Month: April 2019

1,000 Days joined the International Coalition for Advocacy on Nutrition (ICAN) to submit the following statement to the Multi-stakeholder Hearing for the UN High-Level Meeting on Universal Health Coverage held on April 29, 2019. The statement was delivered by WaterAid on behalf of the coalition. This statement has since been updated and delivered at the 72nd World Health Assembly; 1,000 Days and partners have signed on to show support as we head towards the UN High-Level Meeting on Universal Health Coverage

Preventing and treating malnutrition, especially during the first 1000 days, is a critical pathway to realising UHC. Affecting every third person, malnutrition and related NCDs underlie almost half of all child deaths, and 71% of global deaths.

Malnutrition disproportionately affects the poorest and most vulnerable, aggravating the intergenerational cycle of ill-health and poverty. Essential nutrition services like breastfeeding and dietary counselling, hygiene promotion, wasting treatment, and, vitamin and micronutrient supplementation promote development, reduce NCDs, and increase immunity and resiliency to infection. Investing in these high-impact, low-cost interventions will support the achievement of UHC.

We urge Member States to prioritise nutrition in the HLM outcome document as a determinant of UHC and commit to:

• Integrate nutrition interventions and health promotion in PHC, focusing on the poorest and most marginalised, especially women and girls;
• Train and support community health workers to deliver key nutrition services;
• Ensure essential medicines include health products to prevent and treat malnutrition;
• Allocate greater financing for and ownership of nutrition by health decision makers, in collaboration with other stakeholders including WASH, education, agriculture and social protection.

1,000 Days believes that every mom, child and family in America deserves a healthy first 1,000 days. We support guaranteed access to high-quality, affordable health insurance that offers comprehensive benefits for preconception and prenatal care, maternity services, breastfeeding and postpartum care, pediatric care and other critical maternal, infant and young child health services. In addition, we reject all efforts that would make it more difficult for families to access comprehensive health insurance, result in increased numbers of uninsured people, or put needed services out of reach. This would roll back the progress we’ve made — and would result in worse health outcomes for moms and children.

With health care in the news a lot these days, we want to provide an update on what’s been accomplished to date, what’s really on the horizon — and what’s at risk.

The Affordable Care Act Matters to Moms and Babies

Just over 9 years ago, the Affordable Care Act (ACA) became law, making it easier for moms and young children to access high-quality and affordable health insurance. Today, more American families have health insurance, whether through their employer, the Health Insurance Marketplace or Medicaid. Additionally, their insurance is required to include essential health benefits — services that support the health of women and young children.

As a result of the ACA, just being a woman is no longer a reason for insurers to charge more for equal coverage. Maternity and newborn care, hospitalization, mental health services and recommended preventative services are all considered essential health benefits, meaning these services must be included in all new insurance plans. And women can no longer be denied coverage for pre-existing conditions such as a previous pregnancy, C-section, diabetes or cancer. These positive changes to our health insurance system have meant more moms, children and families have the health security they deserve.

Threats on the Horizon

Despite these gains, a series of legal challenges threatens the ACA’s future — and possibly the health coverage many families need. Most notably, a lawsuit has been filed that would overturn the entire ACA. While this lawsuit has a long legal fight ahead of it, it made news again recently because the Trump Administration stated its agreement that the entire ACA should be deemed unconstitutional and struck down. These attacks on the ACA put comprehensive coverage at risk for many families.

In separate legal action, courts will be examining expanded access to plans that offer limited benefits packages. Earlier this year, a court ruled against the Administration’s “association health plans” (AHPs). AHPs are not required to offer comprehensive benefits and are allowed to charge more for certain needed services. Another long legal battle will determine the fate of these limited-benefit plans.

If the ACA goes away or if limited-benefit plans are allowed to proliferate, here’s what’s at risk:

Comprehensive maternity, newborn and pediatric care could be put out of reach.

Health insurance plans would be able to pick-and-choose what benefits they offer. Essentially, this could mean a return to a pre-ACA health system when 75% of plans on the individual market did not include maternity coverage. Women would be left to choose between going without needed health services or paying out-of-pocket. That’s a decision no woman should be forced to make.

Women could pay more for less health coverage.

We’d be stepping back in time, before the passage of the ACA, when women could be charged more for their health insurance just because they are women.

Pregnancy could become a pre-existing condition (again).

If the ACA goes away or consumer protections are eliminated, insurers would be able to decide what is – and is not – a pre-existing condition, and then charge more accordingly. Just like before the passage of the ACA, women could be denied coverage (or charged a lot more) for health insurance just for having given birth or being of child-bearing age.

Because we know that comprehensive, affordable coverage is critical for the health and well-being of women and young children, 1,000 Days will continue to advocate for policies that strengthen our health care system and help ensure more families can access the care they need. We will work with bipartisan Congressional champions to make sure that all efforts take into consideration the unique needs of the first 1,000 days so that we can maintain access to the services women, children and their families need.

This year we’ve seen real momentum around a critical issue for working families in the United States: access to paid leave. At 1,000 Days, we are thrilled to see our nation’s leaders giving this important issue the attention it deserves. We believe that no parent should have to choose between taking time to care for and bond with their child and earning the income they need to support their family. And all women should be able to take the time they need to care for themselves during pregnancy and after childbirth.

Unfortunately, this is not the reality for many parents in the U.S. Only a small fraction of workers have access to paid leave – and those workers who do are typically in higher paying jobs. As a result, nearly 1 in 4 women in the U.S. returns to work within just 2 weeks after giving birth.

Access to comprehensive paid leave would help working parents give their children the strongest start to life. Research shows that paid leave contributes to healthier outcomes for moms, babies and their families. From helping to reduce the risk of infant death and illness, to helping women breastfeed more successfully and for longer periods of time, to promoting healthy cognitive, social and emotional development in children, the benefits of paid leave are numerous and far-reaching. Without access to paid leave, moms’ and babies’ health and well-being are put at risk.

Our Vision for Paid Leave

With grassroots support building around the country for a national paid leave program, it is important to remember that details matter. Not all paid leave policies would enable parents and their children to have the healthiest first 1,000 days and all the days that follow.

1,000 Days calls for a comprehensive paid family and medical leave program that covers all workers. To best support families during the first 1,000 days, the program must:

1. Provide sufficient time off. At a minimum, 12 weeks of paid leave should be provided to working parents upon the birth or adoption of a child. 1,000 Days supports efforts to increase paid leave up to 24 weeks annually, which is especially critical to supporting women to breastfeed exclusively for six months, as recommended by the American Academy of Pediatrics, the American Congress of Obstetricians and Gynecologists and the World Health Organization.
2. Cover all employers and all employees. Paid leave must be available to all workers, regardless of the size of their employer, the sector they work in, the length of their employment or whether they work full-time, part-time or are self-employed. Leave must be available to both women and men, regardless of marital status, and policies must be designed in a way to prevent unequal treatment in the workplace and hiring discrimination based on age, gender, sexual orientation and other criteria.
3. Ensure economic security now and in the future. Employees’ wages and benefits must be maintained so that workers are not forced to decide between their caregiving obligations and their jobs. Employees must also retain the right to resume full paid employment after taking leave. Additionally, policies must ensure that taking leave now does not threaten employees’ future retirement security.
4. Cover medical and family caregiving needs. Any plan should be available for the full range of personal medical and family caregiving needs, such as those established by the Family and Medical Leave Act.

The FAMILY Act (S.463/H.R.1185) introduced by Senator Gillibrand (D-NY) and Representative DeLauro (D-CT) is the only bill in Congress right now that meets all of these criteria.

As conversations continue around our country’s vision for paid leave, let’s keep the needs of moms and babies top of mind and work to pass a strong paid leave policy that works for ALL families.