Archive for the ‘health care’ Category
Think tank echoes AtMP’s health reform proposals
This year AtMP really stepped up its efforts to raise awareness about the impact of marital status on access to health care. For example, we submitted comments to the Senate Finance Committee in May, and started distributing fact sheets to a variety of health care reform advocates in July. It’s a daunting task: there are so many complicated aspects of health care, and so many organizations working on it. Just when I started to get discouraged, we achieved a dramatic success!
The Center for America Progress, a progressive think tank, incorporated several of AtMP’s policy recommendations at the end of its analysis about how the House of Representatives’ health reform package will help unmarried women.
While not on the table in the current debate, some additional policy proposals that would address the discrimination in health insurance coverage based on marital status include:
- Plus-one and/or household plans. Encourage or require employers and exchanges to treat two adults the same regardless of relation or marital status, which would allow unmarried women to support their loved ones just as married partners do.
- Domestic partners are provided coverage at many firms, but these should be defined broadly as same-sex or opposite-sex partners. Similarly, the definition of “family” should not be limited to an individual plus his/her spouse and dependents, but should include unmarried interdependent adults, such as domestic partners.
- COBRA. Employers are currently not required to provide COBRA continuing coverage to domestic partners or other adult nonspouses when the primary insured loses his or her job. Rather, all persons who were previously eligible under an employer’s plan should continue to be eligible under COBRA.
- Divorce and separation. Changes in marital status should not result in automatic loss of insurance for anyone covered as a dependent, unless both primary and dependent parties agree.
MVP and MIP on DP benefits for federal employees.
Last week the Senate committee on Homeland Security and Governmental Affairs held its hearing on the Domestic Partnership Benefits and Obligations Act. In comparison to the House hearing held this summer, the Q & A took wonderfully positive steps in the direction AtMP advocates: let every federal employee share employment benefits with one non-dependent adult, regardless of gender or sexual relationship.
Senator Sue Collins has been our Most Valuable Player on this bill for years; she consistently and sincerely raises the example of Maine’s inclusive domestic partnership registry and benefits for state employees (as opposed to the specious questions raised by Representative Chafetz in the House hearing). We are delighted to also give a Most Improved Player award to John Berry, the director of the federal Office of Personnel Management for responding to Sen. Collins that “You clearly have identified a fairness issue” and for promising that the federal government will look into the costs of extending more inclusive benefits. This is extraordinary progress over a just few months. For a good time, listen to their exchange at appx. 70:20 in this video clip.
Congratulations and a big thank you to all the AtMP members who have been working on this project, especially the fantastic team in Madison, Wisconsin who are committed to the crucial task of educating Representative Tammy Baldwin. Pablo the intern is trying to build a similar team of Connecticut residents to educate Senator Lieberman – can you help?
Bad news on hospital rights
Today we got terribly disappointing news from Lambda Legal: a FL court has dismissed the potentially ground-breaking case which we hoped would have created a legal basis for the widespread assumption that hospital patients have a right to visitation.
The court ruled that the hospital has neither an obligation to allow their patients’ visitors nor any obligation whatsoever to provide their patients’ families, healthcare surrogates, or visitors with access to patients in their trauma unit.
This is not a gay issue, nor a same-sex marriage issue, nor even an unmarried issue. Everyone who is concerned about patients’ rights should be outraged, and this court ruling should spark a statewide movement in FL at the very least, if not an addendum to national health reform legislation. We’ll be strategizing about what AtMP can or should do… suggestions welcome!
Arizona takes back gifts it gave unmarried couples
Among the news reports filtering in during Unmarried and Single Americans Week, it is upsetting to find that the state of Arizona has rescinded the domestic partnership benefits it had just recently extended to state employees.
Although DP benefits are often wrongly described as a “gay rights” issue, the article points out that more than 3/4 of the employees receiving benefits were in different-sex couples. That fits what we hear all over. In 2006 the NYC media reported that different-sex couples made up 3/4 of NYC registered domestic partners.
In fact, Pablo, the AtMP intern working on plus-one benefits for federal employees, discovered these facts about state employees:
- Washington State – The Human Resources Department reported a positive boost in recruitment and retention since instituting benefits for both same- and different-sex partners.
- Vermont – the earliest state to champion equal benefits for both same-sex and different-sex partners, it found initial, marginal increases in premium costs but ultimately saw no effect on state costs.
- New York State – covers over 4,880 employees’ domestic partners, and the majority of these are different-sex partners. New York reports that the plan has been easy to implement.
Unmarried, uninsured, out of luck?
Hunter, our demographic research intern, has put together some important, disturbing and highly motivating statistics.
