Affordable Care Act (ACA)

National Women’s Law Center is proudly taking part in the Health Equity Can’t Wait! blog carnival celebrating National Minority Health Month. Participating bloggers are health, consumer, civil rights, and provider advocates committed to promoting health equity. You can find all the posts for the carnival here.

Women pay about $1 billion more for health care on the individual market just because they are women. Yet women are only paid 77 cents for every dollar paid to their male counterparts. We are charged more and we are paid less.

And that’s only part of the problem. The wage gap is even greater for African American women and Hispanic women. But the cost of health care is still high. So what does that add up to?

Well, if you try to add up it all up, you find out that African American and Hispanic women are more likely to be uninsured than white women. You learn that African American women ages 45 to 64 are almost twice as likely to have a disability, handicap or chronic disease that limits activity compared to white women in the same age range. You discover that Latina women have higher rates of diabetes and hypertension. You read that older women of color are undertreated for their cancer pain. You realize that there is a problem. Read more »

You may have heard about a new report claiming the Affordable Care Act will increase the deficit by $340 billion, rather than decreasing it by $143 as projected by the Congressional Budget Office. Now, there is a big difference between these two numbers, so you would be justified in asking how this new study could come to such a different conclusion from the CBO, the government’s own nonpartisan scorekeeper. The answer is by using some very fuzzy math.

It’s a little complicated, even for me and I’m a numbers person! But the issue is basically this: Medicare benefits are paid out of a trust fund. Legally, the trust fund can’t spend money it doesn’t have. So this new study is based on the assumption that when the trust fund is expected to run out, the government will simply stop paying for Medicare benefits. This is important because one way the ACA reduces the deficit is through long term Medicare savings. The new study argues that these savings shouldn’t be considered, since the Federal Government won’t be paying for Medicare benefits eventually. Basically, if the government wasn’t going to spend the money anyway, we shouldn’t consider this money “savings.”

But frankly, this is bogus. Does anybody think that the government is really going to cut off health care benefits to millions of seniors? Read more »

This week in our roundup, a… unique basketball team, another angle on the benefits of the Affordable Care Act, and how the new CEO of IBM is creating a bit of a stir around Augusta National Golf Club – whether she intends to or not.

If you’ve read some of my previous posts, you might know that I am a bit of a basketball fan. So today I’m excited to share with you the story of a team out in Minnesota. They’re called the Faribault Hotshots, and all the team members are women over 50 years old.

They call it granny basketball.

The story is probably best told in their own words, so be sure to watch the news clip below. The grannies – as they call themselves – modify the game a bit: instead of the standard five-on-five full-court game, they divide the court in the three parts. Players can’t run, nor can they leave their designated area, and they play 8 minute quarters. From time to time, the Hotshots will play Minnesota’s only other granny basketball team, which hails from Wanamingo. And when they do, the gym is full of their friends and family to cheer them on.

Given the strength of the precedent supporting the constitutionality of the individual responsibility provision, most legal observers going into the argument yesterday expected the Supreme Court to uphold it. A poll of prior Supreme Court clerks and attorneys who frequently argue before the Court, for example, showed this group of insiders thought it very unlikely that the law would be struck down.  After all, some of the most high-profile conservative Court of Appeals judges in the country have found it to be constitutional. The argument yesterday therefore surprised many. While the Justices’ questions at argument aren’t necessarily a reliable indicator of their ultimate votes, questions by several of the conservative Justices showed both little concern for precedent and little understanding of the impact of the health care law on individuals’ lives.

There’s no question the Commerce Clause of the Constitution gives Congress the power to pass laws regulating commercial markets, including the insurance industry. The Constitution and Supreme Court precedent are also clear that Congress has the authority to craft national solutions to national economic problems. The individual responsibility provision, which requires non-exempt people to maintain insurance (and provides subsidies to low- and moderate-income individuals) or pay a fine, is an integral piece of just such a national solution. Congress designed the individual responsibility provision to work in tandem with the ban on preexisting condition exclusions and the requirement that all insurers must sell health insurance to anyone who wants to purchase it, recognizing that near-universal participation—which the individual responsibility provision and the associated subsidies for purchasing health insurance are meant to achieve—is required for these insurance reforms to succeed. Otherwise, some people would likely forego insurance coverage until they get sick, sharply driving up the costs of insurance for all when they eventually seek care. Because (in constitutional terms) the provision is a “necessary and proper” means for carrying out these reforms of the insurance industry, it should be constitutional under long-established Supreme Court precedent. Read more »

Transitioning from school to the workforce can be a very difficult time. I remember when finished graduate school and made the decision to move to Washington, DC and sign a lease on an apartment even though I didn’t have a job. Access to health care is one more thing to worry about. But today, as the Supreme Court hears arguments on the health care law, I think about all the young women who will have one less thing to worry about when they graduate.

