The Republican Party is planning to repeal and replace the Affordable Care Act; a move that experts believe is going to be a nightmare for women.
The Republican House leaders in the U.S have a loathsome preoccupation that may cripple access to women’s health care. They are debating about the American Health Care Act (AHCA), which should abolish and replace Obama’s historic Affordable Care Act (nicknamed Obamacare).
The Trump-Pence Administration has made it clear that it is anti-abortion, anti-contraception, and anti-Obamacare. These could be some of the motives behind their new initiative, which professionals claim may endanger the health of many American women.
The Affordable Care Act (ACA), which may be wiped out, has considerably improved maternity coverage and brought several other benefits to women. Before its inception, only 12% of health insurance plans included coverage for maternity care. During those ‘dark days,’ insurers charged women more than men for the same coverage.
In addition, pregnancy was treated as a pre-existing condition, and it could prevent women from getting insurance in several states.
Obamacare included maternity care as one of the ten essential health benefits (EHB) that needed to be covered by all individual plans. This law guarantees that women receive preventive health services and supports free wellness visits. It protects women from gender discrimination and ensures women are not charged more just because they are female.
The ACA has changed the game and has increased coverage for millions of American women. Under the law, nine-and-a-half million women obtained health insurance, and 55 million women found access to preventive services. But sadly, the life-changing law is on the verge of being ‘massacred.’
Here are the things women should know about Obama Care before it is taken away:
15 Women May Be Denied Insurance Simply For Being Women
Before the introduction of ACA, insurers could easily turn down women based on pre-existing conditions like being a victim of sexual assault or having undergone Cesarean section. But once Obamacare came into place, the practice was outlawed and women with pre-existing conditions – who had been uninsured – were given a chance to take up insurance.
Before Obamacare, insurers in several states charged women – who purchased individual insurance – more than men for the same coverage, a practice that was referred to as gender rating. This is despite the fact that the available plans did not cover vital services like prescription drugs, mental health services, and maternity care.
It is estimated that in 2011, 6.5 million women purchased coverage and many of them paid higher rates than men. In fact, before ACA, women spent $1billion more than men every year for the same plans. But gender rating became illegal by 2014.
The AHCA has not confirmed its intentions to change this, but those who do not maintain a continuous coverage are going to be forced to pay higher premiums, especially after a coverage gap.
14 Free Prevention Care May No Longer Exist
Obamacare requires that health plans provide women-focused preventive care services for free. These preventive services include things like Pap smears for cervical cancer, breast cancer genetic and mammogram screenings, testing for STDs, counseling for drug abuse and domestic violence, and yearly wellness visits.
While millions of women could not afford such services initially, ACA made them available because it included them without copayment. 48.5 million women now benefit from these prevention services, thanks to Obamacare. Many more women have been able to stay healthy due to this provision.
Preventive care services save money and promote health, but they were initially out of women’s reach owing to coinsurance, copays, and deductibles. Before ACA, more than 50% of women were hesitant to seek medical care because of the high costs, but Obamacare changed that.
According to statistics, more than 45 million women had already taken advantage of these changes by May 2012. In fact, in 2012, more preventive services were introduced, and women have embraced them over the years. They included breastfeeding supports, gestational diabetes screening, interpersonal violence screening, contraceptive education, HPV DNA testing, Colonoscopies, and HIV testing.
13 Insurance Companies May Start Placing Limits On Covered Medical Expenses
Before Obamacare, insurance companies used to set a lifetime spending limit, and these limits were mandated at the state level. This was a way to protect themselves and to keep their premiums competitive. Maintaining a limit was a way of preventing them from paying millions in treatment for chronically ill patients who had conditions like cancer or leukemia.
However, when Obamacare came into place, it stopped insurers from setting such limits, especially on essential benefits.
Women are likely to suffer chronic conditions compared to men. And a chronic illness or medical emergency can cause a woman to reach a cap much faster, forcing her to source for funds from external sources. In most cases, the money that is required is usually a lot and may become a burden to the woman.
When Obamacare is repealed, insurance companies may go back to setting a limit. This means that more women are likely to suffer in the event of a chronic illness.
12 Private Insurance Plans May Not Cover Abortion
Under the new GOP plan, abortion coverage will likely become expensive. This is because health plans that have an elective abortion coverage will not be given federal tax credits. In other words, the government will not subsidize, and women will have a difficult time finding policies that cover abortion. Even if they do, those policies will likely be overpriced.
Consumers often get fed up when they have to go through a rigorous process to find a product/service that suits them. And, furthermore, they will not be willing to pay more for this service because it is expensive. This, together with the fact that there will be no tax benefits, will not motivate private plans to cover abortion.
This is saddening considering that abortion is a legal medical procedure. It looks like GOP wants it to be a matter of the marketplace. For this reason, more women are going to find it difficult to access abortion services. ACA subsidizes costs and has made it easier for private insurance plans, but that is not going to be the case soon.
11 Marginalized Groups May Soon Have Difficulty Accessing Healthcare
Before Obamacare, women from marginalized groups were mostly uninsured. They included transgender people, bisexual, lesbian, and women of color. But Obamacare has made substantial progress in providing these vulnerable group with quality health care.
The new law increased funding for community health centers, improved access to insurance coverage, ended discrimination in the health insurance market, and improved health literacy.
All these measures bore fruit, and as of 2012, the number of women – from marginalized groups – who had received preventive care had increased tremendously.
The Republican healthcare plan is probably going to make this group suffer as they may lose their Medicaid coverage, meaning they may lose their birth control coverage. In fact, research revealed that 4-6 million Medicaid enrollees may lose their insurance if the Republican plan is implemented.