Unmarried people are concentrated in economically disadvantaged categories. For example, unmarried Americans are disproportionately
- African-American: 69.1% of blacks adults are unmarried; 19.8% of all unmarried Americans are black.
- Women: 56.4% of unmarried adults are female.
- Young: 33.7% of unmarried adults are 18-29 years old.
- Poor or low-income: 14.7% of unmarried people aged 16 years or older live below the poverty level; 38.6% of unmarried households earn under $30K.
- LGBT: 100% of people in same-sex partnerships are currently counted as unmarried (though it looks like the Census will start crediting same-sex marriages soon!); of course, many bisexuals and transgendered people are married to different-sex partners, as are some people who identify as lesbian or gay.
Not coincidentally, the demographic groups that are most likely to be unmarried are also the same groups that get less health care, get sick more and don’t get well as much as other Americans. Making health insurance more affordable for unmarried people, and taking other measures to increase their access to care, could decrease disparities and increase health equity.
Unmarried workers disproportionately lack health insurance: 40.5% of the workforce is unmarried, yet unmarried people constitute 59.7% of all workers without coverage and only 36.4% of workers with coverage. The impact of marital status is even more pronounced among part-time workers, who more frequently lack coverage: 67.1% of uninsured part-time workers are unmarried. Unmarried people are also the majority (56.4%) of the unemployed uninsured. In all, 59.8% of uninsured Americans are unmarried.
Obviously, these stats do not mean that all unmarried people are out of luck, and clearly getting married would not solve everyone’s problems. But they should make you wonder, why aren’t health care reformers promising equal costs and access to all Americans regardless of marital status?
Do something about it! Download our free one-page fact sheet or tri-fold brochure “Why You Should Care about Barriers to Coverage for Unmarried People” and get it into the hands of the health reform advocate you admire most – be it your doctor, your state health coalition, your Congressperson, or the President. And let us know what they say!
Illegitimacy and advance directives in the news
I keep an eye out for news that affects the cultural context surrounding AtMP’s efforts to reduce singlism and marital status discrimination, as well as news about specific projects we’re working on. This week two aspects of the attacks on President Obama and his health care reform efforts caught my eye.
First, the over-publicized, utterly fabricated stories about the President’s birth certificate. How could that nonsense possibly be relevant to us? I have a Google news alert for “illegitimacy + birth,” and I’m concerned any time I see an increase in the use of that outdated combination of words. It’s worth remembering that the concept of illegitimacy was abandoned just a few decades ago, and that some people (who prefer divisiveness to diversity) keep trying to bring it back. AtMP has consistently spoken out against calling children “illegitimate,” from educating the conservative Washington Times in 2001, to chastising an anti-immigrant group in 2007. The current lies about President Obama don’t call for our intervention. But, it is nice to recall that (after being born in the U.S.) he was raised in perfect picture of family diversity, experiencing a single mother, an extended family household, a step-parent, and half-siblings with a variety of geographic and cultural origins. Just like so many of us!
Second, the mis-representation of a very small, very good element of health care reform – a proposal to help more people write advance directives. AtMP spends a lot of energy informing people that we all have the right to name our medical decision-makers and state our wishes through advance directives, regardless of our marital status. Too few people take advantage of this power, so we’re glad to see that Barack and Michelle Obama have written their advance directives, and that legislation might encourage more people to do so. Here’s how it’s explained at Salon.com:
The legislation would order Medicare to pay for consultations between patients and doctors on end-of-life decisions, which it currently doesn’t cover. But the consultations wouldn’t be mandatory; if your grandmother doesn’t want to go talk to her doctor about end-of-life care, she won’t have to. Because Medicare doesn’t pay for this kind of planning now, only 40 percent of seniors who depend on the government insurance say they have an advance directive that tells healthcare providers what measures they do and don’t want used to prolong their life, even though 75 percent say they think it’s important. The lack of planning actually costs a lot of money. Medicare spends billions and billions of dollars annually on expensive treatment during the last year of a dying patient’s life. Without allowing Medicare to pay for end-of-life consultations, it’s hard to know whether patients even want to go to such expensive lengths.
AtMP submits congressional testimony on DP benefits
Last week, thanks to the quick work of a new intern, AtMP submitted written testimony about domestic partner benefits for federal employees to the House Subcommittee on the Federal Workforce etc. In sum, we told Congress that
The Domestic Partnership Benefits and Obligations Act of 2009 offers an important opportunity to give unmarried Americans who work for the federal government better access to health coverage. However, by offering to include only same-sex partners, it falls short not only of the needs of federal employees but also of the standard set by competing employers.
The committee website also offers links to testimony by other organizations, labor unions and individuals.
