Nat’l Women’s Law Center: Women Experiencing Declining Income, Increasing Poverty, and Loss of Private Coverage

Jodi Jacobson

Census data from 2008 show an increase in the number of women who have lost income, lost private coverage and are falling into poverty. The increase in the number of women without coverage stems from the continued erosion of private insurance –- primarily through the loss of job-based coverage--even before the worst of the economic crisis hit.

Census data released today for 2008 show that growing numbers of women lost private health care coverage, saw their incomes decline, and fell into poverty, according to an analysis by the National Women’s Law Center (NWLC).

The Census data released today are for 2008 and do not reflect the impact of the decline in real wages, dramatic increase in unemployment, and corresponding loss of employer-sponsored health insurance in 2009.

“The Census data show increasing numbers of women are joining the ranks of the uninsured – at great risk to their health and financial security,” said Marcia D. Greenberger, NWLC Co-President.

Compared to 2007, nearly half a million more women lacked coverage – bringing the total number of women without insurance in 2008 to nearly 17.6 million.
This increase in the number of women without coverage stems from the continued erosion of private insurance – primarily through the loss of job-based coverage. The increase would have been even higher if not for growth in public health care coverage such as Medicaid.

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“Women’s security and well-being – and that of their families – depends on Congress passing health reform legislation that will guarantee quality, affordable comprehensive health care for us all,” Greenberger said.

The data show that poverty and extreme poverty increased for women, children, and men. The number of women living in poverty increased by 800,000 since 2007 to a total of 15.2 million in 2008.

“Women’s poverty was already higher than men’s, so this increase should be a wake up call to policy makers to take swift action,” stated Nancy Duff Campbell, NWLC Co-President.

“The Economic Recovery Act is providing desperately needed help to many families and communities, but we need to do more to combat poverty, especially with growing unemployment rates,” Campbell said. “For example, it’s critical that Congress acts to extend unemployment benefits by the end of the year to over 1 million workers who will otherwise lose this critical help. The states, too, need to take advantage of the federal funds already available.”

NWLC’s analysis of the Census data finds:

The number of women, men and children with employer-sponsored health insurance (ESI) continued to decline. The overall number of people without health insurance rose to 46.3 million in 2008—a number that would have been even more pronounced if not for gains in public health insurance coverage.

  • The number of women without health insurance increased by nearly half a million in 2008. The uninsurance rate among women was statistically unchanged since 2007, with 15% of all women (more than one in seven) lacking coverage.

  • Rates of private health coverage continued to decline. For example, the percentage of women with private ESI declined from 58.5%  in 2007 to 57.8% in 2008 – representing a decrease of nearly a quarter of a million women.
    Gains in public health insurance offset the decline in private coverage rates among women. In particular, the proportion of women with Medicaid coverage rose from 9.8% in 2007 to 10.4% in 2008. Nearly 850,000 additional women had coverage through this essential program in 2008.

  • Rates of uninsurance among children continued to decline from 11% in 1007 to under 10% in 2008. This was primarily due to the continued success of public health insurance programs like Medicaid and the Children’s Health Insurance Program (CHIP). In 2008, one in three children (33%) had public coverage, representing an increase of 1.7 million since 2007.

 

Poverty – and extreme poverty – increased significantly between 2007 and 2008 for women, children and men.

  • The number of women living in poverty rose to 15.2 million in 2008 from 14.4 million in 2007.  The number of children living in poverty rose to 14.1 million from 13.3 million and the number of men living in poverty rose to 10.6 million from 9.5 million.

  • Women’s poverty rate rose to 13% in 2008 from 12.5% in 2007.  The poverty rate among Hispanic women increased significantly – to 22.3% in 2008 from 20.8% in 2007 – while the poverty rate was statistically unchanged from 2007 among both White and Black women, at 9.4% and 23.3% respectively.

  • The child poverty rate rose to 19% in 2008 from 18% in 2007. The poverty rate for married-couple families with children rose significantly, to 7.5% in 2008 from 6.7% in 2007. 

  • The poverty rate for female-headed families with children was much higher than that for married couples, at 37.2% in 2008, but was statistically unchanged since 2007.

  • Men’s poverty rate increased to 9.6% in 2008 from 8.8% in 2007.
    The poverty rate for men increased at a faster rate than that of women or children between 2007 and 2008, but the poverty rate for women (13%) and children (19%) continues to be substantially higher than the poverty rate for men (9.6%).

