> <p> Women will NOT end up having to &ldquo;pay out of pocket&rdquo; for health care just because they&rsquo;ve had a pregnancy, or a C-section, or have been treated for postpartum depression, as a doctor quoted in the <em>Parents</em> article implies.&nbsp;Insurers will still offer them coverage&mdash;though they may have to pay more than those with the very lowest premiums if they delay applying for coverage or choose to change plans when they are already pregnant or in need of impending treatment. But importantly, many women will likely have more affordable options for insurance under the AHCA, allowing them to get a policy before they develop a condition or become pregnant.</p> <p> Women generally consume more health care than men do, which is why before the ACA, women&rsquo;s premiums tended to be higher. The ACA erased that difference, but everyone&rsquo;s insurance premiums soared because of the ACA&mdash;which was bad news for women, even if it was worse news for men. The AHCA will repeal many of the ACA&rsquo;s provisions, but it will not repeal the rule that insurers cannot offer someone a higher price just because of gender. <em>Gender-based pricing will still be outlawed.</em></p> <p> The AHCA does have protections for those with pre-existing conditions that might otherwise make them uninsurable, or extremely expensive. There are state-based safety nets, but there is also a federal safety net or guaranteed protection fund for those with pre-existing conditions, called the &ldquo;Federal Invisible Risk-Sharing Program.&rdquo; This program would allow people with pre-existing conditions to enroll in any insurance plan at the same price as everyone else; it simply allows insurers to pass along most of their premiums into the government fund, which would pay out for most of their claims.</p> <p> Parents and editors can learn more about how this provision works by reading<a href=""> here</a>.</p> <p> Readers deserve better than politicized misinformation from magazines like <em>Parents</em>.&nbsp;Tell the editors at <em>Parents Magazine</em> (<a href="">@parentsmagazine</a>) that readers who really care about health care and good outcomes for people want facts, not fearmongering.</p> <p> <em>Hadley Heath Manning is the director of health policy at the Independent Women&rsquo;s Forum</em></p> HeathTue, 9 May 2017 10:05:00 CSTen-usIndependent Women's ForumWhy the left should be weary of framing divide as Clinton Vs. Trump • After The Bell HeathFri, 5 May 2017 12:05:00 CSTen-usIndependent Women's ForumNot every health problem is a pre-existing condition<p> Several media outlets are seizing on a new narrative: They&#39;re saying the House Republican American Health Care Act that just passed the House would allow insurance companies to treat rape and domestic abuse as pre-existing conditions.</p> <p> The narrative isn&#39;t exactly true, but it points to a very important discussion in the world of health policy right now: What does it mean to have a &quot;pre-existing condition&quot; and how should our laws handle this issue?</p> <p> Supporters of the Affordable Care Act, or Obamacare, have intentionally confounded two things: a condition that makes someone &quot;uninsurable&quot; (another buzzword!) and a factor that indicates someone is likely to have higher than average health insurance expenses.</p> <p> This is why the Left and Right disagree so often about the scope of the problem of pre-existing conditions. The Right wants to focus on only those people who struggled to obtain insurance due to their pre-existing conditions. The Left, in an effort to make Obamacare&#39;s benefits seem applicable to more people, focuses on any risk factors that could contribute to higher insurance costs and calls those factors &quot;pre-existing conditions.&quot;</p> <p> For example, you may have heard that before Obamacare, being female was a &quot;pre-existing condition.&quot; No. Before Obamacare, women often paid more than men for health insurance because women generally consume more healthcare than men. In other words, insurance companies charged women more because they paid more claims for women, and insurers tried to offer premiums that reflected claim costs. This is the same dynamic that&#39;s at work in other types of insurance, like auto, except that it&#39;s men and younger people who tend to pay more because they tend to have more expensive accidents in vehicles.</p> <p> While this practice in health insurance might seem unfair to women or any higher-risk group, it actually helped balance insurance pools. Men don&#39;t want to pay more for insurance than they think they&#39;ll get out of it, and if we raise their premiums to match women&#39;s, some men are going to walk away from the offer, choosing to go uninsured instead. That means the pool of insured will be less healthy and more costly, pushing premiums even higher.</p> <p> That&#39;s exactly what happened with Obamacare. Obamacare made it so insurers basically had to charge everyone similar premiums, regardless of many risk factors. Predictably, younger, healthier (often male) people said no thanks. Cue the death spiral.</p> <p> The American Health Care Act won&#39;t repeal the prohibition on gender-based pricing in insurance, but it will allow states to get waivers from &quot;community rating,&quot; or the prohibition on all health-related risk-based pricing. This policy hopes to allow some states to stabilize their insurance markets by letting insurers offer lower prices to healthy people in an effort to get them to buy in.</p> <p> The wailing and gnashing of teeth from the Left is overwhelming. In an effort to grasp for the most egregious possible outcome, CNN and other media outlets are now claiming that this could result in some insurance companies treating rape or abuse as a risk factor or &quot;pre-existing condition&quot; that would result in a higher premium or even the denial of insurance.</p> <p> Yet this is really a red herring in the debate about how our insurance markets ought to operate. I could see how someone might think that insurers could flag rape or abuse as a risk factor, as survivors might have health needs down the road associated with the traumatic, heinous crimes committed against them. But everyone &ndash; including the insurance industry &ndash; agrees that survivors shouldn&#39;t be discriminated against for insurance. That&#39;s why the National Association of Insurance Companies issues guidance to their members not to use rape or domestic abuse as risk factors, and the industry follows this guidance. Furthermore, the practice is outlawed in all but a few states. These experiences certainly aren&#39;t &quot;pre-existing conditions.&quot;</p> <p> At the <a href="">Reason blog</a>, Elizabeth Nolan Brown digs up a <a href="">2009 PolitiFact investigation</a> showing no evidence of insurers charging higher premiums or denying coverage to survivors, and she points out important shortcomings in the few stories highlighted by CNN that were meant to serve as evidence.</p> <p> It&#39;s unfortunate that so much of the fear-mongering about the Republican health plan is aimed at women. It&#39;s not just the claims about rape or domestic violence, but there are other misguided articles claiming that pregnancy, c-sections, or post-partum depression will qualify as pre-existing conditions. These are meant to make women feel like they won&#39;t be able to get coverage, but that&#39;s not reality.</p> <p> In fact, returning to a situation in which insurers can actually offer tailored health insurance plans and take health factors into account will come with benefits for states who would pursue such waivers. Some seemed to want to celebrate Obamacare because men&#39;s premiums were the same as women&#39;s, but ignored that prices went through the roof for both. Absent these regulations prices will go down for both women and men, and there are special provisions designed to help make sure that those who face higher costs and health conditions will get the support they need.</p> <p> The bottom line is that we can all rest assured that the practice of denying insurance coverage to women simply because they are survivors of rape or abuse isn&#39;t about to come into vogue, regardless of what type of health reform ultimately becomes law. There are serious debates to be had about risk, insurance, and how to pay for healthcare. Scare tactics &ndash; like pointing to rape and abuse survivors as potential victims of some boogeyman &quot;war on women&quot; &ndash; don&#39;t contribute anything to these debates but unnecessary fear and misinformation.</p> HeathFri, 5 May 2017 07:05:00 CSTen-usIndependent Women's ForumPodcast #80 Should Medicaid Be Converted to a Block-Grant Program?<p> IWF&#39;s Charlotte Hays interviews IWF Director of Health Policy Hadley Heath Manning on block granting Medicaid to the states. Is this good policy?</p> HeathWed, 3 May 2017 12:05:00 CSTen-usIndependent Women's ForumTrump’s essential VA reforms bring transparency, choice to veterans<p> While Americans anxiously watch Congress debate the repeal of ObamaCare, President Trump and Congress are taking steps that will benefit millions of veterans who receive health care through the Veterans Health Administration (VHA). An extension of the 2014 Choice Program and the introduction of new accountability measures are two steps that are paving the way for even greater reforms to come.</p> <p> The ultimate goal of reforming the VHA should be to ensure that every American veteran gets the highest quality care available from the provider of his or her choice when he or she needs it. Furthermore, the VHA should be held to the highest standard of transparency and accountability.</p> <p> Sadly, reality is far from that goal today. It is an abomination that any veteran should have to suffer within a poorly managed bureaucracy, but in 2014, investigations revealed that 40 veterans died while waiting for care in the Phoenix VHA system on &ldquo;unofficial&rdquo; and manipulated waiting lists. Further investigations by the Veterans Affairs inspector general, Congress and the White House revealed that the problem was not isolated to Phoenix, but actually affected tens of thousands of veterans nationwide.</p> <p> As a response, Congress passed and then-President Obama signed the <a href="">Access, Choice and Accountability Act</a>, which created the Choice Program. Veterans who are unable to get an appointment within 30 days at a VHA facility or who live more than 40 miles away from a VHA facility can seek care at a private facility, and the law authorized funding to pay those private providers.</p> <p> The program has had mixed results: According to Sen. <a href="">John McCain</a> (R-Ariz.), <a href="">more than 1 million veterans</a> have received care at more than 7 million appointments with private providers, indicating that the need was there and that the program has successfully helped to address it.</p> <p> On the other hand, the Choice Program still faces implementation challenges in the face of a slow and cumbersome bureaucracy. Just as recently as 2016, reports from the Veterans&rsquo; Affairs (VA) Office of the <a href="">Inspector General</a> and the <a href="">Commission on Care</a> (created by the 2014 reform law) showed that structural problems still exist within the VA and further reforms are needed.</p> <p> President Trump&rsquo;s extension of the Choice Program will allow it to continue operating through early 2018, rather than expiring on August 7, 2017, during which time Congress can debate even greater reforms that would allow more veterans to more easily access care from the providers of their choice. The extension also includes provisions to speed up VA payments to private providers and encourage greater sharing of medical records.</p> <p> Ultimately, VHA facilities, like private facilities, should be optional to all veterans no matter where they live or how long their anticipated wait time. Studies have indicated that the care veterans receive at VHA facilities is high quality; it is simply the complex and disorganized administration of these facilities that makes them hard for veterans to navigate and can lead to poor outcomes.</p> <p> By allowing more veterans to go outside of the system for care, policymakers can hit two birds with one stone. This would connect more veterans with the care they need in a timely manner, and it would take volume off of an overburdened VA.</p> <p> This extension of the Choice Program isn&rsquo;t the only good news for vets: <a href="">The VA Accountability First Act</a> would (as the name of the legislation implies) empower the VA Secretary to remove, demote, or suspend any VA employee, including Senior Executive Service employees, for substandard performance or misconduct.</p> <p> The vast majority of VA employees &mdash; health providers and administrators &mdash; are honest, hardworking people. But basic accountability measures, like those that exist in the private sector, should be available to leaders to identify bad actors and hold them accountable.</p> <p> Americans should applaud these latest steps to improve the VA, the agency tasked with providing healthcare to some of our most honorable citizens, our veterans. If Congress and the president want to do even more for veterans, they will continue to pursue an agenda that increases transparency, accountability, and choice.</p> HeathWed, 3 May 2017 09:05:00 CSTen-usIndependent Women's Forum