Nancy Pelosi's Office responds to my Letter

photo: House Speaker Nancy Pelosi with husband Paul Pelosi at the 2008 Kennedy Center Honors Award










January 19, 2010


Dear Nicole:


Thank you for contacting me to express your views on health care reform for women. I appreciate hearing from you on this critical issue.

In our current health care system, women often face higher health care costs than men and multiple other barriers to obtaining health insurance. Fewer women are eligible for employer-based coverage, and in the individual insurance market, women face discrimination - often being charged substantially higher premiums for the same coverage as men or being denied coverage for such "pre-existing" conditions as pregnancy, giving birth by Cesarean section, domestic violence, or breast cancer. In a recent study, more than half of women reported delaying needed medical care due to cost.

On July 14th, the Chairmen of the three Committees with jurisdiction over health policy in the House?"Chairman Henry Waxman and Chairman Emeritus John Dingell of the Energy and Commerce Committee, Chairman Charles B. Rangel of the Ways and Means Committee, and Chairman George Miller of the Education and Labor Committee?"introduced H.R.3200, America's Affordable Health Choices Act of 2009 to curb out-of-control costs, encourage competition among insurance plans to improve choices for patients, and expand access to quality, affordable health care for all Americans.

On October 29th, I was proud to announce that House Democrats had achieved consensus to create one bill, H.R.3962, the Affordable Health Care for America Act. The Affordable Health Care for America Act is founded on key principles of American success: opportunity, choice, competition, and innovation.

This legislation directly addresses the issue that women are charged nearly 50 percent more than men for the same coverage when they purchase insurance in the individual market. H.R.3962 makes it illegal for insurance companies to use "gender rating" - charging women more than men for the same coverage. This bill also makes it against the law for insurance companies to deny coverage or charge higher premiums based on "pre-existing" conditions, such as pregnancy, C-sections, domestic violence, or breast cancer.

H.R.3962 also protects reproductive and preventive care services that are essential to a woman's health. Maternity services are included in the essential benefits package outlined in the bill. As a result, all health insurance plans in the Health Insurance Exchange would be required to cover maternity services and over time, plans outside the Exchange would be required to do so as well. This bill also makes key preventive services, ranging from mammograms to well-baby care, more affordable by eliminating all co-pays and deductibles for recommended preventive services.

Both pro-life and pro-choice Members of Congress worked with Representative Lois Capps (D-CA) to craft a compromise amendment adopted by the House Energy and Commerce Committee to H.R.3200 that would maintain longstanding federal policy on abortion services. This amendment barred federal funding for abortions as consistent with the Hyde amendment, which bans federal funding for abortions in all cases except in the cases of rape, incest, or life endangerment; however, private insurance companies would continue to be able to offer abortion coverage using private funds. Additionally, the Capps amendment provides that at least one plan in each market area must offer such services and one plan must not.

During debate on the House floor on November 7th, Representative Bart Stupak (D-MI) and Representative Joe Pitts (R-PA) offered an amendment to H.R.3962 that would go beyond current law. This amendment would extend the Hyde amendment restrictions and ban coverage for most abortions from all public and private health plans in the Health Insurance Exchange created in this bill. It also requires women to purchase a separate policy rider for abortion services. The Stupak-Pitts amendment passed by a vote of 240 - 194.

On November 7th, the House of Representatives passed the Affordable Health Care for America Act, H.R. 3962, in a bipartisan vote of 220-215.

The Senate followed suit on December 24th and passed their version of health insurance reform, the Patient Protection and Affordable Care Act, H.R. 3590, by a vote of 60 - 39. This bill includes an amendment crafted by Senator Ben Nelson (D-NE) that would permit private and public health care plans to offer abortion services, but would bar federal funding for abortions as consistent with the Hyde amendment. Rather than requiring women to purchase a separate policy rider for abortion services, this amendment requires that enrollees make two separate payments: one for their basic policy premium and one for coverage of abortion services.

The Stupak-Pitts amendment goes beyond current law to place restrictions on private plans. I am working with my colleagues to ensure that we pass health care reform for all Americans, while still maintaining current law regarding abortion services.

I have long been a supporter of a woman's right to affordable and accessible reproductive health care, and I am firmly committed to health insurance reform that protects that right and ends insurance discrimination against women. Please be assured I will keep your comments in mind as I continue to fight for legislation that puts Americans and their doctors back in charge, holds insurance companies accountable, guarantees stability and peace of mind, lowers costs, and provides more choices for higher quality care.

Thank you again for contacting me on this critical issue. I hope you will continue to communicate with me on matters of concern to you. For more information on this or other issues affecting our city and our nation, please visit my website at www.house.gov/pelosi or sign up to receive e-mail updates at www.house.gov/pelosi/IMA/subscription.html.


Sincerely,
Nancy Pelosi
Member of Congress