Good afternoon, everyone. Welcome to today's live town hall, the state
of women's health. I'm Kelly Wallace with ivillage, thrilled to be here once again with secretary Kathleen Sebelius of health and human services.
This event is for you. It will be live streamed on ivillage.com and
healthcare.gov/live. Throughout the next half hour we'll take yourquestions and you can send them to us live on Twitter at ivillage, hash tag,HSSchat.
Madam secretary thank you for being here.
Kelly, great to have you here.
Happy new year. We haven't seen each other since 2012 began.
I know. Forgive me I have to wear glasses.
I have mine here too.
So many questions. First regarding the provision that most employers will now be required to provide free contraception as part of the healthcare law.
One of our ivillage community members asking will the so-called morning after pill be covered
in that?
Well, all of the FDA recommended contraception is included in the notion that women should
have access to contraception. Kelly, this is a drug that is taken by women more frequently between ages 14 and 40 than any other kind of medicine. We know from the scientists that it's contraception is incredibly important for women's health and for family's health, children's health and it often is a financial issue for a lot of women who can pay up to $50 a month out of pocket, for accessing doctor's prescription. So this really was the institute of medicine's recommendation that as they looked at women's preventive services, what often is missing in insurance plans, domestic violence screening, various kinds of mental health benefits, help with nursing mothers an contraceptive services will be included as an essential benefit in health plan.
The community member asking and the so-called morning after pill covered as well?
It can be covered as one of the options women would have.
You know a number of people in our audience talking about what happened just back in December, right? How the FDA ruled that it should be okay to
receive the morning after pill over the counter for all ages.
You did something unprecedented. You vetoed that move.
Some people were saying why did you do it if the science is one way and was it politically
motivated, one of our community members is asking.
I don't think there's any question that the so-called plan B-1 step is safe and effective,
that's one of the standards and the FDA signed off on that, it's been available to women
throughout this country and in Europe for years.
The issue really is over the counter then needs a second set of standards, is the language
able to be comprehended by all language at all points?
And is their actual use matchup with label comprehension.
Because you don't have any healthcare, not a pharmacist or healthcare, doctor involved.
So I thought the data presented as part of the over the counter application did not include
the full range of girls for whom over the counter access would be available.
That's why I made the decision. My only choice was straight up or straight
down. People say why didn't you modify it, pick
a different age? That's not within our jurisdiction.
It was prove what entirely the company would ask for, all age, all shelve, all stores or
deny it. And I'm hoping that we can revisit this issue.
It doesn't change the availability of plan B right now, which is on the shelf, over the
counter for women 17 and older and with a prescription for women 17 and under.
That did not change at all by this application.
And one question that came in while you were talking, regarding contraception, coverage
of condemns too? No that's out of pocket costs for the individual
consumer?
I think condoms will be covered by this. If somebody chose to use their insurance coverage
to actually get a condom because that is clearly in the range of the FDA approved contraceptive
issues. There has been a lot of misinformation, is
part of reaction to the rule decision that the statement I have seen several times at
board of patients, drugs that cause some kind of spontaneous abortion, would indeed be covered
in that, is just not accurate. Those are not regarded as contraception and
wouldn't be covered by this.
These are questions that come in, you hear these stories all the time.
I'm a 58-year-old female unable to work because of severe migraine headaches and severe depression.
I have no insurance so I can't go to the doctor. What do you suggest I do so I can get medical
attention and be able to afford the medicine I need?
One of the pieces of very good news, Kelly, about the affordable care act, the law president
Obama signed in March of 2010 is that we are beginning to change the situation for the
kind of women who are out there totally uninsured or miserably underinsured, where they have
coverage but it doesn't cover their needs. It's really part of what I think the president
was talking about the other night in the state of union, when he talked about a set of American
values where everybody gets a fair shake. Your healthcare shouldn't be determined by
who your employer is or where you live in the country or which insurance company decides
to pick and choose you in or out. Those days are coming to an end.
Right now your questioner has some limited choices.
She may qualify for the pre-existing pool in her state if she has been denied health
coverage because she has a pre-existing condition and no insurer will take her.
Every state in the country now has an existing pre-existing condition pool she maybe applicable
for. If she indeed doesn't work and doesn't have
the money to buy insurance she may well qualify for medicaid program, again, in her state.
That is available. By 2014 we'll have a new market in every state
where people will have an opportunity to get financial help from the Federal Government
if below an income level and shop for insurance without any preexisting condition limitations
being put on anybody. A big step forward for women who often are
in the market without insurance or very undersured and paying -- underinsured and paying 50%
more on average in an individual market for policies that deliver exactly the same benefits
as their male colleagues have.
Absolutely. I want to encourage everyone again, bring
us your live questions. You can tweet them to us at ivillage, hash
tag,HHSchat. And following up on that, one ivillage community
member pointed out according to the national law center in 2010, you know these numbers,
nearly 20% of American women, one in five, lacked health insurance.
The numbers are even worse in New Mexico. Are there numbers -- is there anybody you
can point to that the affordable care act has done to change those numbers?