This afternoon, we’re watching the webcast of the hearing. We had a brief moment of glee when Representative Chafetz of Utah expressed concern about discrimination against unmarried different-sex couples. Of course, the moment quickly passed when his comments made clear that he is more interested in “protecting” “traditional marriage” than recognizing family diversity. (Hear his comments roughly around 44 minutes and 1 hour 22 minutes into the webcast. Nonetheless, we’ll try reaching out to him to persuade him that discrimination is real and, unlike what Representative Baldwin said, not “easily cured” by getting married.
Federal employment benefits for whom?
A lot of cooks are stirring the pot these days, trying to cook up more inclusive federal employment benefits. I’m hoping they’ll ultimately dish out a truly satisfying dish that allows federal employees to define and take care of their own families.
Most recently, President Obama hinted that he’d let same-sex partners share benefits via executive order. AtMP members reacted quickly and strongly, sending him over 110 emails saying
All federal employees should be allowed to put one adult on their health plan along with their children. At a minimum, benefits should go to both different-sex and same-sex partners of government employees.
In fact, Obama changed only a few rules, not touching the big prize: the Federal Employees Health Benefits Program.
The executive branch believes it does not have the right to broaden the definition of family in its personnel policies.
The legislative branch has proposed both sweeping and targeted expansions. The Domestic Partnership Benefits and Obligations Act was re-introduced in both House and Senate in May. It would give same-sex partners blanket access to everything that spouses get. A more specific bill addresses benefits for foreign service officers.
The judicial branch is handling a case in which federal employees who married their same-sex partners in MA are suing for spousal benefits. Back in February a court decided in favor of a federal employee’s suit for benefits for his same-sex partner.
So far, all three branches look to be cooking up a thin broth that will be tasty only to people in same-sex married or marriage-like relationships. AtMP calls on all decision-makers, whether executive, legislative or judicial, to recognize that the real problem is treating conjugal (romantic, sex-based) relationships differently from all the other relationships in federal employee’s lives. We’d like to propose the Sergio A. Olaya Equal Benefits for All Employees Act, by which all federal employees would be allowed to put one non-dependent adult on their benefits plan along with their dependents. (And, we’d like to propose single-payer, truly universal health care!)
Care time: another face of discrimination in health care
I often check the New Old Age blog, because anecdotes suggest that unmarried people may be tapped (more than their married siblings or peers) to become caregivers for elderly parents. Today’s post caught my eye: families can write contracts to compensate the caretakers for lost income. That’s a good idea for people who leave their jobs entirely. But what about people who “just” take time off work to care for parents, siblings or anyone not their spouse?
I call “being able to take time off work to care for a family member without being fired” care time for short. Care time improves the health and economic well-being of workers and their families. Although unmarried people have real family care needs and responsibilities, they disproportionately lack care-time because
- their employers are allowed to penalize employees for taking care-time, or
- their employers are mandated to provide some kind of care-time, but are allowed to use marital status to determine which employees get care-time.
The Family and Medical Leave Inclusion Act would greatly improve people’s right to care for non-spouses. It would amend the Family and Medical Leave Act of 1993 to permit leave to care for a same-sex spouse, domestic partner, parent-in-law, adult child, sibling, or grandparent who has a serious health condition. Congress tried to pass it in 2007 but didn’t get anywhere. It was re-introduced on April 28th with more co-sponsors, and is now in committee.
A related proposal, the Family Leave Insurance Act would provide up to 12 weeks of paid leave benefits to workers who need to care for an ill family member (child, parent, spouse, domestic partner, grandchild, grandparent, or sibling) or new child, to treat their own illness, or to deal with an exigency caused by the deployment of a member of the military.
AtMP is seeking a volunteer to track the progess on these bills and help us further develop our care time strategy. Though I love to meet our volunteers, this work can be done anywhere via phone and email. If you’re interested, please post here or send me an email.
More about the NY Family Health Care Decisions Act
Tuesday was a successful and educational day in Albany. AtMP co-founder Marshall Miller and I met with nine state lawmakers and/or their legislative staff, and met dozens of fellow members of the Family Decisions Coalition. In total, Coalition members visited 59 legislators.
We learned a great deal about the Act and its history. Most important: it does provide a challenge mechanism for potential surrogates, so we revised AtMP’s recommendations.
Most incredible: the Act has been proposed every year for the past 16 years! This year it has the best chance of passing, because most key factions have been mollified. For example, one faction had long opposed giving domestic partners the same status as spouses. In recent years, however, bills on hospital visitation and burial that treat domestic partners and spouses equally have successfully passed both houses and been signed into law.
Nicky at NY state capitol building to support passage of FHCDA
