WASHINGTON -- Women's health groups, legal organizations and some female senators are fighting for a host of little-known provisions in the health care legislation being debated in Congress that they say will dramatically improve health care and insurance coverage for women.
From a ban on insurance companies charging women more for the same policies as men to a requirement that companies provide maternity coverage as part of their basic plans, advocates say the provisions would correct long-standing inequities and offer more coverage to women at lower costs.
Some Republicans, such as Sen. Jon Kyl of Arizona, say basic policies shouldn't be required to include coverage for things that not everyone will use.
"I don't need maternity care, and so requiring that to be in my insurance policy is something that I don't need and will make the policy more expensive," Kyl said during a debate about the legislation last week.
"I think your mom probably did," Sen. Debbie Stabenow, D-Mich., shot back.
Their spat has become a hit on YouTube, with nearly 150,000 hits as of Sunday.
The ongoing fight in Congress over whether government-funded insurance should cover abortions has generated most of the headlines about women's health issues, but women's health advocates say issues such as maternity coverage and fair pricing affect far more women, who have received inadequate care and coverage for too long.
According to the National Women's Law Center, a non-partisan legal advocacy group:
*Forty states and the District of Columbia allow "gender ratings," in which insurance companies can charge women more for the same health coverage as men and can charge businesses with mostly female workers higher group rates. According to the Kaiser Family Foundation, 4.7 million women bought individual insurance last year in states with this pricing practice.
*In eight states and the District of Columbia, insurance companies can deny coverage to victims of domestic violence.
*Insurance companies may offer policies that exclude coverage for some pre-existing conditions. If a woman has delivered a baby by cesarean section, for example, companies can deny coverage for future C-sections. In other cases, some insurers will deny maternity coverage if a woman is pregnant when she buys a policy.
"When it comes to health insurance, women are discriminated against," said Sen. Barbara Mikulski, D-Md. "We pay more and we get less, and often we are denied care."
Mikulski also wants the health care legislation to require that policies cover preventive cancer screenings for women, such as mammograms and Pap tests.
Provisions addressing at least some of the issues are included in all of the five health care bills moving through Congress, said Judy Waxman of the law center. She said women still have "a fight on our hands" to keep the provisions in final legislation because lawmakers are "wheeling and dealing" to keep costs down.
Kyl spokesman Ryan Patmintra said his boss and some Republicans generally don't believe in "mandating certain types of coverage" because that "drives up costs" for everyone.
"We just believe you should be able to choose the coverage you want," Patmintra said.
The insurance industry is generally behind the requirements pushed by women's groups, said Robert Zirkelbach of America's Health Insurance Plans.
The industry supports eliminating pricing based on gender, he said, and "we strongly believe that nobody should be denied coverage because they're a victim of domestic abuse."
He said most plans already provide maternity coverage. As for mandating that all do, he said there's a "good chance" basic benefits packages will be required to cover maternity.
Gerald Joseph of the American College of Obstetricians and Gynecologists calls the problems women face "one of the most glaring reasons why we need health reform."
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