  • The percentage of women and children living in extreme poverty – less than half of the federal poverty level – increased significantly.  The extreme poverty rate among women increased to 5.5% from 5.1%.  Among children, the extreme poverty rate increased to 8.5% from 7.8%. Among men, the extreme poverty rate increased to 4% from 3.5%.

Real median earnings declined for women and men in 2008 and the wage gap was 77%, statistically unchanged from 2007.

  • Median earnings for women working full time, year round, were $35,745 in 2008, down from $36,451 (adjusted for inflation) in 2007. 

  • Median earnings for full-time, year-round male workers were $46,367 in 2008, down from $46,846 (adjusted for inflation) in 2007.

  • Women working full time, year round in 2008 earned 77% of what comparable men earned – statistically unchanged from 2007.

  • Median earnings for White, non-Hispanic women working full-time, year round were $37,389 in 2008, 73% of the earnings of White, non-Hispanic men ($51,244). 

  • Median earnings for Black women working full-time, year round were $31,489, 61.4% of the earnings of White, non-Hispanic men. 

  • Median earnings of Hispanic women working full-time, year-round were $26,846, 52.4% of the earnings of White, non-Hispanic men.

Roundups Sexual Health

This Week in Sex: The Sexually Transmitted Infections Edition

Martha Kempner

A new Zika case suggests the virus can be transmitted from an infected woman to a male partner. And, in other news, HPV-related cancers are on the rise, and an experimental chlamydia vaccine shows signs of promise.

This Week in Sex is a weekly summary of news and research related to sexual behavior, sexuality education, contraception, STIs, and more.

Zika May Have Been Sexually Transmitted From a Woman to Her Male Partner

A new case suggests that males may be infected with the Zika virus through unprotected sex with female partners. Researchers have known for a while that men can infect their partners through penetrative sexual intercourse, but this is the first suspected case of sexual transmission from a woman.

The case involves a New York City woman who is in her early 20s and traveled to a country with high rates of the mosquito-borne virus (her name and the specific country where she traveled have not been released). The woman, who experienced stomach cramps and a headache while waiting for her flight back to New York, reported one act of sexual intercourse without a condom the day she returned from her trip. The following day, her symptoms became worse and included fever, fatigue, a rash, and tingling in her hands and feet. Two days later, she visited her primary-care provider and tests confirmed she had the Zika virus.

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A few days after that (seven days after intercourse), her male partner, also in his 20s, began feeling similar symptoms. He had a rash, a fever, and also conjunctivitis (pink eye). He, too, was diagnosed with Zika. After meeting with him, public health officials in the New York City confirmed that he had not traveled out of the country nor had he been recently bit by a mosquito. This leaves sexual transmission from his partner as the most likely cause of his infection, though further tests are being done.

The Centers for Disease Control and Prevention (CDC)’s recommendations for preventing Zika have been based on the assumption that virus was spread from a male to a receptive partner. Therefore the recommendations had been that pregnant women whose male partners had traveled or lived in a place where Zika virus is spreading use condoms or abstain from sex during the pregnancy. For those couples for whom pregnancy is not an issue, the CDC recommended that men who had traveled to countries with Zika outbreaks and had symptoms of the virus, use condoms or abstain from sex for six months after their trip. It also suggested that men who traveled but don’t have symptoms use condoms for at least eight weeks.

Based on this case—the first to suggest female-to-male transmission—the CDC may extend these recommendations to couples in which a female traveled to a country with an outbreak.

More Signs of Gonorrhea’s Growing Antibiotic Resistance

Last week, the CDC released new data on gonorrhea and warned once again that the bacteria that causes this common sexually transmitted infection (STI) is becoming resistant to the antibiotics used to treat it.

There are about 350,000 cases of gonorrhea reported each year, but it is estimated that 800,000 cases really occur with many going undiagnosed and untreated. Once easily treatable with antibiotics, the bacteria Neisseria gonorrhoeae has steadily gained resistance to whole classes of antibiotics over the decades. By the 1980s, penicillin no longer worked to treat it, and in 2007 the CDC stopped recommending the use of fluoroquinolones. Now, cephalosporins are the only class of drugs that work. The recommended treatment involves a combination of ceftriaxone (an injectable cephalosporin) and azithromycin (an oral antibiotic).

Unfortunately, the data released last week—which comes from analysis of more than 5,000 samples of gonorrhea (called isolates) collected from STI clinics across the country—shows that the bacteria is developing resistance to these drugs as well. In fact, the percentage of gonorrhea isolates with decreased susceptibility to azithromycin increased more than 300 percent between 2013 and 2014 (from 0.6 percent to 2.5 percent).

