HEALTH CARE/Joan Retsinas

Obamacare is a Victory for Women

From the start, I admit: I’m a woman. Biologically, hormonally, maybe psychologically (experts differ on those gender-based differences), I am female. So when I laud Obamacare, I laud it as a potential beneficiary. In addition, I have two daughters, two granddaughters. I’m not detached.

And I am ebullient: the Affordable Care Act will help women, a group that comprises more than half the American population, yet a smidgen of the Washington DC-based solons.

Let me detail the wondrous benefits.

First, health plans will recognize that women not just indulge in, but enjoy, sex. Plans will cover contraceptives (except for plans under the aegis of religious organizations that see sex primarily as a prelude to pregnancy). Women depend on physicians for access to the contraceptive spectrum: pills, patches, implants. Plans will give women access to physicians – and pay for that spectrum with no co-payment. To buy contraceptives, or have insurance pay, women don’t need to be married – a specter from the 1960s, when Bill Baird went to jail protesting states’ bars on contraceptives for women. Women will be able to sever the link between sex and pregnancy – something men have long been able to do.

Pre-Obamacare, insurers, particularly the “individual market” plans, did not need to cover contraceptives for women; and many did not. The men who designed the benefits package considered contraception to be women’s problem, women’s responsibility – as though men were absent phantoms.

Ironically, insurers didn’t regard men with the same mindset. Insurers, recognizing that men enjoy sex, have generally covered Viagra, Cialis, and the devices (vacuum suction pumps and penile implants) designed to help men have sex. The intent is not to facilitate procreation. Consider those pharmaceutical ads promising relief of erectile dysfunction: graying men are cavorting off with smiling women (most not graying). The ads don’t show pill-popping men comforting colicky babies at midnight. Insurers have also generally covered vasectomies (though not reversals). As for a double standard, insurers haven’t seen one.

Second, health plans will cover pregnancy. You would have thought that the pre-Obamacare insurers who rejected coverage of contraception would have eagerly covered pregnancy – a pro-natalist mindset. But plans were never required to cover pregnancy. Most company plans did (most companies employ some women); but the plans on the “individual market” often did not. The National Women’s Law Center looked at “individual market” plans: 12% offered maternity care.( Again, the designers of these plans considered men extraneous to pregnancy.

Under Obamacare, services for pregnant women are not optional.

Third, Obamacare nixes gender rating. Before Obamacare, states let insurers charge women more. In the National Women’s Law Center report, “Nowhere to Turn: How the Individual Market Fails Women,” researchers looked at insurers that “gender rate.” In some instances, twenty-five year old women ended up paying 45% more than 25 year-old men. Non-smoking women ended up paying more than smoking men. Perversely, in businesses that employed mostly women, women paid more.

Finally, Obamacare takes breast-feeding seriously, giving it more than lip-service support. We all know the benefits of breast feeding. Medical research stresses it. Pediatricians urge mothers to persevere for the first year.

But, realistically, most women work; they get no more than a few weeks of paid maternity leave. (Many women whose employers allow unpaid maternity leave cannot lose the income). Working women who want to breast-feed for a year must pump, generally at work – squeezing time into cramped schedules, squeezing themselves into cramped bathrooms. In this coming new world order, employers must offer women time to pump, a place to pump (not a bathroom), and insurers must pay for the pump.

As an American, I applaud President Obama for persevering with comprehensive health insurance. As a woman, doubly so.

Joan Retsinas is a sociologist who writes about health care in Providence, R.I. Email

From The Progressive Populist, November 15, 2013

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