Collective Action Strategies

Gender Impacts Policy, a project of the non-profit Center of Southwest Culture, has submitted a report to the New Mexico Human Services Department under a federal health care reform planning grant on the sex and gender implications of a New Mexico health insurance exchange. The project director was Giovanna Rossi and project adviser was Dr. Justina Trott.
Sex-Gender Final Report June 2011

Sex and gender differences in health outcomes are significantly impacted by a person’s environment and cultural practices in diet, geography, education, social practices, and resource availability (especially economic). Consequently, there is need for analyzing the inter-relational impact of diversity and other social determinants of health in implementing sex- and gender-based programs to truly achieve health equity, and that such an analysis must be conducted at multiple levels of intervention (policy, planning, programs, services, and research).

This project utilizes a sex and gender lens to analyze barriers to health coverage, participation in a health insurance exchange, benefits and services, and customer information to assess the differential impact on women to achieve health equity. The benefit package of insurance products sold in a health insurance exchange and other health insurance exchange services will need to be designed to address the needs of and be accessible to populations of both men and women in all of their diversities.

For the purpose of our study and this report, sex and gender stakeholder population is defined as, and this project focuses on, input from diverse populations of women, including ethnicity, socio-economic status, age, abilities, geographic region, and sexual orientation. The stakeholder input methodology is designed to include people in greatest economic and social need, particularly low-income, minority, and rural individuals. The methodology includes four key informant interviews, seven focus groups, a policy forum, and a gender analysis of secondary sex-disaggregated data. A statewide stakeholder participant recruitment plan is developed, which includes input from Native Americans, Hispanic/Latinas, parents of transgendered teens, young women, low-income women, monolingual Spanish speakers, and rural women.

Key Recommendations for Establishing a Health Insurance Exchange
The recommendations presented here are organized around the core areas studied: health coverage, participation in a health insurance exchange, benefits and services, customer service, and gender roles. We then group themes that include cost; family impact; power structures and cultural barriers; information, knowledge and trust; and comprehensive, integrated and colocated services. And given the needs identified in this report, a Basic Health Plan (BHP) in New Mexico would benefit the population studied.