“If we want to achieve true equality for women … we have to reform the system. The status quo is unacceptable. It is holding women and families back, and we know it.”

— First Lady Michelle Obama

First Lady Michelle Obama’s recent national call to action underscored the importance of health care reform as a women’s equality issue. Every day, women live in fear that they can be denied health coverage because they had a Caesarean section or because they are a survivor of domestic violence. They have to deal with the fact that insurance companies can charge them higher premiums than men – even while they earn only 77 cents to the dollar compared to men.

We’ve been saying it for what seems like a long time now: Women are ready for health reform that addresses their specific health care needs and the challenges they face in getting care. The America’s Healthy Future Act – currently being debated in the Senate Finance Committee – meets some of these needs and contains some important promises. But we’re not going to be happy until there are several key improvements.

Let’s give some major credit where it’s due: the Act takes important steps to fix the broken system. It includes a new structure through which every person could ultimately get coverage, it ends insurance discrimination that women face in the individual market by eliminating gender rating and pre-existing condition exclusions, and it ensures that health plans cover certain basic health care needs, including maternity coverage.

Yet the bill fails miserably when it comes to making coverage affordable for those who need it most. Senator Baucus has agreed to amendments that would mean that a family of three making $27,500 per year could face premiums and out of pocket costs totaling almost 20 percent of their income. A family of three earning $36,620 could face health costs reaching almost one-quarter of their income. Yet, despite facing such high costs, under this plan these families would not escape the penalties of the individual mandate. The Committee should adopt amendments that would devote additional funds to increasing subsidies and providing cost-sharing protections for lower-income individuals.

To protect all women from discrimination, the insurance reforms included in America’s Healthy Future Act – such as those that would permit premium rating only on the basis of age, family size, geography and tobacco use – must be extended to the entire group market and not just the individual and small group markets.  Failing to do so would ultimately penalize businesses that outgrow the protections of the small group market even by a single employee – leaving these moderately-sized businesses without protection from harmful insurance industry practices such as gender rating.  The Committee should adopt changes that would immediately provide these basic protections to the entire group market.  

Finally, it’s disappointing that the bill singles out abortion for different and unfair treatment.  Such treatment discriminates against women, harms women’s health, and further stigmatizes this basic health need.  The Committee should oppose any amendment that would result in a ban on private insurance plans from including abortion coverage or other amendments to make the provisions in the Chairman’s bill even more restrictive.

Every day, women must live with the serious realities of how this broken health care system affects their lives and their families. And that’s why women need to make sure their voices are being heard. The National Women’s Law Center is organizing women across the country to remind their Members of Congress that women need health care that meets their needs. The message? Work quickly to improve the bill, and move it forward. We’ve waited long enough.