The Lose Your Benefits Bill
The Real Consequences of the Health Insurance Marketplace Modernization and Affordability Act; Women in Every State Will Lose Health Care Benefits
The U.S. Senate is considering a bill that would have a serious and damaging impact on health coverage for people across the United States. The Health Insurance Marketplace Modernization and Affordability Act (HIMMAA), introduced by Sen. Mike Enzi (R-WY) would allow insurance companies to ignore nearly all state laws that require insurance coverage for certain treatments or conditions, such as laws that require them to include contraceptives in their prescription plans. Rather than improving the health care system, this bill would do just the opposite — it would take away health care benefits that millions of people depend on. It is a good example of bad legislation, for which a more honest name would be the "Lose Your Benefits Bill."
State Laws that Protect and Improve Women's Health Will Be Lost
This legislation would raze hundreds of state laws that ensure patients get the medical care they need. Women specifically would lose protections they were guaranteed under state laws, including
- direct access to their ob/gyns, rather than being forced to be screened by their primary care doctors first
- fair coverage for contraception
- ability to stay with the same doctor throughout a pregnancy, even if that doctor is dropped by the insurance provider
Women in Every State Will Be Affected
This proposed legislation would allow many insurance plans to ignore state laws that require certain benefits to be covered, unless 45 states have enacted the same benefit protections. This means that women in every state could lose benefits they have come to depend on. For example:
- Women in Ohio may lose direct access to their ob/gyns, coverage for infertility treatment, and coverage for cervical cancer screenings.
- Women in New Hampshire may lose coverage for contraceptives, direct access to their ob/gyns, and coverage for maternity care.
- Women in Tennessee may lose coverage for osteoporosis screenings and direct access to their ob/gyns.
Equity for Women's Health Is at Stake
States have enacted protective laws to ensure that patients receive the quality health care and fair treatment they deserve. Women in nearly every state will lose the coverage they depend on. Unlike men, women often rely on both a primary care doctor and an ob/gyn for their basic health care. When managed care companies started limiting access to specialists, 38 states enacted laws enabling women to visit their ob/gyns directly without additional cost and delay. If this bill passes, these protections will be lost.
Even though contraception is basic health care for millions of women, insurance plans regularly refused to include it in their otherwise comprehensive drug benefits. In response to this inequity, 23 states now require plans that cover other prescription drugs to provide the same level of coverage for prescription contraceptives. Under this bill, these protections will be lost.
Laws that remedy inequities in contraceptive coverage have broad public support. Recent polls by Lake Snell Perry & Associates and the Kaiser Family Foundation show that more than three-quarters of voters favor requiring health insurance policies to cover contraception.
Women Will Lose Benefits that Improve their Health
The benefit protections that are at stake with this bill are not unnecessary or extravagant. They give women access to basic health care services, such as contraceptives, that improve their health and lives. This is an issue of basic fairness. A 1994 study found that women of childbearing age pay 68 percent more in out-of-pocket health care costs than men in the same age group in part because they must pay for birth control out of pocket. Birth control offers multiple health benefits, including prevention of certain cancers, endometriosis and anemia.
Women who visit an ob/gyn regularly are more likely to receive cervical cancer screenings, pelvic exams and HIV/AIDS counseling than women who do not. All of these are needed medical services that can save women's lives.
Health care is essential, and Congress should support efforts to protect patients, not endanger them.
March 15, 2006