Though no cases of treatment failure has been reported in the United States, this is a troubling sign of what may be coming. Dr. Gail Bolan, director of CDC’s Division of STD Prevention, said in a press release: “It is unclear how long the combination therapy of azithromycin and ceftriaxone will be effective if the increases in resistance persists. We need to push forward on multiple fronts to ensure we can continue offering successful treatment to those who need it.”

HPV-Related Cancers Up Despite Vaccine 

The CDC also released new data this month showing an increase in HPV-associated cancers between 2008 and 2012 compared with the previous five-year period. HPV or human papillomavirus is an extremely common sexually transmitted infection. In fact, HPV is so common that the CDC believes most sexually active adults will get it at some point in their lives. Many cases of HPV clear spontaneously with no medical intervention, but certain types of the virus cause cancer of the cervix, vulva, penis, anus, mouth, and neck.

The CDC’s new data suggests that an average of 38,793 HPV-associated cancers were diagnosed each year between 2008 and 2012. This is a 17 percent increase from about 33,000 each year between 2004 and 2008. This is a particularly unfortunate trend given that the newest available vaccine—Gardasil 9—can prevent the types of HPV most often linked to cancer. In fact, researchers estimated that the majority of cancers found in the recent data (about 28,000 each year) were caused by types of the virus that could be prevented by the vaccine.

Unfortunately, as Rewire has reported, the vaccine is often mired in controversy and far fewer young people have received it than get most other recommended vaccines. In 2014, only 40 percent of girls and 22 percent of boys ages 13 to 17 had received all three recommended doses of the vaccine. In comparison, nearly 80 percent of young people in this age group had received the vaccine that protects against meningitis.

In response to the newest data, Dr. Electra Paskett, co-director of the Cancer Control Research Program at the Ohio State University Comprehensive Cancer Center, told HealthDay:

In order to increase HPV vaccination rates, we must change the perception of the HPV vaccine from something that prevents a sexually transmitted disease to a vaccine that prevents cancer. Every parent should ask the question: If there was a vaccine I could give my child that would prevent them from developing six different cancers, would I give it to them? The answer would be a resounding yes—and we would have a dramatic decrease in HPV-related cancers across the globe.

Making Inroads Toward a Chlamydia Vaccine

An article published in the journal Vaccine shows that researchers have made progress with a new vaccine to prevent chlamydia. According to lead researcher David Bulir of the M. G. DeGroote Institute for Infectious Disease Research at Canada’s McMaster University, efforts to create a vaccine have been underway for decades, but this is the first formulation to show success.

In 2014, there were 1.4 million reported cases of chlamydia in the United States. While this bacterial infection can be easily treated with antibiotics, it often goes undiagnosed because many people show no symptoms. Untreated chlamydia can lead to pelvic inflammatory disease, which can leave scar tissue in the fallopian tubes or uterus and ultimately result in infertility.

The experimental vaccine was created by Canadian researchers who used pieces of the bacteria that causes chlamydia to form an antigen they called BD584. The hope was that the antigen could prompt the body’s immune system to fight the chlamydia bacteria if exposed to it.

Researchers gave BD584 to mice using a nasal spray, and then exposed them to chlamydia. The results were very promising. The mice who received the spray cleared the infection faster than the mice who did not. Moreover, the mice given the nasal spray were less likely to show symptoms of infection, such as bacterial shedding from the vagina or fluid blockages of the fallopian tubes.

There are many steps to go before this vaccine could become available. The researchers need to test it on other strains of the bacteria and in other animals before testing it in humans. And, of course, experience with the HPV vaccine shows that there’s work to be done to make sure people get vaccines that prevent STIs even after they’re invented. Nonetheless, a vaccine to prevent chlamydia would be a great victory in our ongoing fight against STIs and their health consequences, and we here at This Week in Sex are happy to end on a bit of a positive note.

Commentary Contraception

For Students at Religious Universities, Contraception Coverage Isn’t an Academic Debate

Alison Tanner

When the U.S. Supreme Court sent a case about faith-based objections to the Affordable Care Act's contraceptive mandate back to lower courts, it left students at religious colleges and universities with continuing uncertainty about getting essential health care. And that's not what religious freedom is about.

Read more of our articles on challenges to the Affordable Care Act’s birth control benefit here.

