More than one million women call the Silver State home.  Throughout my career in Congress, I have worked on their behalf to improve women's health care, strengthen their legal and civil protections, and fight for equal opportunities in the classroom and in the workplace.  I understand that every issue before Congress impacts women and I will continue to fight for the priorities that matter to women across Nevada and the country.

Fighting for Better Health Care
I am pleased to have worked to pass legislation that will lower costs, create greater choices, and improve the quality of health care for Nevada’s families.  With the Affordable Care Act signed into law by President Obama, insurance companies are no longer able to deny children health insurance because of a pre-existing condition, or drop coverage if a patient becomes sick.  The new law also means that parents can keep children on their health plans up to age 26.  When fully implemented, health reform will prohibit insurers from discriminating against women or against consumers based on health status.  This historic health reform strengthens Medicare for our seniors, closes the “donut hole,” and ensures that women always have guaranteed choices of quality, affordable health insurance if they lose their jobs, switch jobs, move, or become sick. 

• One-Stop Shopping to Put Women in Charge  Women are often the decision-makers when it comes to health care for their families.  Health reform will provide standardized, easy-to-understand information through the Exchanges on different health insurance plans available in Nevada so women can easily compare prices, benefits and performance of health plans to decide which quality affordable option is right for themselves and their families.
• Reduced Premiums and Premium Tax Credits to Expand Private Insurance Coverage in Nevada  Health insurance reform will reduce family health insurance premiums by $1,380 to $1,970 for the same benefits, as compared to what they would be without health reform by 2016.  Reform will also provide $5 billion in premium tax credits and cost-sharing tax credits for residents in Nevada from 2014 to 2019 to purchase private health insurance. 
• Preventive Care for Better Health  The Affordable Care Act eliminates copayments and deductibles for recommended preventive care and screenings in new private insurance plans, which will help to reduce the tremendous burden of preventable disease among women in Nevada.  The law also eliminates out-of-pocket costs for recommended preventive care and screenings like mammograms in Medicare, while adding an annual wellness visit to the program, giving women the opportunity to develop personalized prevention plans and to assess risk factors for disease.
• Increased Medicaid Support  The Federal government will fully fund the coverage expansion for the first three years of the policy, and continue substantial support, paying for 90% of costs after 2020, compared to Nevada’s current FMAP of 50.2%.  In total, Nevada could receive $3.6 billion more dollars in federal funds for Medicaid as a result of the expansion from 2014 to 2019.

For more information on benefits of the Affordable Care Act, please click here.

Putting Prevention First
The United States has among the highest rates of unintended pregnancies of all industrialized nations.  Half of all pregnancies in the United States are unintended, and nearly half of those end in abortion.  That is why I am the sponsor of legislation, the Prevention First Act, which will improve access to women's health care, reduce the rate of unintended pregnancy, and reduce abortions - all while saving scarce public health dollars.

The Prevention First Act includes common-ground, common-sense policies.  A low income woman is four times as likely to have an unintended pregnancy, five times as likely to have an unintended birth and more than four times as likely to have an abortion as her higher-income counterpart.  That is why the Prevention First Act would make family planning services more accessible to low-income women.  For every dollar spent on publicly funded family planning, $3.80 is saved in pregnancy-related and newborn care cost to Medicaid.

The bill would also improve awareness and understanding of emergency contraception, and would ensure that it is available to victims of sexual assault.  It also ensures that government-funded sex education programs provide medically-accurate information about contraception.

In addition, this comprehensive measure includes the Equity in Prescription and Contraception Coverage Act (EPICC), bipartisan legislation that I have long championed.  EPICC would require insurance plans that provide coverage for prescription drugs to provide the same coverage for prescription contraceptives.  Women of reproductive age pay 68 percent more in out-of-pocket medical expenses than men, largely due to their reproductive health-care needs.  EPICC will take a significant step toward eliminating this inequality in health care coverage that unfairly impacts women.

Finally, this legislation includes a provision called the Prevention Through Affordable Access Act, to that was recently signed into law.  This provision remedies a problem that unintentionally cut off hundreds of safety-net providers from access to low-cost prescription contraception.

Eliminating Health Disparities
Funding promising medical research on women-specific diseases is a priority.  When I first entered the Senate, I was dismayed to find that research funding for such diseases had been shortchanged.  While certain illnesses cut across gender lines, they affect women differently or in higher proportion than men.  For example, women are more likely than men to suffer a second heart attack.  I will continue to support funding for more research to study how illnesses affect women and to learn more about the illnesses that disproportionately affect women.

