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Top 10 Obamacare Benefits at Stake for Women

Supreme Court Decision Could Set Women’s Health Back

SOURCE: Center for American Progress

Supporters of the Affordable Care Act reform rally in front of the Supreme Court in Washington, D.C. on the final day of arguments regarding President Barack Obama's signature piece of legislation. A ruling that strikes down this important law would not only undo decades of precedent, it would have a devastating effect on the health and well-being of millions of women.

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The Supreme Court is currently reviewing the constitutionality of the Affordable Care Act, more commonly known as “Obamacare.” This landmark piece of legislation signed into law by President Barack Obama drastically reforms the way health insurance works in our country. Below we outline 10 reasons why, as stated in the Center for American Progress report “Women and Obamacare,” women in America have so much riding on the Supreme Court’s decision.

1. Obamacare guarantees coverage of preventive services with no cost sharing. Preventive care promotes health and saves money. Yet many preventive care services are out of women’s reach due to high co-pays, deductibles, and co-insurance. More than 50 percent of women have delayed seeking medical care due to cost, and one-third of women report forgoing basic necessities to pay for health care. But under the health reform law, insurers are now required to cover recommended preventive services such as mammograms, Pap smears, and well-baby care without cost sharing. More than 45 million women have already taken advantage of these services. And starting this August more services, including contraception, gestational diabetes screening, and breastfeeding supports, will be added to the list of preventive care that must be covered at no additional cost.

2. Maternity care will be required in new insurance plans. Coverage for maternity care—health care that only women need—is routinely excluded in the individual insurance market. Only 12 percent of plans sold in the individual market even offer maternity coverage, which is frequently inadequate because of waiting periods or deductibles that can be as high as the cost of the birth itself. But once Obamacare is fully implemented in 2014, about 8.7 million women will have guaranteed access to maternity care in all new individual and small group plans.

3. Women will no longer be denied insurance coverage for gender-related reasons. In today’s insurance market, it is common for insurers to refuse to cover women because of gender-based “pre-existing conditions,” such as having had a Cesarean section or being the victim of domestic violence or sexual assault. Thankfully, this practice will be outlawed under Obamacare in 2014. In the meantime, adults with pre-existing conditions who have been uninsured for at least six months can purchase affordable coverage through temporary Pre-existing Condition Insurance Plans.

4. Women will no longer be charged more for their insurance coverage just for being women. Under a practice known as “gender rating,” insurers currently charge women higher premiums than men for identical health benefits. As a result, women now pay $1 billion more than men each year for the same health plans in the individual market. As of 2014, however, under the Affordable Care Act, gender rating will become illegal in all new individual and small group plans.

5. Women have more control over their health care. Already, women no longer need a referral to see their obstetrician-gynecologist thanks to Obamacare. And they get to choose their primary care physician and their child’s pediatrician from their plan’s list of participating providers.

6. Women will gain better access to affordable health insurance. Starting in 2014 women and their families, as well as small businesses, will receive tax credits on an income-based sliding scale to help purchase insurance coverage. This will help individuals who earn up to $43,000 per year and up to $92,200 for families of four. Also in 2014 up to 10.3 million women will gain insurance coverage when Medicaid expands its income eligibility to include people with incomes below 138 percent of the federal poverty level—less than $15,000 for individuals and about $31,809 for a family of four in 2011. The health law also eliminates Medicaid’s categorical requirements, so that low-income women who meet the income requirements can be enrolled even if they have no children and are not pregnant.

7. Insurance companies can no longer place limits on the amount of money they’ll spend on covered medical expenses. Women are more likely than men to suffer from a chronic condition, and an unforeseen medical emergency or a chronic illness can cause an insured person to rapidly reach a coverage cap in their insurance plan, leaving enrollees to fend for themselves, sometimes with thousands of dollars in unpaid medical bills. But under Obamacare lifetime coverage caps have been eliminated and annual limits are being phased out. Approximately 39.5 million women have already benefited from the ban on lifetime caps.

8. Women and their families benefit from critical consumer protections in Obamacare. Because women use health care services at higher rates on behalf of themselves and their families, ensuring just insurance practices is of critical importance. The Affordable Care Act has already eliminated the practice of “rescission,” when an insurance policy ends the moment a beneficiary gets sick. The health law also requires insurers to spend at least 80 percent of premiums on actually providing health care, as opposed to administrative costs, or pay enrollees a rebate. Policyholders and employers will receive approximately $1.3 billion in premium rebates this year alone.

9. Women in marginalized communities are seeing reforms that respond to their needs. Women of color, lesbian and bisexual women, and transgender people are disproportionately uninsured and subject to higher rates of health disparities. Obamacare is making critical strides in providing vulnerable women with quality health care through increased access to insurance coverage, increased funding for community health centers, promoting health literacy and cultural competency, prohibiting discrimination in the health insurance market, and improving data collection. For instance, already an estimated 5.5 million African Americans, 6.1 million Latinos, 2.7 million Asians, and 0.3 million Native Americans, many of them women, have received preventive service coverage with no cost sharing under the health reform law.

10. Mothers have peace of mind, knowing that their children have health insurance. Obamacare prohibits insurers from denying coverage to children under age 19 because of pre-existing conditions. And adult children can now stay on a parent’s plan up to age 26, an especially helpful provision in this tough economy, where finding a job with benefits is challenging. Young women in particular report delaying needed health care because of high costs. To date, 2.5 million young adults have gained coverage under the Affordable Care Act.

Obamacare is a lifeline for women and their families. Women cannot afford to go back to a world where they pay more for less health care coverage, are denied preventive and essential health care services, and are treated like pre-existing conditions. A ruling that strikes down this important law would not only undo decades of precedent, it would have a devastating effect on the health and well-being of millions of women. Women have gained too much from Obamacare to lose it now.

Jessica Arons is the Director of the Women’s Health and Rights Program and Lucy Panza is a Policy Analyst with the Women’s Health and Rights Program at American Progress.

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