Emily McKhann, TheMotherhood.com

When I first started blogging in 2004 I had no idea the impact it would have on my life. Yes, I found a place to talk about what was going on in my world, but much more important as it turned out, I got to read - in fact really hear – the stories of other moms and their day-to-day raising of their kids.

Nothing like a good story to draw you in. Because that’s what moms do – we tell our stories and are there for each other in ways big and small that help us make a little progress each day.

For years now, moms have been posting about how worried they are about paying for doctor visits or hospital stays or the medicines they and their family need. With names, faces and sometimes life and death decisions to make, the personal stories have given me a whole new understanding of what it means when the headlines say 50 million Americans don’t have health insurance.

Before blogging, healthcare reform was a big, impersonal issue that had little relevance to my life.

Not anymore. Many women I know both online and off have been decimated by health care costs and while I am lucky to have insurance, I am appalled at the rates and how often I have to fight for coverage of the most basic services.

Now, with health care reform working its way through Congress, it’s looking like things might change.

But, really, do we know if it’s going to work out for us moms?

TheMotherhood.com hosted a live chat with a leading expert in the field, Melissa Schober from Women’s Policy, Inc. and a mother herself, to ask our questions about health care reform and the implications for moms and families. Here are some highlights (you can read the entire chat here):

Will there be a public plan?

Melissa: For now, it seems some sort of public plan will be included along with health reform. That means a plan paid for and perhaps administered by the federal government. We already have some of these -- Medicaid, Medicare, etc. Some work well (the Veterans Administration is touted for being a cost-savings innovator while still providing quality care); some don't (Medicaid reimbursement rates are low, compared to private ins., so it is very difficult in some areas to find a doctor and especially a dentist).

Will it really cost a TRILLION dollars?

Melissa: That oft-repeated figure of ONE TRILLION sounds scary. But try to think about it like this -- it is $100 billion a year over 10 years. To cover some 45-50 million Americans. Think about this the next time you hear someone getting hysterical about costs: Every year, Congress passes a bill to fund the Departments of Labor, Health and Human Services, and Education. That bill? In 2009, the Senate proposed $626 BILLION for JUST ONE YEAR (including spending on Medicaid and Medicare).

What does healthcare reform mean for women and families?

Melissa: Wow, what a great question! I think the implications -- if it goes well -- could be huge. It will mean less fragmented care. What do I mean? Well, as a minor a girl might be covered by her parents' insurance but only until she finishes college. Or she might receive public insurance but only via the State Children's Health Insurance program. Then she might be able to buy coverage as young healthy adult, either via her college or employer or privately. But that coverage almost certainly won't include maternity benefits. As she ages and needs maternity care, she'll find her ability to find a policy on her own more difficult.

Just that small anecdote illustrates the lack of continuous coverage. It is precisely this sort of coverage -- sometimes referred to as a medical home -- that is so important to preventive care and early disease detection. Personally, the idea that the US is alone among industrialized nations in NOT providing insurance and NOT providing paid family leave is a moral failing. It is simply wrong.

Why are so many women without health insurance? From what I've heard it's many more women than men.

Melissa: Basically it boils down to this: Women are more likely to be employed in service sector industries (retail, some health care) that are less likely to be unionized and less likely to offer benefits of any kind. 60-some-odd percent of low income wage workers -- many of whom are women -- have no paid leave at all. Zero. Some women are covered by their husband's insurance policy. If he loses his job, and COBRA is too expensive, then she loses coverage. Young women typically have luck in buying individual policies in the open market. However, as soon as they want a policy with maternity care they are suddenly out of luck. And as they age and want a policy with appropriate screening -- mammogram, bone density, etc. -- they are much more likely to have difficulty finding a policy. The Kaiser Family Foundation has GREAT resources in this area.

How did we (the US) attach health care to employers? Will this reform allow employers to drop coverage for their employees?

Melissa: Health care got attached to employment during WWII and after. In the early 40’s, the National Labor Relations Board instituted a wage freeze BUT they exempted fringe benefits such as health benefits. So, to attract employees, employers began offering health benefits. In the mid 50’s, health insurance benefits were exempted from the IRS – they weren’t considered wages for taxation. Then in the 60’s we saw the Great Society programs. Whether employers will drop coverage depends on what reform looks like. There could be a statutory prohibition on dropping coverage, or some subsidies for employers to keep covering employees, or even a pay or play requirement (employers have to offer coverage or pay into a fund to cover the uninsured).

Read the whole chat here:

http://www.themotherhood.com/circlechat.php?l=55923

Share with us here your questions, concerns and stories. And click on the link below to send a letter to Congress saying:

The time is now: Get real healthcare reform done immediately, and get it right for kids and families!

- Emily McKhann, TheMotherhood.com