Students choose which university to attend for a variety of reasons: the programs offered, the proximity of campus to home, the institution’s reputation, the financial assistance available, and so on. But young people may need to ask whether their school is likely to discriminate in the provision of health insurance, including contraceptive coverage.

In Zubik v. Burwell, a group of cases sent back to the lower courts by the U.S. Supreme Court in May, a handful of religiously affiliated universities sought the right to deny their students, faculty, and staff access to health insurance coverage for contraception.

This isn’t just a legal debate for me. It’s personal. The private university where I attend law school, Georgetown University in Washington, D.C., currently complies with provisions in the Affordable Care Act that make it possible for a third-party insurer to provide contraceptive access to those who want it. But some hope that these legal challenges to the ACA’s birth control rule will reverse that.

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Georgetown University Law Center refused to provide insurance coverage for contraception before the accommodation was created in 2012. Without a real decision by the Supreme Court, my access to contraception insurance will continue to be at risk while I’m in school.

I’m not alone. Approximately 1.9 million students attend religiously affiliated universities in the United States, according to the Council for Christian Colleges and Universities. We students chose to attend these institutions for lots of reasons, many of which having nothing to do with religion. I decided to attend Georgetown University Law Center because I felt it was the right school for me to pursue my academic and professional goals, it’s in a great city, it has an excellent faculty, and it has a vibrant public-interest law community.

Like many of my fellow students, I am not Catholic and do not share my university’s views on contraception and abortion. Although I was aware of Georgetown’s history of denying students’ essential health-care benefits, I did not think I should have to sacrifice the opportunity to attend an elite law school because I am a woman of reproductive age.

That’s why, as a former law clerk for Americans United for Separation of Church and State, I helped to organize a brief before the high court on behalf of 240 students, faculty, and staff at religiously affiliated universities including Fordham, Georgetown, Loyola Marymount, and the University of Notre Dame.

Our brief defended the sensible accommodation crafted by the Obama administration. That compromise relieves religiously affiliated nonprofit organizations of any obligation to pay for or otherwise provide contraception coverage; in fact, they don’t have to pay a dime for it. Once the university informs the government that it does not want to pay for birth control, a third-party insurer steps in and provides coverage to the students, faculty, and staff who want it.

Remarkably, officials at the religious colleges still challenging the Affordable Care Act say this deal is not good enough. They’re arguing that the mere act of informing the government that they do not want to do something makes them “complicit” in the private decisions of others.

Such an argument stands religious freedom on its head in an attempt to impose one group’s theological beliefs on others by vetoing the third-party insurance providers’ distribution of essential health coverage to students, faculty, and staff.

This should not be viewed as some academic debate confined to legal textbooks and court chambers. It affects real people—most of them women. Studies by the Guttmacher Institute and other groups that study human sexuality have shown that use of artificial forms of birth control is nearly universal among sexually active women of childbearing years. That includes Catholic women, who use birth control at the same rate as non-Catholics.

Indeed, contraception is essential health care, especially for students. An overwhelming number of young people’s pregnancies are unplanned, and having children while in college or a graduate program typically delays graduation, increases the likelihood that the parent will drop out, and may affect their future professional paths.

Additionally, many menstrual disorders make it difficult to focus in class; contraception alleviates the symptoms of a variety of illnesses, and it can help women actually preserve their long-term fertility. For example, one of the students who signed our brief told the Court that, “Without birth control, I experience menstrual cycles that make it hard to function in everyday life and do things like attend class.” Another woman who signed the brief told the Court, “I have a history of ovarian cysts and twice have required surgery, at ages 8 and 14. After my second surgery, the doctor informed me that I should take contraceptives, because if it happened again, I might be infertile.”

For these and many other reasons, women want and need convenient access to safe, affordable contraceptives. It is time for religiously affiliated institutions—and the Supreme Court—to acknowledge this reality.

Because we still don’t have an ultimate decision from the Supreme Court, incoming students cannot consider ease of access to contraception in deciding where to attend college, and they may risk committing to attend an university that will be legally allowed to discriminate against them. A religiously affiliated university may be in all other regards a perfect fit for a young woman. It’s unfair that she should face have to risk access to essential health care to pursue academic opportunity.

Religious liberty is an important right—and that’s why it should not be misinterpreted. Historically, religious freedom has been defined as the right to make decisions for yourself, not others. Religious freedom gives you have the right to determine where, how, and if you will engage in religious activities.

It does not, nor should it ever, give one person or institution the power to meddle in the personal medical decisions of others.