New York's Women's
Health and Wellness Act

By Bonnie Ann Gelback
Vice President, Communications of LIWA

Recently both houses of the New York State Legislature passed identical versions of a comprehensive women’s health bill which later was signed into law by Governor Pataki on September 17, 2002. These proposals (Senate S.6265 and Assembly A.3000) are referred to as the “Women’s Health and Wellness Act”. The act seeks to correct a gender insurance coverage inequality which up until now restricted women’s access to healthcare due to restrictive and/or financial reasons. As the New York’s Civil Liberties Union noted, every year women were spending 68% more money out of their pocket then men on health care. For example, certain health services are used primarily by women (i.e. gynecological/birth control services). “If insurers are able to exclude coverage of those services while covering comparable services used by men, … then women are effectively barred from equal access to health care coverage.”

Over the last three and a half years, several points kept the two houses at odds, preventing a women’s health bill from passing. The most hotly contended point was the inclusion of contraceptive coverage. This topic also stirred up strong opposition from the Catholic Church. The second sticking point was the issue of co-payments and deductible exclusions for mammograms and pap smears. Inclusion of these points were also strongly opposed to by the insurance industry. As a result, when an Assembly version of this bill passed in 2000 which included mammograms and cervical cancer screenings without co-pays or deductibles, and also included coverage for contraceptives without religious exemptions for providers or special riders; the Senate dropped the bill and instead announced the formation of a task force. Yet, at the same time a bill expanding men’s health coverage was passed by the Senate. It did pass at a time when one in eight men were developing prostate cancer, but at the same time one in eight women were developing breast cancer.

In a collaborative effort to pass the Assembly version of the Health & Wellness bill, LIWA [in conjuncture with some of our member organizations (i.e. Planned Parenthood of Nassau County, Planned Parenthood of Hudson Peconic, National Council of Jewish Women, and Adelphi NY Statewide Breast Cancer Hotline.)] joined a statewide coalition of 79 women’s health oriented groups. To break the stalemate, both houses finally agreed to adopt and pass a compromised version of each of their Women’s Health & Wellness proposals. The final bill requires employers and insurance companies to offer prescription drug plans that include coverage for approved contraceptive drugs and devices. However, the bill does include a narrow religious exclusionary clause which gives exemptions regarding the offering of contraceptive coverage to church institutions involved in teaching religion, and who are primarily employing and serving people of a faith that forbids contraception. Yet if contraceptive drugs are prescribed for other than contraceptive reasons they must be covered. Also, women who are employed at these work places can now get birth control needs met by third party providers at reasonable rates. The bill also stipulates that Catholic-owned hospitals, colleges and social services agencies are not to be exempt from providing coverage to their female employees.

The compromise bill also requires insurers to pay for annual breast cancer detecting mammograms for women beginning at age 40 (rather than at age 50 which is currently required). It should be noted that New York is the first state to lower the mandated coverage for mammograms to age 40. However, the act did not eliminate co-pays and deductibles for breast and cervical screening, but it did expand the funding ($500,000) to the Healthy Women’s Partnership program. This program is offered through the NY State Department of Health to assist low income women who cannot afford to pay the co-pays or deductibles. Additionally, for women who have a “first degree relative” with a history of breast cancer, health insurers and HMOs are now mandated to cover mammograms at any age .

Other major provisions of the compromise bill that became effective on January 1, 2003 are:

· Insurance carriers are required to cover the cost of pap smears in the detection and prevention of cervical cancer which still affects 1 in 117 women.

· Insurance coverage is mandated for bone density measurement and FDA approved drugs and/or devices deemed medically appropriate for the treatment of osteoporosis in order to aide the more than 10 million Americans that have osteoporosis, 80% of them being women.

Passage of this bill goes a long way to encourage early detection and the prevention of certain health conditions affecting women.

1/03