Breast cancer is one such disease that takes a devastating toll on Nevada's women, with over 1,600 women diagnosed in our state each year.  I am proud to have authored the Breast Cancer Environmental Research Act, which is now law.  This legislation boosted research and established a national strategy to study the role of the environment in the development of breast cancer.  The resulting discoveries could be critical to improving our knowledge of this complex illness, which could lead to new treatments and perhaps, one day, a cure.

At the same time, I will continue to support federally-funded programs that ensure access to lifesaving screenings and treatment, such as Nevada Women's Health Connection.  Also known as the National Breast and Cervical Cancer Early Detection Program, this program has been tremendously successful across the country.  This program has provided 6.9 million screening examinations in all 50 states, with more than 29,000 breast cancers and 1,800 cervical cancers detected as a result.  Unfortunately, because these women are uninsured, they often do not have the resources to get treatment for their cancer.  To help solve this problem, I cosponsored the Breast and Cervical Cancer Treatment Act to allow women who are diagnosed under the screening program to receive needed care. As a result, Nevada women diagnosed through Women's Health Connection are eligible for Medicaid coverage until their treatment and follow-up visits are completed.

Making Work Pay
Women deserve equal pay for equal work.  Unfortunately, the average woman is still paid only 77 to 81 cents for every dollar her male counterpart is paid.  Even after accounting for differences in education and the amount of time in the work force, women's pay still lags far behind men who are doing the same or similar work.  That is why I am proud to have led the Senate in passing the Lilly Ledbetter Fair Pay Act, the first bill President Obama signed into law.  This landmark legislation restores back pay and enforces civil rights protections for workers who faced discrimination based on gender, age, race, national origin, religion or disability.  Additionally, I am also an original cosponsor of the Paycheck Fairness Act, which would revise and strengthen the Equal Pay Act of 1963 and will further target gender pay discrepancies in the work place.

In the 110^th Congress, I also proudly helped increase the federal minimum wage for the first time in 10 years, giving millions of women a pay raise in 2007.  As too many Nevadans know all too well, the cost of housing, food, gasoline, and other expenses has increased since the minimum wage was last adjusted.  This issue is particularly significant for women, as they comprise nearly two-thirds of workers who make less than the current federal minimum wage.  Many are often the sole support for their families.

Protecting Women at Home and Abroad
We must support the rights of women both at home and abroad.  I have long supported efforts to reverse the global gag rule, a misguided policy that denies funding to groups that promote women's health and reduce the rate of unintended pregnancies by educating women about family planning methods.  I was pleased that President Obama repealed this policy in January 2009.  This decision will go a long way toward improving maternal and child illness and death, reducing the rate of unintended pregnancies and abortions, and fighting the spread of HIV/AIDS and sexually transmitted infections in developing countries.

I also have been a strong supporter of funding the United Nations Population Fund (UNPFA), an international organization that provides life-saving reproductive health services, works to prevent female genital mutilation, fights the spread of HIV/AIDS, and helps mothers safely undergo childbirth.

Additionally, we must demonstrate our support for the women of Afghanistan by providing humanitarian relief, health care and education for them.  I am working with my colleagues in the Senate to ensure that women are included in the rebuilding of Afghanistan and to help women around the world.

Ending Domestic Violence
Throughout my career in Congress, I have supported federal legislation and programs designed to prevent domestic violence and help its victims, including the Family Violence Prevention and Services Act, grants to combat violence against women, and the Victims of Crime Act.  I also cosponsored the original Violence Against Women Act (VAWA), the landmark law that significantly expanded the federal government's commitment to eliminating violence against women.  Among other provisions, VAWA provides federal funding to law enforcement officers, prosecutors, and advocates for prosecuting crimes, addressing victims' needs, educating the public, and otherwise preventing sexual and relationship violence.  I have continued to support VAWA each time it has been reauthorized and have consistently pushed for more VAWA funding.

Protecting Title IX
I strongly support Title IX, which prohibits discrimination on the basis of gender in federally-assisted education programs or activities.  The public perception of Title IX revolves around its application to athletics, yet this landmark law applies to every area of gender-based discrimination in an educational setting.  Title IX has been instrumental in promoting sports equality for female athletes at high schools and colleges around the nation. Achieving equal opportunity for women in intercollegiate sports, however, remains an ongoing challenge.  We need to level the playing field and continue opening up athletics to more women.