Archive for the ‘health care’ Category

A bit of good news on marital status in health reform

AtMP is seeking volunteers to investigate all the ways that the new health reform law may reduce or increase differences in cost of coverage for married couples, unmarried couples and unmarried individuals. If you can help, please contact us!

We confirmed one piece of good news today: adult children won’t be kicked off their parents’ health plans just because they get married! Over the past few years, many states have required insurance companies to let unmarried adult children stay on their parents’ plans up to a certain age (ranging from 24 to 29), but most states allowed the twenty-somethings’ insurance to be terminated as soon as they got married. This has been a source of poignant entreaties from young lovers barred from the alter by illness. Now, as the New York Times reports,

Starting in September, adult children younger than 26 can be added to their parent’s health policy. Some plans already extend coverage to adult dependents as long as they are full-time students. Although Health and Human Services still must announce the exact eligibility requirements, Congress deleted a restriction related to marital status.

“We may see a loosening of requirements around who qualifies as a dependent child,” said Jennifer Tolbert, associate director of the Commission on Medicaid and the Uninsured for the Kaiser Family Foundation. “When they removed the requirement that a dependent child didn’t have to be unmarried, that was a signal to say, ‘We want this to a apply to a larger group.’ ”

This was so unexpected that we actually phoned the Kaiser Family Foundation for confirmation – and got it! KFF’s Chris Lee says that the reconciliation bill does permit married adult children to stay on their parents’ plans (however, it does not allow the adult child’s child (the plan holder’s grandchild) to be on that plan, and probably does not allow coverage the adult child’s spouse either).

A more personal update on AtMP’s hospital rights initiative

So far, 2010 has been quite an exciting year for me.

I primarily worked on the FHCDA campaign and was thrilled to find out it finally passed, after 17 years! All that hard work paid off. To continue on with AtMP’s focus on hospital rights in NY, I am helping organize presentations at Callen-Lorde and SAGE where Nicky and I will discuss the FHCDA, the importance of advanced directives, NY’s hospital visitation law and broader, nation-wide health policy issues. I’m also honored to report that we’ll be active participants of National Health Care Decisions Day, April 16th!

Be sure to check out our hospital rights page that features an updated map on states’ decision-making policies. Thank you efficient Internet mapping programs!

Hope you all are also enjoying 2010!

-Jessica, AtMP Communications Intern

Don’t like plus-one health benefits? Try minus-one!

In a jaw-dropping demonstration of what happens when institutions value their exclusive notion of marriage over everything else including health care, Catholic Charities of Washington, DC has announced that

Effective tomorrow, its employees will no longer be able to add a spouse to employee health benefit coverage. Spouses who are currently covered will continue to be covered.

Thanks to Professor Nancy Polikoff for bringing this to our attention, and for slamming it as unnecessary as well as cruel.

From an advocacy perspective, maybe there’s a silver lining: if more employers drop benefits for spouses and partners, there will be more couples throwing their political support behind single payer health coverage.

Hospital rights victory in New York

For over 17 years, New York has struggled to attain medical decision making rights for its patients. Not anymore! Just two days ago, New York voted YES on the Family Health Care Decisions Act! It’s been a long time coming!

The FHCDA helps protect people who don’t document their wishes. It gives family members and friends (including broadly defined domestic partners) the authority to make treatment decisions for incapacitated patients who have not signed a health care proxy or left specific oral or written treatment instructions.

Patients in NY now can have someone they love and trust visit them in the hospital make medical decisions for them, without regard to marital status!

For more information, read Governor Paterson’s press release.

Congratulations, New Yorkers!

Different-sex domestic partners pay more at Syracuse U.

Last year we noted Virginia‘s offer to let state employees share benefits with household members regardless of relationship, but charge them full price while deeply subsidizing benefits for spouses. Syracuse University now joins that unwelcome trend.

For several years, AtMP members and fellow Syracuse graduate students tried to persuade the University to provide inclusive domestic partner benefits. In late January, the University announced it was “including opposite-sex domestic partners in health care benefits and providing a $1,000 offset to a federal tax on same-sex domestic partner benefits.” Huh?

Obviously, domestic partner benefits are taxed as income regardless of the partners’ gender, while spouses’ benefits are tax-free. Syracuse’s calculations have nothing to do with federal law, and everything to do with valuing (or fearing) workers in same-sex relationships more than workers in unmarried different-sex relationships, and/or endorsing the idea that employees should marry for health benefits.

Exploring “marriage penalties” in health reform

Though it didn’t get much major media attention, several small and so-called conservative outlets have been complaining that the health reform bills moving (or not) through Congress are unfair to married people. AtMP tracks news about “marriage penalties” for two reasons: first, we oppose and look for ways to solve all forms of marital status discrimination, even when married people are disadvantaged; second, we’ve found that most discussions of “marriage penalties” are actually smokescreens for even bigger marriage bonuses – policies that reward people for marrying and disadvantage unmarried people.

The latest news on health reform follows the latter trend. In a nutshell: the bill creates a subsidy for people who have to buy their own insurance; in some cases that subsidy would be lower for a married couple than for two identical unmarried people because the eligibility threshold for a married couple is less than twice that for a single person.

Before getting into the details, take a moment to savor the Heritage Foundation’s position on whether this is just:

Proponents of the Senate health care bill might argue that these marriage penalties would reach their full effect only in situations where neither partner had employer-provided health insurance. It is true that married couples with employer coverage would face less bias; however, this defense of the bill remains weak because discrimination against marriage remains discrimination even if it does not fully affect all married couples. Such discrimination is unacceptable even in a single instance.

If only they had written “marital status discrimination is unacceptable even in a single instance!” But no, discrimination that puts married couples above unmarried couples, families and individuals is just fine to them.

Heritage hints at one aspect of the smokescreen effect: married people with employer-based insurance often get to put their spouse on their health plan at a much lower cost than if the spouse had to buy her/his own coverage.

Further aspects of the smokescreen are revealed in House Speaker Nancy Pelosi’s Mythbuster analysis, and the Center for American Progress Action Fund’s Wonkroom analysis. Both link the subsidy calculation to the way the federal government calculates eligibility for subsidies generally: married couples are assumed to share all of their income and expenses, unmarried people are assumed not to share any at all. At AtMP, we believe this use of marital status often results in unequal treatment of people who are in equivalent situations – some married people don’t share, many unmarried people do, and few people share 100%.

In addition to this ‘equivalency’ problem, using marital status to determine subsidy eligibility can also create a justice problem. Subsidies are directed to people with low and moderate incomes. The amount of money a couple might save by sharing resources is often much less than the amount they stand to lose in subsidies if they expose their relationship by getting legally married. That’s why we hear from so many people with disabilities who can’t get married because marrying would make them ineligible for affordable health insurance. When will Heritage take up their cause?

It probably doesn’t make sense to treat all people in relationships as if they were isolated individuals. Instead, we’d like to see a new way of determining which people have combined their income and expenses to create an economic unit that should be subsidized or taxed at a different rate than an individual. We’re collecting suggestions on how to do that – please post yours as a comment!

News roundup for the new year

Several AtMP members around the county used their winter holidays to scour the news for interesting stories about marriage and its alternatives. Here are just a few of the many worth talking about:

Ann was the first to spot the efforts of different-sex unmarried couples to be included in domestic partner coverage being offered to employees of the U.S. State Department. (Yay! if you have a connection to Mr. Howard or Ms. Ros-Lehtinen, please let us know!) According to the L.A. Times,

Supporters of extending benefits to unmarried heterosexuals include such key Congress members as House Foreign Affairs Committee Chairman Howard L. Berman (D-Valley Village) and the committee’s top Republican, Ileana Ros-Lehtinen of Florida.

Thomas was the first to point out the ironies of Karl Rove’s divorce, as Rove worked to build connections between the Bush II administration and religious/political figures who favored marriage promotion.

Stephanie was the first to share the news that Virginia’s statewide Advance Health Care Directive Registry is set to go live for individuals on February 17, 2010.

Marisa pointed out CNN’s approach to covering the “people get married for health insurance” story. Hardly news, but a good summary of the issues with lots of relevant and not too obnoxious comments.

I really appreciate AtMP members sending these tips, which always go beyond what I catch via key words on Google Alerts. I also pick up interesting news from other organizations’ email lists. Just before the new year, folks at Smartmarriages shared the Onion’s trenchant predictions on cohabitation, and Women’s Enews publicized fascinating legal reforms around marriage and divorce in Uganda and Nepal.

Possible plus-one benefits for VA state workers

Virginia’s Department of Human Resource Management is considering a regulation that would create plus-one health insurance for state employees. Sounds very exciting, but there’s a catch. Benefits for employees’ spouses would be paid for by the state, but employees who share their benefits with Other Qualifying Adults would have to pay the entire premium themselves, from after-tax dollars. Thanks to Meaghan for the tip and Pablo for the research!

(I’d really like AtMP to submit comments while this regulation is being debated, and help members in VA do so as well. But, year-end fundraising takes precedence over everything else on my desk. You can help AtMP focus on policy instead of funding by making a tax-deductible donation today!)

Two steps forward, one back for domestic partners

If you live in Washington DC you probably know this already, but it’s worth celebrating the fact that the DC Council decided not to shut down its domestic partnership registry. Congratulations and thank you to all the AtMP members who emailed the Council, and especially to Board Chair Meaghan Lamarre for testifying at the Council hearing.

If you follow health care reform, you might have heard that the House bill would end taxation of DP benefits (making them the cost equivalent of spousal benefits). Several news reports made it sound like this would apply only to same-sex domestic partners. This is a BIG peeve of mine. Why does the media (and the LBGT rights movement) consistently ignore people in different-sex partnerships (many of whom identify as B and T!)? Rest assured, the law applies equally to all partners. Many thanks to Pablo the intern for fact checking!

And thanks to Bruce and Marshall for bringing to my attention that domestic partners lost a legislative battle in Rhode Island. They sought the right to make funeral arrangements without being designated in writing in advance.

[Jan. 12, 2010 - a quick update: the RI legislature overrode the governor's veto on funeral arrangements.]

Totally aside, I’m fascinated that the phrase for ‘two steps forward, one step back’ in Afganistan is “Ten times we fought, two times we laughed.” Seems to me, 2-1 = 1, but 2-10= (-8). Another reason I’m grateful not to be in Afganistan.

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.

has been working to raise awareness about the impact of marital status on access to health care. For example, we submitted the attached comment on the Senate Finance Committee’s initial proposals in May, and started distributing the attached one-pagers to a variety of health care reform advocates in July. We also mobilize constituents on special issues; there are examples here: www.unmarried.org/health-campaigns.html Updates on these campaigns are featured here: http://unmarried.org/blog/category/health-care/

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