I recently met Rebekah Horowitz, a very smart and talented woman who has been volunteering with the Law Center while she looks for a job. She shared with me her thoughts on being a recent graduate and the impact the health care law will have on women in her position:

“In 2011, I finished my JD/MPH program in Philadelphia. In spite of my education, I am currently unemployed. My hope is that fact will soon change and it is likely that when I do get a job, I will receive health insurance through my employer. In the meantime, I have been keeping a close watch on the health care law and its impact on unemployed women.

Today, the Supreme Court will hear argument on two issues, both critically important to women. First, if the individual responsibility provision is struck down as unconstitutional, do other parts of the Affordable Care Act go with it? And second, is the Medicaid expansion in the ACA unconstitutional?

The first issue is a question of what is called “severability.” Some laws have a provision called a severability clause, which says that if any part of the law is deemed unconstitutional, the rest of the law will remain in force. The ACA doesn’t have a severability clause, and so if any part of it is held unconstitutional, it is up to the Court to decide whether Congress would have intended other parts of the law or all of the law to remain in force in its absence. The government has argued that the individual responsibility provision is constitutional, but that if it is struck down, then the provisions prohibiting insurance companies to make insurance available to anyone who wants it, regardless of preexisting conditions, should be struck down as well. Read more »

Access to contraception without cost sharing is one of the many important gains for women in the Affordable Care Act. And it has become much more well-known in the last couple of months because of the kerfuffle on Capitol Hill and on talk radio. But here’s one of the in-the-weeds, wonky things about this provision of the law that has people in the reproductive rights community like me excited: the provision applies to emergency contraception. Read more »

You've heard of slash and burn, but how about slash and burden?

On Thursday, the House is expected to vote on a budget for Fiscal Year 2013 introduced by Rep. Paul Ryan (R-WI). The Ryan budget would devastate vital services for women and their families while giving trillions in new tax cuts to the wealthiest Americans and large corporations — on top of extending provisions of the Bush-era tax cuts that benefit only the very wealthy.

Let's make it clear that we will not stand for a budget that slashes programs for women and families and puts the burden of paying for tax breaks for millionaires and corporations on middle- and low-income Americans.

Tell your Representative to oppose the Ryan Budget. As your Members of Congress start budget negotiations, they need to know that their constituents expect them to protect programs for women and families — and to require the wealthy and corporations to pay their fair share of taxes.

What's wrong with Rep. Paul Ryan's Budget? For starters, it would:

• Repeal the Affordable Care Act (ACA). Insurance companies could continue to charge women higher premiums than men, deny coverage to women due to preexisting condition, and refuse to cover maternity care.

Today is the headline day at the Supreme Court in the Affordable Care Act (ACA) cases as the Court considers the constitutionality of the personal responsibility provision. Yesterday, by all accounts, the Justices seemed inclined to hold that they need not wait until 2015 to decide whether this provision is constitutional, which means that the argument today is likely to lead to a decision on the fate of the provision in June.

Women should be watching. The individual responsibility provision, which requires nonexempt individuals to maintain health insurance or pay a fine, and provides subsidies to low- and moderate-income people for this purpose, is closely bound up with the provisions in the ACA banning pre-existing condition exclusions and requiring insurance companies to make coverage available for all. As Speaker Pelosi declared the night the House voted for the legislation, echoing the words of a National Women’s Law Center campaign, “After we pass this bill, being a woman will no longer be a preexisting medical condition.”

Insurers in the individual market have routinely denied coverage for so-called “pre-existing conditions,” such as having given birth by Caesarean section. For example, in 2009, Peggy Robertson of Colorado testified in Congress that because of her previous C-section, an insurer told her that she could only obtain coverage if she were sterilized. Other women have been deemed to have a preexisting condition because they are pregnant or because they are survivors of domestic violence or sexual assault. Read more »

Today, the Supreme Court will begin arguments about the constitutionality of provisions within the Affordable Care Act.

Watch our short video explaining the legal challenges, why we think the law is constitutional, and what women could lose if the law is struck down.

Read more »