Women and the Health Care Law in the United States

For a PDF version with footnotes, please see below.

The health care law, also known as the Affordable Care Act, protects women from discriminatory health insurance practices, makes health coverage more affordable and easier to obtain, and improves access to many of the health services women need. Approximately 17 million women will gain coverage because of the Affordable Care Act.  Millions of women already benefit from the new law, and all women will gain important protections when the law is fully implemented in 2014.

Problems Women Face Today

While the broken health insurance system affects everyone, women are particularly disadvantaged by current insurance practices and unmanageable health care costs:

• Women comprise a disproportionate share of health care consumers, often managing multiple chronic conditions and paying more out-of-pocket costs, causing their health care to be prohibitively expensive and frequently unaffordable.
• Women routinely forgo needed services and care. Indeed in 2008, one in four women reported going without needed health care because they could not afford it.
• In most states, women are routinely denied coverage because of Pre-Existing Conditions such as having had a C-section, breast or cervical cancer, or receiving medical treatment for domestic or sexual violence.

What These Problems Mean for American Women

• As of 2010, approximately 19,017,000 women, over 19.6% of women, are uninsured. The numbers are even higher for women of color. 24.1% of Black women and 37.3% of Hispanic women are uninsured compared to 14.6% of White women.
• Women who are able to buy health insurance on the individual market often have to pay more than men for the same coverage, a practice known as gender rating. In the U.S., 92% of plans practice gender rating, with 56% even charging non-smoking women more for coverage than male smokers.
• Individual market insurance plans often don’t cover all of the services women need. In the U.S., only 12.5% of individual market plans cover maternity care.

How the Health Care Law is Already Working for Americans

Immediate Access to Health Care for Women and Families

• The law allows young adults to remain on their parents’ health insurance until age 26. Over 1 million young women across the country have gained insurance coverage through this provision of the health care law. Over 2,500,003 young people have gained coverage thanks to the law.
• Children with pre-existing conditions can no longer be denied health coverage. This provision is already helping 4,952,100 kids with pre-existing conditions access health care.
• 61,619 uninsured women with pre-existing conditions have already enrolled in either state or federally run Pre-Existing Condition Insurance Plan.

Greater Access to Preventive Care

• Health plans must now cover certain preventive services such as mammograms, flu shots, and colon cancer screenings at no additional out-of-pocket-costs such as co-payments.  Approximately 19,187,946 American women can receive preventive services without a co-payment.

Insurance Reforms and New Limits on Costs

Insurance companies must already abide by new rules that enable people to keep their health coverage and get the care they need.  For example, health plans are no longer allowed to cancel health insurance policies or drop coverage when people become sick, and must offer an explanation when they increase premiums by more than 10 percent.  Plans must post all explanations online and consumers must have a chance to comment on the rate increase.  The health care law also reduces what women and families will have to pay for health care by capping out-of-pocket expenses.

Furthermore, in the United States:

• Nearly 39,534,000 women no longer have a lifetime limit on their health coverage. The law prohibits lifetime limits on most benefits.
• 76,180,000 people are already seeing the effects of a federal requirement that insurance companies must spend 80-85 percent of premiums on health care, instead of on administrative costs and profits. Insurance companies that have not met this standard are required to provide rebates to consumers, which are expected to total $426,192,338 in 2012.

Benefits for Women on Medicare

• Over 19,187,946 women on Medicare in the U.S. have received preventive services at no additional cost in 2011.
• Already, 2,049,480 women on Medicare in the U.S. have saved an average of $604 on prescription drugs as the new law has begun closing the so-called doughnut-hole in Medicare’s prescription drug benefit.

Many Benefits and Protections on the Way

Access to Coverage in the United States

• By 2014, there will be a health insurance exchange up and running where women can easily compare plans and shop for affordable, comprehensive health insurance coverage for themselves and their families. Starting in 2014, uninsured women will have new options for insurance coverage.
• 10 million American women will be newly eligible for Medicaid coverage.
• 7 million American women will be eligible for tax credits to help them purchase coverage through the exchange.

Services American Women Need

• Starting in August 2012, all new health plans must cover a list of women’s preventive services with no co-payments ; these include the full range of FDA-approved contraception methods and contraceptive counseling, well-woman visits, screening for gestational diabetes, breastfeeding support, supplies, and counseling and domestic violence screening and counseling.
• Starting in 2014, all new health plans must cover a list essential health benefits including maternity and newborn care, mental health treatment, and pediatric services such as vision and dental care.

An End to Insurance Discrimination

• Starting in 2014, women will no longer be treated as a pre-existing condition and be denied insurance coverage for a history of pregnancy; having had a C-section; being a survivor of breast, or cervical cancer; or having received medical treatment for domestic or sexual violence.
• By 2014 insurance companies will no longer be allowed to charge women and small employers with a predominately-female workforce more for coverage. American women will save an estimated $1 billion in total.

Document(s):

US Health State Profile Factsheet