Taking care of health care

The contrast couldn’t be more stark. Republicans in Washington announced their plan to jam through an Obamacare replacement last week, potentially stripping tens of millions of people of their health care. Meanwhile several bills sponsored by Democratic women from Washoe County were heard in the Nevada Legislature to preserve basic preventive health care measures from the Affordable Care Act by enshrining them in Nevada law.

Assemblymember Teresa Benitez-Thompson presented AB 249, building on the efforts of former Assm. Chris Giunchigliani requiring insurance policies in Nevada to cover contraceptives without co-pays. When that legislation was passed in 1999, Giunchigliani was forced to include a religious exemption in order to get the bill approved, providing a loophole for insurance companies to claim religious liberty as a reason for denying women access to birth control. It’s no surprise that insurance companies have declined to claim the exemption, no doubt realizing birth control helps women avoid unwanted and expensive pregnancies.

Assembly Bill 249 removes the religious exemption while also requiring pharmacies to distribute up to 12 months of contraceptives at one time, rather than limiting women to a 90-day supply. The Affordable Care Act currently covers the full cost of contraceptives, deeming it a key prevention component of women’s health care, but that provision may be eliminated under the new American Health Care Act supported by President Trump and the Republicans.

Sen. Julia Ratti is the lead sponsor of Senate Bill 233, which also contains the new contraceptive language. Her bill requires insurance plans to continue to cover Pap smears and mammograms, screenings for diabetes, blood pressure abnormalities and depression, federally-recommended vaccinations, prenatal care, hormonal replacement therapy, and counseling for breastfeeding, sexually transmitted diseases and domestic violence. Ratti noted that “Cancer screenings, prenatal care and birth control aren’t luxuries, they’re necessities. If the federal government won’t commit to preserving this care for women, then Nevada will.”

Republicans hearing the bills expressed a concern that emergency contraception would be covered, which some see as contributing to abortion. It’s an ironic position because as contraceptives have become more accessible, the nation’s abortion rate has decreased by 26 percent along with the number of unplanned pregnancies.

A third bill heard last week addresses the national GOP plan to defund Planned Parenthood. SB 122 from Sen. Yvanna Cancela creates a mechanism for Nevada to receive family planning grants services and redistribute them to community organizations such as Planned Parenthood. President Trump reportedly approached Planned Parenthood with a proposal to continue its federal family planning funding if they would stop providing abortions, an idea quickly rejected by its leaders, who prefer to stay true to their mission of offering women a full array of health care services.

The bills are especially timely as women brace for Obamacare repeal and loss of preventive care. Across the nation women are frightened that their local family planning clinic might disappear. Many are visiting the clinics to switch to long lasting and cheaper birth control methods, worried about not being able to afford the more convenient but expensive birth control pills.

Three states in the West have already gone further than the proposals in Nevada, allowing birth control pills and certain other contraceptives to be prescribed by pharmacists without a doctor’s visit. Eleven other states are considering similar bills this year.

The Nevada bills have an excellent chance of passage given widespread support in the Democratic caucuses and the prioritization of these issues by leadership. But will Gov. Sandoval sign them? As the Republicans proceed with their zealous destruction of the Affordable Care Act, Sandoval will risk the wrath of half the state’s population if he denies them access to basic health care.