Thanks to the Affordable Care Act (the ACA or Obamacare) health plans are required to cover many women’s preventive services, including birth control, without copays or deductibles. However, a new Kaiser Family Foundation study of health plans and their birth control coverage found that some plans are utilizing “medical management” for some birth control methods, often resulting in barriers for women accessing the method that has been prescribed to them by their health care provider. Examples of medical management used by plans includes placing some methods into cost-sharing “tiers,” requiring that providers give pre-authorization for a prescription before covering it, and in some cases requiring that a covered method “fail” before covering a woman’s preferred method.
At a briefing held yesterday at the Kaiser Family Foundation, panelists discussed the implications of the study and the potential harm when medical management becomes an obstacle for women accessing birth control. One panelist – an insurance plan representative – described the logic behind this type of medical management as “indefensible.” Our own Gretchen Borchelt, VP for Health and Reproductive Rights at the National Women’s Law Center (NWLC), drove home the importance of compliance by health plans, by explaining that these are not just problems or barriers, but are violations of the law. Read more »
Is it working? In the health care context, you might ask this about a prescription drug, a chemotherapy regimen, or a rehabilitation plan. But we don’t really need to ask that any longer about the Affordable Care Act. According to the latest Gallup-Healthways survey, the uninsured rate among American adults has fallen to 11.9 percent — a drop of more than 5 percentage points since the end of 2013, which was right before coverage began through the ACA’s health care Marketplaces.
While it is exciting enough to see the uninsured rate for American adults fall by nearly one-third, it is even more exciting to see that the groups most likely to lack insurance — low-income Americans, Latinos, young adults and African Americans — have seen the most change under the law. The good folks at Gallup-Healthways haven’t broken down their data by gender, but we do know that 54 percent of Marketplace enrollees are women — which tells us that many of the individuals with new coverage are likely to be women. Read more »
Can you believe it? The ACA is already five years old. It seems like just yesterday we were celebrating the law’s passage. Today, we can celebrate the law’s continued success.
It’s clear the law is working. Because of the ACA, women are protected from discriminatory health insurance practices, health coverage is more affordable and easier to obtain, and women have better access to many of the health services they need. Read more »
Imagine an insurance market where only 12% of health insurance plans include maternity coverage. Imagine further that if a woman wanted to add maternity coverage, she would have to pay thousands of additional dollars each year and, even then, the insurance would not cover her pregnancy until she passed a one or two year waiting period. If a woman was pregnant when she applied for coverage or had a previous caesarian delivery, she could be denied health insurance.
It shouldn’t be too difficult to imagine, since this was the individual health insurance market in the United States just fifteen months ago.
When LaDonna Appelbaum became pregnant in 2010, she discovered that her health insurance did not cover maternity care — it did not cover any costs related to prenatal care, nor any related to her eventual miscarriage. When she searched for a new policy that would provide these benefits, she was told that she would have to endure a one-year waiting period for pregnancy coverage — and then her premiums would quadruple.
The individual health insurance market failed women like LaDonna before the passage of the Affordable Care Act. On Wednesday, March 4, the Supreme Court will hear a case that could bring those failures back. Read more »
On March 4th, the U.S. Supreme Court will hear arguments in King v. Burwell, a case challenging a core provision of the Affordable Care Act (ACA). The Court will decide whether individuals and families will continue to receive tax credits to help purchase insurance on the federally-facilitated health insurance marketplaces. There are currently 37 states that utilize this kind of marketplace.
The loss of tax credits would have dire consequences in these states — we estimate that nearly 7 million women would lose access to affordable coverage. Last year, 86 percent of people who sought coverage in the federally-facilitated marketplaces used tax credits to lower their premiums [PDF], and this year’s enrollees similarly rely on this help. If such a high proportion of Marketplace enrollees lose coverage following the Court’s decision, premiums for remaining enrollees would skyrocket, further destabilizing the market. Read more »
Open enrollment for health coverage on the Health Insurance Marketplaces begins this weekend. Open enrollment is an annual opportunity for women to compare their insurance options and, depending on their circumstances, renew with their current plan, enroll in a new plan, or apply for Marketplace coverage for the first time. In 2014, more than 4 million women enrolled in coverage through the Health Insurance Marketplaces. This year, many more women and their families are likely to shop for coverage and select a new health plan.
As women consider their options during open enrollment, here are five things to keep in mind: Read more »
Today is my little brother’s birthday. It’s a big birthday, but not for good reasons. Today, TJ turns 26, which means that he can no longer be on my parents’ health insurance. He works as a bartender at a few different places and does not have health insurance through his employer. Last week, he and I sat down to figure out what plan he should sign up for on the healthcare exchange. And things got complicated.
Because TJ’s shifts and hours change with such frequency, he has a really hard time budgeting. He could not tell me for sure how much he could afford to pay for health insurance in any given month. He couldn’t tell me which subsidies he might qualify for. This type of instability is a common problem for workers in low-wage hourly jobs. In one study [PDF], between 20 and 30 percent of low-wage workers reported a reduction in hours or a layoff when work was slow. And another found [PDF] that for 59 percent of retail employees employed by one major retailer, either the shifts or the days they worked changed each week. Read more »
This week’s annual release of Census Bureau insurance data tells us that, once again, all states are not equal. Over 90 percent of women aged 18 to 64 in states like Massachusetts and Minnesota are insured. But, again this year, Texas leads the nation in the proportion of women without health insurance, with nearly one-third of women going without health coverage.
Here is the sad list of the worst states for women’s health insurance coverage: Read more »
Today, the Census Bureau released new data about the number of Americans with health insurance. The Current Population Survey (CPS) offers a revealing look at Americans’ health coverage in 2013. The data does not yet reflect the full implementation of the Affordable Care Act (ACA), but provides a baseline to understand who had coverage and from where prior to full ACA implementation, setting us up for some interesting analysis next year.
In brief, too many women remained uninsured in 2013. Overall, 14 percent of women and girls lack health insurance coverage. For adult women 18 to 64 the proportion is even higher; 17 percent of women went without health insurance in 2013. Read more »