Author Archives: JulianneR05

Congressional Republicans Found the Most Useless Way to Combat Race and Sex Discrimination

by JulianneR05 Posted on April 25, 2016

Mother Jones

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Republicans in Congress are trying to end race and sex discrimination—in the womb. The Prenatal Nondiscrimination Act (PRENDA) would ban abortion on the basis of the race or sex of the fetus. Republicans say the measure is necessary to protect the civil rights of African Americans and women.

“It took the Civil War to make the state-sanctioned practice of human slavery come to an end,” said Rep. Trent Franks (R-Ariz.), the bill’s author, during a recent hearing on the measure. “One glaring exception is life itself, the most foundational civil right of all.”

According to Franks, who has introduced various versions PRENDA since 2008, ending race- and sex-selective abortions is the “civil rights struggle that will define our generation.” During a hearing by an all-male committee earlier this month, Franks also noted that upward of 50 percent of African American babies are “killed before they’re born,” and that “a Hispanic child is three times more likely to be aborted than a white child.”

The proposed measure would make it illegal for a physician to perform on abortion on a pregnant woman who wants the procedure because the fetus isn’t her desired sex or race. Under the measure, the father of the unborn child and the pregnant woman’s parents could sue a physician who performs such an abortion. Doctors would also be required to report suspected cases to law enforcement.

It’s unclear where Franks is getting his numbers. A 2012 Guttmacher report found that evidence of sex- and race-based abortions in the United States is limited and inconclusive. According to the report, two studies using 2000 US census data found that although the sex ratio of first-born children was normal in families of Chinese, Indian, and Korean descent, those families did have a preference for sons in second and third births. The authors in that study were unable to conclude whether the imbalance was caused by abortion or fertility treatments.

But in a single 2011 study, commonly cited by PRENDA advocates, 65 Indian Americans who were interviewed had practiced sex selection, through either fertility treatments or abortion.

More recent data suggests that contrary to some stereotypes, Asian American communities are not biased in sex selecting for sons. A 2014 report by researchers at the University of Chicago Law School and two abortion rights groups analyzed population data from 2007 to 2011 and found that Chinese, Indian, and Korean Americans have more girls that white Americans.

Evidence to suggest that black and Hispanic communities are targeting their abortions is even less clear. According to Guttmacher, abortions are more common in black communities than white ones because unintended pregnancies are also more common. As a result, African American women get abortions at a rate five times higher than white women. “The truth is that behind virtually every abortion is an unintended pregnancy,” wrote Susan A. Cohen in a 2008 article on abortion and women of color.

In a letter to the House, the Leadership Conference on Civil and Human Rights, a coalition of 200 civil rights organizations, points out that health and economic disparities of black and Hispanic women are likely to blame for increased abortion. “African American women and Latina women have less access to contraception, prenatal care, and other critical reproductive health services, resulting in stark disparities across a number of sexual and reproductive health indicators,” the Leadership Conference wrote.

Loretta Ross, the national coordinator of SisterSong, a reproductive justice organization for women of color, told Mother Jones in 2011, “It’s kind of hard to find evidence that a black woman is going to have an abortion because she’s surprised to find her baby is black. It just strains credulity to think that’s a problem. I mean, she wakes up in the morning and says ‘Oh my God! My baby’s black!’?”

According to abortion rights advocates and Democratic legislators, the measure could increase discrimination against pregnant women, particularly women of color, by forcing doctors to speculate on the reasons their patients seek abortions, and then requiring the physicians to report suspected discriminatory abortions. Because of stereotypes that Asian communities prefer male children, advocates worry that Asian women would be especially vulnerable to profiling by their physicians.

“This bill is so horrendous that I could not believe it when it was first brought up,” said Rep. Judy Chu (D-Calif.). “It is a nightmare. This is a piece of legislation that would impose criminal penalties on providers and limit the reproductive choices of women of color and all women.”

Seven states already ban abortion based on sex selection. Only Arizona, which Franks represents, also bans race-selective abortions.