And increase the number of women who are insured and not underinsured as you pointed out as
well?
What we know is that two and a half million young adults many women, are now able to be
insured on their parents' health insurance policy.
That is two 1/2 million additional young Americans since the health bill was passed.
We know that a lot of moms are breathing a sigh of relief and I met one of them yesterday,
I met Robin in Baltimore who is the mom of a child who was born with a heart defect.
And Jack's one of the twins, he had the defect, the other didn't.
They spent a lot of money but her son will not be blocked out of the insurance market
because that has gone into effect. So there's some young children, women, who
now are getting insurance. The bulk of the adult, there certainly are
women who now are participating in the high risk pools, the pre-existing pools.
I met Gail from New Hampshire in the midst of chemotherapy treatment that she wouldn't
have had access to if the affordable care law hadn't passed so there are pockets of
women, young women, children, older women who now have insurance.
By 2014, two years from now, women will be able to come fully into the market as adults
without pre-existing health conditions and with some financial help to get insurance.
So interesting, is there under the healthcare law or anything your agency is doing when
it comes to patient advocacy and navigation? We all know, right, what a mine field it can
be. I'm sure the women you met in Baltimore yesterday
gave you an earful about doctors and medical bills.
Is there something under the law or something you're considering to assist people in that
effort, that way?
Right now there are consumer assistance programs in states around the country helping
women and men navigate what is often a very cumbersome complex market.
As you know, Kelly, and you referenced it early on, we have a new website that is much
more transparent about not only the insurance market but some of the benefits in the law,
when they go into effect, what kinds of questions to ask, the website healthcare.gov is also
full of good information about medical condition, questions to ask, ideas to have.
I think as part of the new insurance exchanges there will be a huge consumer outreach to
help people get into the insurance marketplace. On the healthcare side of the puzzle when
you come into contact with doctors an hospitals, one change we have seen is a much more focused
effort on patient-centered care, bringing services to the patient, answering question.
We're going to be rewarding doctors who coordinate care.
So it isn't any longer up to you, if you see three or four different doctors for your diabetes
to figure out what's going on but they will get an incentive and be expected to coordinate
care with one another. The introduction of electronic health records,
lets your primary care doctor for the first time coordinate that care, so if you're going
to see somebody about your circulation and then see a heart specialist and then have
somebody else deal with you, that information will be available and ready to deliver to
you. Right now we have patients are on their own
too often. They're confused.
They're the ones required to do as you said leg work.
Some have more resources than others to do that.
You bet. Those days are coming to an end.
There will be a very specific emphasis through the affordable care act and an expectation
that when you're released from the hospital you're not on your own, somebody follows -- monitor
yours follow-up care and making sure you transition well.
We will be providing incentives for medical home teams to make sure patients can avoid
a hospital stay in the first place, primary care docs get to coordinate care.
Talking to one another is one of the things that the best medical systems in the country
do. We want all medical systems in the country
to begin to do just that.
As a follow-up, a question just came in, what about the mental health patients who
can't advocate for themselves? What happens to them?
Well, there are a couple of cases. First of all, the law has changed so mental
health benefits are now part of all health benefits.
It's not a standalone coverage, it's the so-called parody law that you should have mental health
issues covered the same way as physical health issues.
So that is a legal framework that we're working under now that wasn't the case in the past.
And again, I think it will be up to patients to -- up to the physicians and mental health
technicians and psychologists who coordinate care on behalf of their patients that again
is going to be a payment expectation. It's not just that you get paid for seeing
somebody but you get your pay will depend on outcomes and delivering a kind of service
to that patient that actually leads to better health in the long run.
We have a lot of working moms in our audience. You're a working mom.
Your kids are older now but -- so one of our ivillage community members wanted to know
as a working mom, your best tip to keep children healthy?
what is the number thing working mops can do to keep your kids healthy?
Sleep is good, for kids, and for mom. I think sleep, eat, exercise are probably
the three areas and moms can really not only help keep themselves healthy by doing some
of all of the above, eating healthier meals, playing with your kids but getting them to
bed on time, getting yourself to bed on time. Getting some exercise.
Again, it can all be around family time taking walks together.
Play in the park together. Go outside and shoot some hoops with your
kids. Even if you can't make it into the basket
they're thrilled to beat you a time or two.
Oh, yes.
That kind of activity I think keeps everybody healthier, keeps families together and I think
is -- there's always time to do a little of that and I think it actually keeps kids healthier
in the long run.
Definitely. Someone asked what is the most pressing health
issue facing our country, particularly women?
I do think the biggest silent crisis that we have is the issue around -- there are two
issues. Obesity and smoking.
We know that those are the two major underlying causes of a lot of the chronic conditions.
And so having parents, if they still smoke, stop.
Get some smoking cessation help, keep second hand smoke away from your kids.
Do anything you can to keep your kids from smoking in the first place, there's a huge
move toward your health and certainly toward their health.
