Health Care Reform

Senator Mikulski Puts Women First in Health Care Reform Debate

WASHINGTON, D.C.–(ENEWSPF)–December 1, 2009.  U.S. Senator Barbara A. Mikulski (D-Md.), a senior member of the Health, Education, Labor and Pensions Committee, today put women first in the health care reform debate by introducing as the first amendment to The Patient Protection and Affordable Care Act a measure to guarantee women access to preventive health care screenings and care at no cost.

“For many insurance companies, simply being a woman is a pre-existing condition,” Senator Mikulski said. “Women pay more and get less. My amendment guarantees access to preventive screenings for the number one killers of women – heart disease, cancers and chronic conditions like diabetes – to save lives and save money.” Senator Mikulski’s amendment would require all health plans to cover comprehensive women’s preventive care and screenings with no copayments. Under her amendment, all women would have access to the same baseline set of comprehensive preventive services similar to those of federal employees and Members of Congress enrolled in the Federal Employee Health Benefit Plan. This is an essential protection for women’s access to preventive health care not currently covered in other prevention sections of The Patient Protection and Affordable Care Act.

“I believe that the health care reform bill before us is an excellent bill,” Senator Mikulski said. “It expands access to 94 percent of Americans, ends punitive practices of insurance companies, stabilizes and makes Medicare secure, and bends the cost curve through new quality and prevention measures. However, as I reviewed the bill, I felt we could do more to enhance and improve women’s health care. That’s what my amendment does.”

Services covered under the amendment are based on guidelines supported by the Health Resources and Services Administration and the Centers for Disease Control. Services that would be covered under the Mikulski Amendment are likely to include cervical cancer screenings for a broad group of women; annual mammograms for women under 50; pregnancy and postpartum depression screenings; screenings for domestic violence; and annual women’s health screenings, which would include testing for diseases that are leading causes of death for women such as heart disease and diabetes.

“My amendment guarantees screening for breast cancer – yes, mammograms,” Senator Mikulski said. “We don’t mandate that you have a mammogram at age 40. What we say is discuss this with your doctor, but if your doctor says you need one, my amendment says you are going to get one. Studies have found mammogram screening decreases breast cancer among women by more than 40 percent.”

For a summary of the bill, go to:

View the amendment at:

Senator Mikulski’s prepared remarks follow:

“I rise today to introduce a very important amendment that guarantees women access to life saving preventive screenings and care. This amendment also eliminates one of the major barriers to accessing care – cost – by getting rid of high copayments for preventive services. This amendment is important because it will save money and save lives by reducing the top diseases killing women today.

“Today, according to the Centers for Disease Control (CDC), the top killers of women are cancer: breast, cervical, colorectal, ovarian and lung, and heart and vascular disease. And silent killers if they go undetected like diabetes. For these killers, we have screenings at no cost that are proven to detect these diseases early. Guaranteed access to these screenings will save money and save lives.

“Yet, women often forgo these critical preventive screenings because they can’t afford it or their insurance company won’t pay for it. Many women right now don’t have insurance at all. Seventeen million women are uninsured. That’s about one in five women. Or if they do have insurance, they have to pay large out of pocket expenses.

“Three in five women have problems paying their medical bills. Women are more likely than men to neglect care or treatment because of cost. Fifty percent of women report they delay or go without needed health care because they can’t afford it. Women of childbearing age incur 68 percent more out of pocket health care costs than men.

“Women are often confronted by the punitive practices of insurance companies. We face gender discrimination. We pay more and get less. For many insurance companies, simply being a woman is treated as a pre-existing condition, whether it’s maternity coverage or preventive screenings.

“A 40-year-old woman is charged anywhere from two to 140 percent more than a 40-year-old man with the same health status for the same insurance policy. A 25-year-old woman is charged up to 45 percent more than a 25-year-old man.

“My amendment guarantees access to critical preventive screening and care for women to combat their number one killers and provides it at no cost. This amendment eliminates a big barrier of high copayments.

“Preventive services covered would be based on guidelines supported by the Health Resources and Services Administration. This means all women will have access to similar preventive services that we women in Congress and federal employees have.

“The pending bill doesn’t cover key preventive care for women, such as annual women’s health screenings for women of all ages that focus on women’s unique symptoms, health needs and the impact of chronic illness on women. Of the 15.7 million people with diabetes in the United States, more than half, 8.1 million, are women.

“Heart disease is the leading cause of death for women. Every year, 267,000 women die from heart attacks and 31,837 women die from congestive heart failure. Yet, women are generally unaware of their risk for heart disease and receive few of the recommended preventive services. My amendment would ensure heart disease screenings for women as part of an annual women’s health screening. That keeps the unique symptoms women exhibit for heart disease in mind. Let’s remember the famous study, take an aspirin a day to keep the heart attack away. This study was done on 10,000 male residents. Not one woman was included, which is why we need a separate set of preventive guidelines focused on women.

“My amendment also guarantees screenings for many cancers like breast, cervical, ovarian and lung. Studies have found mammography screenings decrease breast cancer deaths among women in their 40s by over 40 percent. Every year, more than 40,000 women die from breast cancer. Regular pap tests have proved to reduce cervical cancer with death rates by 20 to 60 percent. This year, more than 4,000 women will die from cervical cancer.

“My amendment focuses on women’s health and women’s unique health needs. Keeping a woman healthy not only impacts her life, but it impacts her ability to care for her child and her parents. Early detection saves money, too, by treating diseases early. Screening tests for breast and cervical cancer cost about $150 annually per woman. But the cost of treating advanced breast cancer is over $10,000 on average and over $13,000 for treating cervical cancer. Finally, my amendment would cover family planning services.

“My amendment also leaves the decision of which preventive services to receive between the doctor and the patient. The health reform debate has focused on what you should have and when. We agree that these decisions should be made in a doctor’s office, not a Congressional office. The decision of what is medically appropriate and medically necessary is between a woman and her doctor.

“That’s why I support an overall health reform bill that provides universal access to health care for everyone, ends the punitive practices of insurance companies, stabilizes and strengthens Medicare and improves the quality and public health of all Americans in a well paced, phased in and affordable way.

“There seems to be little awareness about women’s health needs and the need for preventive initiatives. So I am here today to call for change in our health care system when it comes to women’s health. Coverage for women is often skimpy and spartan. Often health care doesn’t cover basic women’s health care like mammograms and cervical cancer screenings. My amendment is about saving lives and saving money to give women access to comprehensive preventive services that are affordable and life saving.