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Congressional Republicans Found the Most Useless Way to Combat Race and Sex Discrimination

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Narrow Networks Are Going to Bite a Lot of Obamacare Customers

by JulianneR05 Posted on March 26, 2014

Mother Jones

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A few days ago, reader JF sent me an email about a problem he’s had with his new Obamacare policy:

I’m a single dad living in LA. I have been underemployed/unemployed for the past few years, and until January had been paying through the nose for an individual policy for myself and my son. I am very familiar with the ins and outs of health insurance and I’m used to checking with every provider beforehand to quantify out of pocket costs. It was a godsend to have affordable insurance as of January. I qualified for a heavily subsidized Silver plan. I want the ACA to work, and to work well.

It didn’t for me. Here’s what happened. The first time I sought care under my new policy it was in January for a standard annual checkup. I’m a healthy guy so for me it’s a few questions from the doctor and then they draw blood. My ACA plan allowed me to get this care with a co-pay of $3.

Then I got the bill from the blood lab for $800. The doctor sent it to a lab outside the ACA network. Yeah, I know, I could have double checked with the doc to make sure the blood was sent to an in-network lab (I had already checked once). Bottom line is that a CBC blood test is going to cost me EIGHT MONTHS worth of my subsidized insurance premiums.

Here’s the bad story on the horizon: Imagine what’s going to happen when millions of newly insured people, not savvy about how to police health care costs, start to get bills that far exceed what CoveredCA or healthcare.gov promised them? “My Obamacare policy cost me $800 for a blood test” is the next headline. It’s in line with the horror stories from Steven Brill last year.

I think progressives need to start talking about this because it should be addressed by our side, not just to avoid mid-term election embarrassment, but because poor folks can be harmed by it. Hand waving this away as “we got poor people insurance, our job is done” is a mistake.

How common are experiences like this? Common enough that a recent Commonwealth Fund report explicitly addresses this precise problem. Andrew Sprung saw the report, and it triggered his memory about a similar problem he had a few years ago when he checked himself into an ER with chest pains:

The ER team decided to keep me overnight and informed me that I would be checking out against advice if I left early. By the time I’d had two EKGs it was clear nothing was wrong with my heart, but I subjected myself to a CT-scan with stress test, an ultrasound, and a $20k tab of which we paid nothing except maybe a $100 deductible (and which the self-insured hospital network essentially paid itself, I suppose).

So I was weak and foolish — with one exception. At the beginning, I had to sign a release agreeing to pay for any out-of-network care I received in-hospital. The attending doctor was at hand at the time. I asked him if he was in-network. He said he didn’t know. I said, how can you not know? He said his office dealt with “hundreds” of insurance plans. He offered to check. I said please do. He came back a few minutes later and said he had confirmed that he accepted the insurance plan provided to employees of the hospital he was standing in.

So there are several lessons here. First, narrow networks aren’t unique to Obamacare. They’ve been a growing problem with private insurance plans for years (see chart on right). Second, it gets worse with Obamacare in some states because of the narrow networks supported by nearly all ACA insurers. JF confirmed to me that he had a Blue Shield plan, but that’s not the whole story. “The blood lab in question is in network for Blue Shield, but not for Blue Shield CoveredCA plans, as per everyone I’ve spoken to about it.”

Third, it’s really hard to be alert enough all the time to avoid this. You have to remember to ask every time. You have to ask every doctor, and you have to ask for every lab test. And most doctors don’t know, and don’t really want to be bothered finding out. So you have to be very, very persistent.

And most of us aren’t very, very persistent. Especially if, say, we’re in an ER worried that chest pains might be an indication of an oncoming heart attack.

How big a deal is this? I don’t have any way of knowing. But JF is certainly right that it’s the kind of thing that can give Obamacare a bad name if it happens often enough. Unfortunately, there’s no plausible legislative tweak to address this, since Republicans are implacably opposed to improving Obamacare in any way, shape, or form. At best, there might be a way to partially address it with HHS regulations.

In any case, buyer beware. If you have any kind of health coverage at all, this is probably something to keep in mind. If you have an Obamacare policy, especially in a narrow-network state like California, it’s something to keep doubly in mind.

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Narrow Networks Are Going to Bite a Lot of Obamacare Customers

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