What do you think is an essential part of your health care?  Is it a specific service that most women need at some time in their lives, like maternity care or contraception?  Is it something that you hope you’ll never need, but it darn well better be covered when you need it, like reconstruction after losing a breast to cancer?  Or is it something that enables you to make the most informed decision possible, like coverage for a second opinion?

All of these are aspects of health care that women have fought for and won…at least in some parts of the country.  Yes, that’s right, that service that you think is essential might not be included in your insurance depending on where you live.  That doesn’t seem right does it?  The law, up until now, has left the regulation of health insurance up to the states.  Women who wanted their insurance to cover contraception (since after all, it covered Viagra!) had to mount campaigns state by state, to get to where we are now, with most policies in most states including contraception if they cover prescription drugs.  But not all services that women consider essential have widespread coverage.  Direct entry midwifery, for example, is only officially permitted in in 34 states.

That’s about to change.  Sometime in the next year, the federal government is going to tell insurers what has to be covered – they’re calling it the “essential benefits package”.  I’m really excited about this.  If the feds do their job right, these rules will mean that whether or not the service you need is covered won’t depend on where you live.  But we’ll have to work hard to make sure the feds do their job right, because there will be all kinds of pressure on them to keep the cost down by creating a very short list of essential benefits.

As a long-time women’s health advocate, I know those state-by-state fights were important.  We made legislators listen to us, and created laws that required insurers to cover services we needed.  Taking it to the top – to the feds – means that we have the chance to expand our victories to cover women in all 50 states.  We also face the threat of losing hard-won gains.  Over the next year, I’ll be working with my partners in the Raising Women’s Voices project to make sure that our voices are heard and our needs are responded to.  After all, our health care is essential.

Cindy Pearson is co-founder of Raising Women’s Voices for the Health Care We Need and Executive Director of the National Women’s Health Network

This blog is part of the #HERvotes blog carnival.