March 2010 marks the 30th anniversary of celebrating women’s history month, a time to reflect on the notable gains that women have made in the last century.  Many of these advancements quickly come to mind such as the right to vote, and we’ve experienced many famous firsts including the first woman astronaut, Supreme Court Justice, combat pilot, Nobel Prize winner, Cabinet Secretary, Academy Award winning director, and even Speaker of the House of Representatives.  A less commonly known achievement for women’s rights came in 1991.  Prior this point, women were not included in any of the clinical trials at the National Institutes of Health, the nation’s premier medical research institution.

That means that less than two decades ago, all research at the NIH was done on white males.  More than half of the population was not being represented in some of the most important medical research happening in the world.  It wasn't until there was a critical mass of women in Congress pointing out the obvious flaws in this practice, that it was changed.

I was reminded of this fact when President Obama held his recent bipartisan health care summit reform with Congressional leaders last month.  The summit was attended by 38 members of Congress, only four of whom were women.  During the approximately 7 hour discussion, a total of 5 minutes were devoted to women’s health issues.

This is not to say that many of the topics that were addressed at the summit do not also affect women.  The larger goals of health care reform, such as increasing access and lowering costs for families and businesses, hold benefits for us all.

However, some provisions do exclusively affect women.  For example, insurance companies are allowed to deny a woman coverage if she has been the victim of domestic violence presuming, as Congresswoman Louise Slaughter (D-NY) suggested at the summit, "if you're been unlucky enough to get yourself beaten up once you might go around and do it again."   And, if a woman is of a certain age, or already pregnant when she applies for health insurance, insurers can deny her any maternity coverage.

Women also on average pay higher premiums than men through a practice known as “gender rating” - 95% of insurance companies engage in the practice.  A 25-year-old woman can pay up to 84% more than a man for a health plan that excludes maternity coverage.  More than 60% of health care plans charge a 40-year-old woman who doesn’t smoke more than a 40-year-old man who does.

Part of the reason these egregious practices have been banned in health care reform proposals is because of the vocal involvement of women members.  Senator Patty Murray (D-WA) had heard that domestic violence victims were being denied coverage when she talked to women who were trying to escape abusive relationships.  Although she introduced legislation in 2006 to ban the practice, it wasn’t until 2009 that this commonsense language was included in both House and Senate health reform bills.  Similarly, Senator Barbara Mikulski (D-MD) was instrumental in requiring health insurers to cover preventive services for women, such as pap smears and mammograms, in the Senate proposal. 

Over the years it’s been women legislators who were able to make certain that diseases like osteoporosis, mainly a woman's disease, cervical cancer, only a woman's disease, uterine cancer and others received serious attention and needed funding.

That is why the perspective and advocacy of women legislators is going to be needed as we work to advance health care reform, and enact laws that protect the health of all people. 

We will advocate for the stronger prohibition against gender rating in all insurance markets.  And, we will insist that the prohibition on denying coverage based on a history of domestic violence be banned immediately.

As many of the health care reforms that are so important to women hang in the balance, the President is right to seek common ground on this critical legislation.  But, as new compromises are forged it is essential that women continue to be involved in that process now and in the years to come.