By Marieme Daff
Tuesday, July 9, 2002
The Republican-controlled New York Senate passed a bill that will require insurance of a wide range of women's health needs. Advocates hope the far-reaching law, passed after two years of sometimes bitter debate, will become a national model
NEW YORK (WOMENSENEWS)--A popular Republican state senator successfully broke a two-year-long stalemate over health insurance for women, making New York state the first to pass a comprehensive women's health bill.
John J. Bonacic, from the college town of New Paltz, managed to persuade the Republican-controlled state Senate to pass on June 17 the Women's Health and Wellness bill that requires insurance companies to provide coverage for contraception, bone scans, mammograms and Pap tests. The senate had rejected similar legislation for the past two years, although the Democratic assembly had approved the bills with large majorities.
"This needed to be passed," Bonacic said. "It was not fair that only 38 percent of women's health needs were covered while 68 percent of men's health needs were."
Women's health advocates, such as JoAnn Smith, president of Family Planning Advocates of New York State, Inc., applauded the bill, noting that it would help to ensure that women's health care needs are covered despite the whims of the insurance industry. "What the New York law does is remove the sometimes heavy hand of the insurance company from the debate," she said.
It could also help to level the playing field in terms of health care costs paid by women and men. Every year, women spend 68 percent more money out of pocket than men on health care, Smith said.
With this new bill, New York is now the first state to require insurers to pay for annual mammograms starting as early as age 40. Previously, the law required coverage for biannual screenings for women aged 40 to 49 and annually from age 50. Some women's health advocates believe that this change will increase the chances of early detection. According to the National Women's Health Information Center, breast cancer is the second leading cancer killer (after lung cancer) among women in America.
The new law also requires insurance carriers to cover the costs of Pap smears--a routine test that has proved effective in detecting and preventing cervical cancer. Cervical cancer still affects 1 in 117 women. In addition, the bill covers the costs of routine bone density scans--a test for osteoporosis-- which will directly affect health care for older women.
This bill "recognizes that women's health is not limited to contraception and that older women have health needs too," said Erica Smock, legislative counsel for the Center for Reproductive Law and Policy.
The National Institute of Aging reports that more than 10 million Americans have osteoporosis, and 80 percent of them are women. So far, only 11 other states have laws that mandate preventive care for osteoporosis.
Perhaps the bill's most widespread impact will come through coverage of contraceptive costs, which can total hundreds of dollars a year. Contraceptives are one of the most prescribed drugs for women--64 percent of women ages 15 to 44 use some sort of contraception--and cost an average of $24 a month. Yet, they are not always covered by insurance plans, forcing many women to pay out-of-pocket for their prescriptions.
The New York Assembly actually passed the Women's Health and Wellness bill in January 2000, but as the session closed, the Republican-controlled Senate dropped the bill and announced instead the formation of a task force to study women's health. The reversal was particularly stinging since immediately following the vote, the Senate swiftly mandated additional health insurance coverage for prostate screening and treatment.
During the past two years, the bill met strong opposition, particularly from the Catholic Church and the insurance industry.
The biggest problem in the negotiation process was the issue of contraception. While one of the top concerns of the advocacy groups was to limit employers' discretion on insurance coverage, their conservative opponents insisted on the implementation of a "conscience clause" that would exempt some religious employers from covering contraceptive costs. New York City's Cardinal Edward Egan personally lobbied legislators for an exemption in the law for religious organizations.
While the law does include such an exception, it is limited to religious organizations that primarily employ and serve members of the faith and does not extend to schools and hospitals owned and managed by religious groups. In limiting this exemption, women's health advocates believe that they have reached a fair agreement. Even with the clause, employees of these organizations would be able to purchase contraceptive drugs at a lower group rate.
"It took a long time," said Lynn Grefe, national director of the Republican Pro-Choice Coalition, which was actively involved in the negotiation process. "It was a real team effort--from women's health organizations to senators, we all worked together to make this happen--and today, we are thrilled."
As conservatives were holding up the law on religious grounds, the insurance industry also had its concerns. Joseph Luchok from the Health Insurance Association of America, a trade association representing 294 health care providers, said that businesses should not be forced to cover costs they cannot afford.
"It is like telling someone who goes to the grocery store that he has to buy a loaf of bread, no matter what," Luchok said. "Whether it is for contraceptive drugs or prostate screenings, we oppose all mandates. This is clearly a decision that needs to be made between the employer and the insurer."
This session, the bill, was passed by a wide bipartisan majority of 49 to 10.
"We looked at the bill as a prevention bill," said Lang Don, Bonacic's legislative counsel, "that would save millions of dollars."
The bill has elevated New York's status as being the most progressive state in terms of covering women's health care needs. While other states require insurance companies to provide coverage for contraception or mammograms, none has similar legislation covering such a wide range of women's health needs under the same law.
And many of the 19 other states that have already enacted laws that require comprehensive insurance coverage for contraceptives allow a larger conscience clause for those employers who wish to claim exemption for religious reasons.
The 19 other states are: Arizona, California, Connecticut, Delaware, Georgia, Hawaii, Iowa, Maine, Maryland, Massachusetts, Missouri, Nevada, New Hampshire, New Mexico, North Carolina, Rhode Island, Texas, Vermont and Washington.
Now that Albany has sent a clear signal, women's health advocates are hoping other states will follow suit. New Jersey is one of several states that has a limited law that mandates some contraceptive coverage, but some advocacy groups are confident that New York's neighbor will drop these limitations.
Advocates note that that new law is just one step in their pursuit of greater health care for women. In a 2001 report card on women's health the entire country received unsatisfactory grades. And although New York has shown some major improvements in various fields, moving up from rank 34 to 28, the Empire state still has a long way to go to attain a satisfactory grade.
"Legislative progress is just not enough to change the picture," said Jill Marieson, senior counsel at the National Women Law Center. "A lot needs to be done in terms of access to health insurance, quality of life and education."
Marieme Daff is a Women's Enews summer intern.
New York State Senate:
"Senate Passes Sweeping Women's Health Bills":
The National Women's Health Information Center:
Family Planning Advocates of New York State, Inc.
Women's Health Care and the History of Gender Inequity: