Policy & Practice : Can't get enough Policy & Practice? Check out our new podcast each Monday.


Women's Health Is Up for Debate

Women's issues made their way to the forefront of the health reform debate in Washington. House Speaker Nancy Pelosi (D-Calif.) asserted last month that women have the most to gain under health reform. On her Web site, the speaker said, for instance, that women are charged up to 48% more than are men for individual health insurance. The version of health care reform that Rep. Pelosi favors would forbid insurance companies from using “gender rating” to charge women more for the same coverage. It also would make maternity care an essential service required in all insurance plans that participate in the health insurance exchanges that are proposed in some bills in Congress. Currently, only 14 states require maternity coverage in policies available on the individual market, and most policies available to individuals do not include it, according to the speaker. Rep. Pelosi's report did not mention abortion, but that issue loomed large in the reform debate. Abortion opponents slammed health reform bills for not explicitly banning public funding for abortions. They also decried inadequate discrimination protection for health care providers who refuse to perform abortions because of moral objections.

Economy Affects Family Planning

Nearly half of women aged 18–34 years said they planned to delay having children or have fewer children because of the economic downturn. The Guttmacher Institute's national, Internet-based survey of 947 women, conducted this summer, found respondents concerned that they wouldn't have the financial means to raise their children if they got pregnant. All the women surveyed were in families with incomes less than $75,000, and 44% said they were cutting back their plans for having children. Financial worries also made some women more careful about getting pregnant. About 29% of respondents said they are more careful to use birth control every time they have sex. Forty-six percent, saying they didn't want more children, reported that they've considered sterilization because of the economy. But the surveyors also discovered that the economy is causing some women to use birth control inconsistently. For example, 4% of women who use oral contraceptives reported skipping pills, 12% said they had delayed getting a prescription filled, 11% had gone off the pill for at least a month, and 8% said they were getting fewer pill packs at a time.

Routine Deliveries Declining

The number of routine, uncomplicated births is dropping, according to data released by the Agency for Healthcare Research and Quality. Although the number of hospital stays for childbirth climbed 16% in the decade ending in 2007, the number of stays for women with “normal” or “uncomplicated” births dropped by 43%, from 544,000 stays in 1997 to 312,000 in 2007. In contrast, hospital stays increased 107% for births by women with previous cesarean sections (to 562,000), 28% by women with high blood pressure that complicated their pregnancies or childbirths (to 235,000), and 22% by women with increases in perineal trauma during childbirth (to 868,000). However, some complications declined. Hospital stays for women who had umbilical cord complications dropped 15%, from 259,000 in 1997 to 219,000 a decade later. The data come from the 2007 Nationwide Inpatient Sample, part of the agency's Healthcare Cost and Utilization Project.

Sister Study Enrolls 50,000th

The National Institutes of Health has enrolled 50,884 women to participate in its study of those with sisters who had breast cancer. The Sister Study was launched in 2004, and this year reached a milestone when it enrolled more than 50,000 women. The 10-year study of environmental and genetic factors that influence breast cancer risk examines why some women who appear to be at increased risk don't develop the disease. Participants are asked to complete brief yearly updates on their health and to share more detailed information on changes in health, jobs, and lifestyle every 2 or 3 years. Approximately 900 participants have reported being diagnosed with breast cancer since 2004. For those women, the researchers are collecting additional information about diagnoses and treatments. For more information, visit the Web site

State Bans Insurance Gender Bias

It will soon be illegal for health insurance companies in California to charge higher premiums to women based solely on their gender, thanks to a new law signed by California Gov. Arnold Schwarzenegger (R) last month. The law closes a loophole that allowed insurers to charge women more if the companies could point to specific actuarial data. The law eliminates the exception for all insurance contracts issued, amended, or renewed on or after Jan. 1, 2011. Only 10 other states ban this practice, called gender rating, in the individual insurance market, and two states limit it, according to the National Women's Law Center.

Next Article: