III 110th CONGRESS 2d Session S. RES. 638 IN THE SENATE OF THE UNITED STATES July 31, 2008 Ms. Stabenow (for herself, Mr. Obama, Ms. Klobuchar, Ms. Cantwell, Mrs. McCaskill, Ms. Mikulski, Mrs. Murray, Mrs. Clinton, Mrs. Boxer, Mr. Kennedy, and Mrs. Feinstein) submitted the following resolution; which was referred to the Committee on Health, Education, Labor, and Pensions RESOLUTION Supporting legislation promoting improved health care and access to health care for women.

Whereas women are the health care decisionmakers for themselves and their families; Whereas women want affordable health care they can count on throughout life transitions, such as starting a family, job changes, part-time and full-time work, divorce, caring for an elderly or sick family member, having a major disease, or retiring; Whereas women with good health coverage worry about keeping their coverage and access to their providers; Whereas women are more likely to seek essential preventive and routine care than are men, are more likely to have a chronic health condition, and are more likely to take a prescription drug on a daily basis; Whereas women pay 68 percent more than men for out-of-pocket medical costs, due in large part to reproductive health care needs; Whereas more than half of underinsured women (53 percent) and 2/3 of uninsured women (68 percent) forego needed care, and about half of the underinsured (45 percent) and uninsured (51 percent) report difficulty paying medical bills; Whereas, in 2004, 1 in 6 women with individual coverage reported postponing or going without needed care because she couldn't afford it; Whereas high-deductible health plans are often targeted to young women as an inexpensive health coverage option, but fail to cover pregnancy-related care, the most expensive health event most young families face and the leading reason for hospital stays; Whereas 75,000,000 adults (42 percent of the under-65 population) had either no insurance or inadequate insurance in 2007, up from 35 percent in 2003; Whereas 47,000,000 people, nearly 16 percent of the United States population, are uninsured, including 17,000,000 adult women ages 18 to 64 (18 percent) and 9,000,000 children (12 percent); Whereas the Institute of Medicine estimated that lack of health insurance coverage resulted in 18,000 excess deaths in the United States in 2000 (a number which the Urban Institute estimates grew to 22,000 by 2006) and that acquiring health insurance reduces mortality rates for the uninsured by 10 to 15 percent; Whereas uninsured women with breast cancer are 30 to 50 percent more likely to die from the disease, and uninsured women are 3 times less likely to have had a Pap test in the last 3 years, with a 60 percent greater risk of late-stage cervical cancer; Whereas 13 percent of all pregnant women are uninsured, making them less likely to seek prenatal care in the 1st trimester and to receive the optimal number of visits during their pregnancies, and 31 percent more likely to experience an adverse health outcome after giving birth; Whereas the lack or inadequate use of prenatal care is associated with pregnancy-related mortality rates 2 to 3 times higher and infant mortality rates 6 times higher than that of women receiving early prenatal care, as well as increased risk of low birthweight and preterm birth; Whereas heart disease is the leading cause of death for both women and men, but women are less likely to receive lifestyle counseling, diagnostic and therapeutic procedures, and cardiac rehabilitation and more likely to die or have a 2nd heart attack, demonstrating inequalities in access to care; Whereas health care disparities persist, leaving Hispanic and Native American women and children 3 times more likely and African Americans nearly twice as likely to be uninsured as non-Hispanic Whites; Whereas, in 2005, nearly 80 percent of the female population infected with the human immunodeficiency virus (HIV) was Black or Hispanic, and the incidence rates of HIV and acquired immunodeficiency syndrome (AIDS) are dramatically higher for Black and Hispanic women and adolescents (60.2 and 15.8 per 100,000, respectively) than for White women and adolescents (3.0 per 100,000); Whereas women are less likely than men to be insured through their jobs and more likely to be insured as a dependent, making them more vulnerable to insurance loss in the event of divorce or death of a spouse; Whereas 64 percent of uninsured women are in families with at least 1 adult working full-time; Whereas health care costs are increasingly unaffordable for working families and employers, with employer-sponsored health insurance premiums increasing 87 percent since 2000; Whereas America's 9,100,000 women-owned businesses employ 27,500,000 people, contribute $3,600,000,000 to the economy, and face serious obstacles in obtaining affordable health coverage for their employees; Whereas the lack of affordable health coverage creates barriers for women who want to change jobs or create their own small businesses; Whereas health care professionals and workers—a significant portion of whom are women—have a stake in achieving reform that allows them to provide the highest quality care for their patients; Whereas 56 percent of all caregivers are women; Whereas the United States spends twice as much on health care as the median industrialized nation, our health care system ranks near the bottom on most measures of health status among the 30 developed nations of the Organisation for Economic Co-operation and Development (OECD), and 37th in overall health performance among 191 nations; and Whereas the National Institutes of Medicine (NIH) estimates that the cost of achieving full insurance coverage in the United States would be less than the loss in economic productivity from existing coverage gaps: Now, therefore, be it

That the Senate commits to pass, and urges the President sign into law, within the next 18 months, legislation that guarantees health care for all women and health care for all people of the United States and that— (1)recognizes the special role that women play as health care consumers, caregivers, and providers; (2)guarantees inclusion of health care benefits essential to achieving and maintaining good health, including comprehensive reproductive health, pregnancy-related, and infant care; (3)promotes primary and preventive care, including family planning, contraceptive equity, and care continuity; (4)provides a choice of public and private plans and direct access to a choice of doctors and health providers that ensures continuity of coverage and a delivery system that meets the needs of women; (5)eliminates health disparities in coverage, treatment, and outcomes on the basis of gender, culture, race, ethnicity, socioeconomic status, health status, and sexual orientation; (6)shares responsibility for financing among employers, individuals, and the government while taking into account the needs of small businesses; (7)ensures that access to health care is affordable; (8)enhances quality and patient safety; (9)promotes administrative efficiency, reduces unnecessary paperwork, and is easy for health care consumers and providers to utilize; and (10)ensures a sufficient supply of qualified providers through expanded medical and public health education and adequate reimbursement.