But also obesity. Which really isn't about how good you look
or what clothes size you have, it is about the condition of your heart and preventing
diabetes. What we found, Kelly, recently is that if
you are pre-diabetic, losing a little weight, I don't mean 50 pounds, 100 pounds, I mean
10, 15 pounds and getting a little exercise, taking a 30 minute walk four or five time
as week, you are 65% less likely to become a diabetic than if you don't do those two
things. So there's very simple strategies that eating
a little healthy, getting more exercise, not just for you but for your kids, that can make
a huge difference in a lifetime of health.
I want to encourage everybody to send us your questions live.
You can tweet them to us at ivillage hash tag HHS chat.
We have our real mom contributors to ivillage. With one wrote how they're following this
courageous battle of a mom who blogs and she's on Twitter at why mom my, she's battling inflammatory
breast cancer and is currently in hospice, it's a heart breaking story but she wanted
to know what message would you give to other women about what else they can do beyond mammograms
to try and keep them safe and is there anything they can be doing to try and keep their kids
cancer-free without coming off as some alarmist here, but is there a message to send our kids
and more we can do as women ourself?
I'll not sure -- it would be wonderful if there was some way to keep your child cancer
free, I was with this wonderful young mother yesterday in Baltimore who totally healthy
two-year-old took her to a check up in October and she has been diagnosed with childhood
leukemia, very curable disease but she has a number of years of very scary treatment
ahead of he, out of blue, totally healthy, so unfortunately there's no simple methodology.
I do think paying attention to the air we breathe is important.
And demanding as moms and as citizens, that we have clean air, that we have clean water.
Paying attention to the kinds of chemicals that are out and about.
There's a lot going on these days, bark the environmental protection agency for its overreach.
But our health and our children's health is effected every day by what kinds of conditions
are out and about. You can't stop your child from breathing but
you can demand in this country that we have clean air and that we have clean water.
So those are tactics that work. I think getting regular check ups, but again
doctors have a belief that there certainly are genetics that lead one to be more cancer
prone. The healthier lifestyle that you can live
the more you keep yourself in good health and the more you get routine checkups so if
indeed something is diagnosed you find it as early as possible and treat it as early
as possible. My aunt died at 33 of breast cancer.
She left behind five children, my cousins, it was the first experience that I had dealing
with a death. I was 12 years old and I remember my mother's
friends breast cancer diagnosis was a life sentence.
They were dead within a number of years. Those statistics look very different today.
Particularly if you deck it early. Early detection means a lifetime in remission
often. Late detection means a death sentence still.
So taking advantage of routine checkups, self-exams, making sure that we are aware of changes in
our own bodies, think is a way, may not prevent a cancer situation from occurring but you
sure can be a lot more aggressive in identifying it, rooting it out and taking advantage of
the technology and medicines that are now available.
We're running out of time Madam secretary. This goes by so fast, I could talk to you
all day. One more question from the viewers.
How will you put a cap on healthcare premiums for families?
Well, again, I think the good news is medical costs are beginning to slow down.
They're still increasing but at a much slower pace.
What we can do and what we are doing is demanding that insurance companies live by the so-called
80/20 rule. 80 cents of every health premium dollar is
on health benefits not CEO salaries. In 2012 a lot of consumers will get checks
back from insurance companies because they didn't meet that.
That slows down the cost. We also have oversight over rate increases
that we are able to indicate if they are justified or unjustified and call on the insurance commissioner
to lower them. We know that in terms of family output T question
we just talked about breast cancer an cancer screenings, insurance policies right now thanks
to the affordable care act are worth far more. Preventive care is covered without co-pays
or co-insurance. We think it's important to encourage people
to take care of their health before they might get into a situation which causes illness.
We think it's important for women to have access to contraception without co-pays or
co-insurancech those kinds of preventive care that are so important to women's health will
now be actually free of charge to encourage people to take advantage of them.
So there are a variety of ways that out of pocket costs will go down.
Very quickly, my audience wants to know will you work in any way in the re-election
campaign?
Absolutely. What will you be doing?
Likely to be out around the country talking to women and talking about some of the health
benefits that are available and why it's so important that we keep moving forward on this
law.
Very finally, people are asking, you're a former governor of Kansas.
A lot has been made of the photograph between governor Brewer of Arizona and the president
where she was pointing at him. You're former governor.
Do you think it's appropriate or inappropriate for a governor to be pointing at a president
regardless if a president is of your party or not?
I think it's more appropriate to make shake his hands and say hello and greet warmly when
he comes to your state. I was able to do that a number of times with
President Bush when he visited Kansas, I was able to greet him so I don't necessarily think
a finger wagging is the most appropriate exchange for anyone to have with anyone else.
Welcome them to your state. If there's a difference of opinions let's
talk about it. Madam secretary, thank you so much for
taking time. We appreciate it.
Absolutely.
Thank you for joining us. Again, this was a forum, a live town hall
for you on the state of women's health. We hope to get the opportunity to do this
again. Come back any time.
I'm Kelly Wallace of ivillage, thanks for join us.
NOTE: The transcript for this program may have been compiled from uncorrected Closed Captioning.
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