During the tumultuous 2016 legislative session, access to affordable, quality health care doesn’t seem to have been on the mind of many state lawmakers. While preparing and submitting a demonstration waiver to the federal government to alter and “reform” the state’s Medicaid program is an accomplishment, lawmakers and administrators have ignored health care policies that are truly innovative and that could extend access to affordable, quality health care to all North Carolinians.
There has been much discussion this session about the safety of women and children, but the fact that 53% of the North Carolinians in the health insurance gap – in which people have too much income to qualify for Medicaid, but do not make enough to afford individual health insurance plans in the marketplace – are women is somehow thought to have nothing to do with that safety.
But the safety of North Carolina women, and of their families, is actually connected quite strongly to their ability to access quality health care, both preventative and in times of illness and crisis. And the ability to access quality health care is still out of economic reach for many. Consider that:
• Nearly one in five North Carolina women lives in poverty and more than one in five women aged 18 to 64 lacks health insurance.
• Over 40 percent of working women in the state are their families’ primary breadwinners.
• Women, particularly women of color, still experience a gender wage gap, are more likely to work in part-time employment that lacks health care benefits and comprise more than half of the minimum wage workers in the state.
• Single women with children are more likely to live in poverty than any other family type in the state.
Many Tar Heel women are already struggling. The inability to access quality, consistent health care leaves women not just physically unsafe as they are more likely to experience chronic health conditions, but also can leave them economically insecure as they struggle to find good jobs while juggling health issues, both personally and in their role as primary caretaker. And it’s difficult to find safe housing, adequate and nutritious food, steady employment and even safe relationships when one is economically on the brink all the time. It becomes a vicious cycle.
In a health care system like ours that still ties health care access to employment, many women and families have been left behind as our society in various ways still operates under the misguided assumption that all families include a male breadwinner and a full-time female caretaker. Medicaid has been a critical safety net program for women and their families in their most dire time of need, and a way that we as society collectively demonstrate our commitment to all families. Access to health care can help families achieve economic security as well optimal health and safety.
Access to health care can also increase women’s safety in other tangible and direct ways. Better and increased access to family planning, pre-natal and post-natal care will help women have safer pregnancies and better birth outcomes. Consistent quality health care, including substance abuse treatment – well before a pregnancy occurs – also contributes to safer pregnancies down the road.
And better access to health care plays a role in supporting victims of domestic and sexual violence (DV/SV). Whether a DV victim stays with her abuser because their health insurance is through this relationship; or a trip to the doctor provides the victim with their first exposure to the DV resources available, increasing access to our health care system can be another tool in our struggle to end domestic violence. And access to health care, particularly mental health care, is a vital service to provide sexual assault survivors with the compassionate care they may need to know they can be safe again one day.
As the short legislative session nears its end, we urge lawmakers to consider ways to close the health care coverage gap if, as has been claimed, the safety of North Carolina women is their top concern. It’s time to back up the rhetoric with actual policies to create that safety.