Soon after the new year, a new presidential administration will take office. We’ll also have a new Congress, the 117th, with a Senate that currently consists of 50 Republicans and 48 Democrats – with two seats in the Georgia Senate to be set in runoff elections in early January – and the House of Representatives, which is made up of 222 Democrats and 205 Republicans exist, with 218 required to pass laws.
This new Congress, which will meet for the first time in Washington, DC, to be sworn in on January 3rd, must immediately address very important issues facing the country – the economy, the need for continued emergency chemical assistance, our crumbling transportation infrastructure and national security, as well as potentially the need to reach a budget agreement if none was successful by the end of 2020.
In addition, there are numerous topics on the agenda that affect women’s health, including affordable health insurance coverage, the continuation of telemedicine and telemedicine, the growing opioid epidemic, and differences in health care and treatment – and we must insist that our lawmakers are both incumbents and those new to Capitol Hill, take them seriously.
Affordable health care
The Affordable Care Act (ACA), which came into force in 2010, was the most important expansion of health insurance since the deaths of Medicare and Medicaid in the 1960s. The law has helped millions of American women gain access to medical care. It has also expanded benefits and improved free screening, including annual appointments for women, birth control, and mammograms.
Before the ACA, women could pay higher health premiums based on their gender alone – in fact, women were billed about $ 1 billion more than men per year for the same coverage. Women were often denied coverage after receiving treatment for pre-existing conditions such as pregnancy (including caesarean section) or breast cancer – even domestic violence was considered a pre-existing condition. Congress has included provisions in the ACA that end these discriminatory, predatory actions by insurers. According to the law, no one can be denied coverage because of their gender or a pre-existing illness.
Unfortunately, the ACA does not address all issues related to access to care – the costs are still often prohibitive. According to the law, those earning up to 400% of the poverty line are entitled to APTC (Advance Premium Tax Credit) subsidies to cover insurance costs. In 2020, 86% of people received such a grant under ACA plans. But even with that assistance, insurance premiums, deductibles, and co-payments are rising, making it difficult for many Americans to pay for their insurance and health care. This has resulted in many people opting out of registering for a plan.
President-elect Joe Biden wants to expand health insurance, cut costs, increase federal subsidies to plans to help more middle-class families and provide more Americans with access to quality care. It is too early to know exactly how the new Congress will react, but especially during a global pandemic, it is clear that aspects of the ACA need to be addressed directly.
Telehealth and Telemedicine
I recently wrote about how lawmakers must make telehealth, which is health care (clinical and non-clinical) delivered remotely through computers and mobile devices, a central policy issue. Earlier this year, the Centers for Medicare and Medicaid Services (CMS) temporarily expanded Medicare coverage for telemedicine visits to allow more Americans to access health care from their homes without exposing themselves or others to the risk of developing COVID-19 . Many private insurers have also chosen to waive or reduce these fees, although there are still co-insurance costs and deductibles.
Millions of Americans rely on telemedicine services, but as of October 1, many telemedicine services expired or were cut by private insurers. Telemedicine costs for Medicaid and Medicaid Advantage patients will remain in place until the public health emergency ends. However, the new Congress needs to review telemedicine rules to ensure that as many people as possible have access to safe health care, even when we are not around amid a global pandemic. Telehealth has become an integral part of quality health care. I urge lawmakers to put in place permanent laws that expand access to telehealth.
The opioid epidemic
It is no exaggeration to say that the opioid epidemic is a serious national crisis. Drug overdoses are a leading cause of accidental fatal injuries in the United States. 128 Americans die every day from overdoses with opioids, including synthetic opioids, prescription pain relievers, and heroin.
While drug addiction used to be seen as a conscious choice, it is now understood as a chronic brain disorder. Women in particular are hardest hit by the opioid epidemic. Women have more chronic pain than men and use prescription opioids in higher doses and for longer periods of time.
In 2018, Congress passed HR-6, the substance use disorder prevention act that promotes opioid recovery and treatment (SUPPORT) for patients and communities to address and hopefully end the opioid crisis. Implementation initiated a series of programs to deal with the crisis. The law also changed many previous pieces of legislation, focusing on welfare programs, public health and law enforcement, to help further manage the crisis.
Although great strides have been made in fighting the opioid epidemic, less attention and funding has been devoted to managing chronic pain. To ease America’s opioid addiction, lawmakers must also address the undetreated pain health crisis. HealthyWomen firmly believes that the implementation of SUPPORT requires congressional oversight. In September, HealthyWomen led a group effort of 33 organizations to send a letter calling on the U.S. Food and Drug Association and the National Institutes of Health to make new, non-addictive pain treatments a research priority.
There are differences in many areas of health care and treatment, from pain management to chronic diseases such as heart disease and cancer. Like the rest of American society, health professionals are racially biased. Because of this systemic racism, for example, black Americans have barriers to access to health care and poorer health outcomes than white patients.
People of color also have more problems accessing insurance than whites. Hispanics, for example, are two and a half times more likely to be uninsured than their white counterparts. The ACA filled some of the gaps in coverage, but Congress must continue to eradicate inequalities by further improving access to coverage and care for women and other uninsured people while addressing the systemic racism that is so widespread in the healthcare system.
To address these issues, Congress needs to express not only bipartisan support for initiatives that focus on women’s health, but also legislate to address systemic racism and inequality in our health care system.