The Affordable Care Act (ACA) is an unprecedented opportunity to change systemic inequities in access to health care. Nineteen million women under the age of 65–20 percent of all women–do not have health insurance. These women are often denied the basic human right to health care due to limited access to affordable, quality care. Low-income women, women of color and immigrant women, whose right to essential reproductive health care is already limited by politics, are most acutely at risk.

Women stand to benefit tremendously if implementation of the ACA at the state level is inclusive of women’s essential basic and reproductive health needs, is widely understood by women themselves, and is accessible and inclusive of women from all backgrounds. Ms. Foundation grantees are working in five precedent-setting states (Colorado, New York, Oregon, Washington and West Virginia) to ensure that women in those states have access to health care. The work in each state tackles obstacles faced by particular communities of women. Grantees are sharing both challenges and successes – creating models for policy change and pioneering innovative outreach strategies to share with advocates across the country working to ensure that women are able to enroll in ACA exchanges.

ACA: Ms. Foundation Grantees at work

COLORADO: Ensuring Latinas Are Covered

ColorLatinaCOLOR (Colorado Organization for Latina Opportunity and Reproductive Rights) is working to help Colorado Latinas understand how health care insurance, the Affordable Care Act and Medicaid expansion can impact their lives. Through community organizing and public education, COLOR is arming Latinas with the information they need to understand the benefit of investing in their health through insurance coverage, and linking them with community navigators so that they receive culturally competent help to enroll.

COLOR is also playing an important monitoring and advocacy role by working to ensure both the Colorado State Exchange Board and federal Health and Human Services rules protect women’s health services, and including reproductive health care as essential care. Staff members serve on two advisory groups to the Exchange Board, provide extensive support around cultural sensitivity to the Colorado state’s navigator program, as well as provide feedback and recommendations on successful messaging for outreach and marketing efforts to Latinas.

NEW YORK: Reaching Out to All Families

RWV2Raising Women’s Voices – New York (RWV-NY) is helping all women and their families get the health care they need, both by advocating for coverage of the full range of reproductive health services – including abortion – and by working to ensure that eligibility, enrollment and consumer assistance policies and programs are user-friendly for diverse groups of women seeking to obtain health coverage through state exchanges.

In the past year, RWV-NY has successfully advocated for joint enrollment and application of tax credits for non-traditional families, such as those headed by same-sex couples or those headed by family members who are not biological parents. Through their efforts and collaboration with other partners, the New York Health Benefits Exchange staff members have indicated that same-sex married couples will be able to enroll into the same health care plan as a family. RWV-NY’s inclusive advocacy and outreach efforts are helping to make health care coverage more accessible for all women throughout New York – especially low-income women, women of color, immigrant women, young women and LGBT people.

OREGON: Developing Model Policies for Women’s Health

OFRHOregon Foundation for Reproductive Health (OFRH) is working to secure preventive reproductive health as a core component of primary care, by ensuring that it is an accepted standard, a covered benefit, and a required outcome measure for all Coordinated Care Organizations (CCOs) and health insurance plans in the Oregon Health Insurance Exchange, Cover Oregon. Additionally, OFRH is educating and mobilizing women to validate the demand for preventive reproductive health as a standard part of primary care and to understand how the Affordable Care Act (ACA) may benefit them.

Taking a two-pronged approach to address the gap in access and the fragmentation of women’s health in health care delivery, OFRH has launched a simple yet innovative policy solution to integrating reproductive health into primary care by establishing the ONE KEY QUESTION® Initiative as an emerging best practice (http://www.onekeyquestion.org). OFRH also is working to ensure preventive reproductive health is incorporated into all appropriate areas of health care reform policy (i.e. primary care home standards) and legislation.

WASHINGTON: Ensuring Access to Abortion Coverage

NOHLANorthwest Health Law Advocates (NoHLA) and its partner Washington Community Action Network Education and Research Fund (WA-CAN!) are working to promote women’s health and reproductive justice as Washington State implements the Affordable Care Act (ACA). Together, NoHLA and WA-CAN have fought to ensure that health reform lives up to its promise for women. After conducting surveys and focus groups to assess women’s needs, the two groups prioritized their work toward ensuring affordable coverage for low-income women, comprehensive services for all women, and women-friendly policies and procedures in the health system.

 

WashCanPlanned Parenthood Public Policy Network of Washington’s (PPPNW) is building the grassroots support necessary to pass and implement the ACA policies that have been developed in coordination with NoHLA and WA-CAN. A primary policy and advocacy goal of PPPNW has been the Reproductive Parity Act, which specifically focused on requiring insurance plans in Washington covering maternity care to also cover abortion, to ensure that women have the freedom and privacy to make the pregnancy decisions that are best for themselves and their families.

In working on this issue, PPPNW successfully convinced every insurance carrier in which they were included as a network provider to include abortion coverage in their 2014 plans. As a result, the women of Washington will have access to the health care they need. Advocates will continue to fight for passage of the Reproductive Parity Act – one of the few examples of proactive reproductive health legislation in the country – so that insurance companies do not have the option of cutting abortion coverage in the future.

WEST VIRGINIA

WHF-12-015 DecalFinalWest Virginia FREE has had a particular focus on ensuring that rural women are able to enroll in the new health insurance exchange created under the Affordable Care Act (ACA) and that health care coverage in the state includes the full range of women’s reproductive health services. In the past year, they successfully fought against legislation that would have eliminated abortion coverage in the state exchanges, taught students biased information about reproductive health, limited when women can receive abortion, and imposed criminal penalties for pregnant women grappling with addiction issues.

Additionally, West Virginia FREE, in partnership with West Virginians for Affordable Health Care, conducted statewide town halls to focus on health care reform and Medicaid expansion for women. They also co-organized and sponsored “Enroll WV” – a statewide conference that brought together over 250 health care providers, nurses, health administrators, nonprofit members and allied professionals, to begin structuring Medicaid expansion that will benefit women.


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