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Pennsylvania is ranked 22nd overall for women’s health in the country, according to a report card released by the Alliance for a Just Society.

LeeAnn Hall, the executive director for the Alliance for a Just Society, said this report should be a wake-up call for those states that didn’t expand Medicaid, despite the federal government offering full funding for the expansion for the first few years.

“The results are particularly telling for the states that have not moved forward on Medicaid expansion,” Hall said. “17 of 21 states that rejected federal funding to expand health care through Medicaid received final grades of C, D, or F in the report. This report card shows that most states that are still refusing funding for Medicaid expansion have poor and failing records on women’s health. These states are failing women and the families that depend on them.”

Pennsylvania Gov. Tom Corbett refused to accept the federal funding without changes to Medicaid expansion because he wanted it to be more like private insurance. However after much back and forth, the U.S. Department of Health and Human Services approved a Pennsylvania plan that lets private insurers administer Medicaid-funded coverage that adheres to Medicaid’s existing rules. The plan vastly expands a Medicaid program that already covers 2.2 million adults and children in Pennsylvania under the name Healthy Pennsylvania. The program goes into effect on Jan. 1, 2015.

While the state ranked in the top 20 for health coverage and access to health care, the outcomes dragged down the average. The report gives the state a C+ overall, with a B+ in health coverage, a B in access to health care and a D in health outcomes.

The Alliance for a Just Society is a national network of 14 racial and economic justice organization across the country, and it aims to execute regional and national campaigns and build strong state affiliate organizations and partnerships that address economic, racial and social inequities.

Since women are increasingly becoming heads of households and society depends heavily on women as the primary health care navigators for families, the report said it’s important to ensure access to quality, affordable health care. The report card found that Pennsylvania has a long way to go to ensure that all women have that access.

“This report card shows Pennsylvania has only an average record on women’s health,” Michael Morrill, executive director of Keystone Progress Education Fund, said in a news release. “It’s time to get past political gridlock and take concerted action to improve women’s health. The first step we should take is to improve preventative care for women here in Pennsylvania. We need to focus on better coordination across health networks, more emphasis on early detection and easier, more affordable access to routine medical visits, not just emergency care.”

Findings

Pennsylvania received a B+ in health coverage for women, with racial disparity ratios highlighting race-based differences in that coverage for women from communities of color ranged as high as 1.9 to 1.

The racial disparity range is determined by dividing the data point for the selected racial group by the corresponding data point for the overall population of women in that state. So, for example, an uninsured racial disparity ratio of 1.33 for black women means the uninsured rate for black women was 33 percent higher than for women overall in that state.

So in the subject area of health coverage for women, the percentage of non-elderly women who were uninsured in 2013 was 10.4 percent with a racial disparity ratio of 1.27 for black women and a ratio of 1.9 for Latinas.

For the section on women’s access to health care, in 2012 the percentage of women who had a routine health exam in the past two years was 86.2 percent, and 71 percent of women visited a dentist or dental clinic in the past year. The percentage of women age 40 and older who had a mammogram within the past two years was 73.3 percent. And the percentage of women ages 21-65 who had a pap test within the past three years was 81.4 percent. The number of women ages 13 to 44 in need of publicly funded contraceptive services was 760,150, with only 37 percent of that need met by publicly funded family planning clinics, ranking the state at 14th in the country for that service.

In women’s health outcomes, the state is ranked 37th in the country, which gives it a letter grade of D. Some of the notable sections in the report card showed that the percentage of women reporting that they have asthma was 13.4 percent with a racial disparity ratio of 1.25 for black women, 1.6 for Latinas and 0.28 for Asian/Pacific Islanders. The percentage of women reporting ever having been diagnosed with diabetes was 9.7 percent with a racial disparity ratio of 1.88 for black women, 1.72 for Latinas and 0.92 for Asian/Pacific Islanders.

The maternal mortality rate per 100,000 live births from 2003 to 2007 was 12.9 and the infant mortality rate overall per 1,000 live births between 2008 and 2010 was 7.2. The racial disparity ratio for infant mortality was 1.74 for black women, 1.18 for Latinas and 0.67 for Asian/Pacific Islanders.

Recommendations

The Alliance for a Just Society also includes recommendations to remedy the situations that cause the grades in each of the categories. For health coverage, the organization said Pennsylvania should invest in community-based outreach and health coverage enrollment strategies targeted toward low-income women and communities of color. It also suggests that policymakers and regulators should monitor the level of choice and competition in the individual and family health insurance marketplace, as well as the small business marketplace.

To help improve women’s access to health care, the alliance recommends that the state establish and enforce strong standards for marketplace health plan provider networks to ensure that all services will be accessible. It also suggests that policymakers protect and expand, not restrict women’s access to all family planning services, including contraceptives and abortions.

In the health outcomes section, the alliance recommends that the state invest in preventative care for women. It said the state needs to encourage a proactive focus on preventative care in order to expand coverage and access to care and improve the outcomes overall. It also said Pennsylvania needs to improve chronic disease management by including better coordination across providers, more emphasis on early detection and warning signs and better education.

“Pennsylvania has an opportunity to improve its overall record on women’s health, catch up with other states that are performing better, and be a leader on eliminating race-based disparities,” Morrill said in a news release. “But if our elected officials continue to drag their feet, we’re only going to fall further behind other states. Women who are denied health care, and the families who depend on them, will pay the price.”

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