Many women, especially those from marginalized groups, have benefited from Medicaid, and almost one out of five women – under the age of 64 – get coverage under Medicaid.
10 Maternity Costs Could Skyrocket
Obamacare took care of maternity care, mental health coverage, and hospitalization. However, under AHCA, these benefits would no longer be covered under the federal law but would become the responsibility of the states.
Overtime, AHCA would shift $370 billion in Medicaid from the federal government to states. And most likely, the states are going to cut costs by kicking people out of Medicaid or paying less to the providers.
Before Obamacare, only 12% of market plans covered maternity care and health insurance was costly for women. But Obamacare came and saved the day. One of the clauses in Obamacare states that everyone would receive essential health coverage come 2019. Under the essential coverage, we have general hospital visits, mental health, and maternity care.
Unfortunately, the repeal wants to hand these responsibilities to the states to enforce. We all know that having a baby can be pricey, and these changes are likely to make things even worse because the states will have the power to decide how they want to allocate their stipend.
9 Women May Face A Gender Tax When Purchasing Private Health Insurance
One of the notable changes that was brought by Obamacare was the possibility to buy private health insurance on an equal basis. This means that women can purchase insurance without being looked down upon because they were females.
Prior to the ACA, most of the health plans charged women more than men for health insurance. Insurers could also cancel or deny covering a woman if she had a pre-existing condition like pregnancy.
During those days, a woman was only safe if she was insured by a large employer, but for those women who worked for employers who did not provide health coverage, paying more and getting less was the order of the day.
The introduction of ACA put an end to any exclusions based on pre-existing conditions and ended discriminatory ‘gender rating.’ It also brought an end to lifetime and annual benefit limits that made many Americans bankrupt. But think about the consequences of phasing it out. One consequence is that woman may start purchasing private insurance with a ‘gender tax.’
8 Birth Control Prices May Go Up
The ACA made contraceptives available at no cost. In 2013 alone, the IMS Institute for Healthcare reported that Obamacare helped women save a staggering $483 million on birth control.
Obamacare requires most plans to cater for all forms of birth control, and this has helped women save money that they would have spent on this important process. A study by the University of Michigan Health System found out that almost 7 in 10 Americans support this mandated coverage of birth control. In fact, it had saved women $1.4 billion each year since it was effected in 2012.
So, what will be the way forward for women who want to continue with birth control?
Some women have started making preparations for the future by getting long-acting birth control like IUDs (Intrauterine devices) before they become unaffordable and maybe illegal. Those who are pregnant or those who plan to get pregnant soon may have to deliver at a time when maternity or pediatric care is expensive or less comprehensive.
7 Having A Baby May No Longer Be Covered
Having a baby can be a major financial strain considering the high costs of prenatal care and delivery. This explains why most insurance companies used to deny or cancel coverage for pregnant women. But the ACA outlawed the practice and catered for prenatal, childbirth, and newborn costs for millions of women in the U.S. In fact, the benefits extended well beyond the delivery room.
Covering maternity care is essential for anyone having a baby, and it reduces the cost of having a child; something that some families fear due to the high costs involved.
Now, what happens when delivery is no longer covered?
Women will not have a piece of mind when they are planning to get babies. The proposed plan emphasizes Health Savings Accounts, where mothers set aside money for future medical care. HAS’s are ideal for women who have regular expected medical costs, and those who have decent paying jobs. Using this option is impractical for women who cannot save.
6 Insuring Kids May Soon Be A Problem
For a long time, since the inception of ACA, mums have taken comfort in the fact that most ACA plans covered a range of preventive services for their children without coinsurance, co-pays, or worries about their deductibles. Most of the coverage range from autism and developmental assessments for toddlers, vision and hearing screening for newborns, and behavioral counseling for older kids.
Kids have not been denied coverage owing to pre-existing conditions.
Obamacare introduced significant changes and has enabled kids to carry on with chemotherapy even after their parents switch jobs. And better, the celebrated law has allowed insurers to allow children on their parent’s plans until age 26.
The age restriction had been a disadvantage to women who got kids during their teens. But Obamacare provided them with a way to cover their children until they are stable enough. Moms no longer have to worry about coverage because they have been given a longer time frame.
5 Defunding Of The Safety Net Providers
Planned Parenthood has been a major player in providing health services to communities across the U.S. In fact, for many women, Planned Parenthood has been the source of family planning because of its wide range of services. According to statistics, one out of five women will visit a Planned Parenthood center in the U.S at least once in her life.
Two-thirds of patients who visit these health care centers access their care through health programs that are funded by the federal government.
Sadly, Republicans are unhappy that Planned Parenthood has been providing women with abortion services. The new GOP plan wants to deny funding to health care providers that have been offering abortion services beyond the accepted cases (incest, rape, or a threat to a woman’s life).
Defunding Planned Parenthood means several critical services will be cut off from millions of women: tests for STIs, birth control, and cancer screenings, among other preventative measures.
Since Planned Parenthood mostly serves young women, low-income women, immigrant women, and women of color, these groups are likely to face the worst health and economic problems.
4 Essential Health Benefits Are At Risk
The ACA made it mandatory for insurance providers to cover essential health benefits. The coverage has been particularly important to women because it includes preventive services, maternity care, and mental health care.
Though there were federal regulations on what private plans needed to cover, ACA reduced variation and standardized coverage. The move has benefited women since they are the biggest beneficiaries of maternity care. Women also rely on other services that are available among the EHB.
Unfortunately, AHCA cancels the EHB requirement for Medicaid programs, meaning that beneficiaries will not be entitled to coverage. AHCA also does not address the procedure for private plans.
What is evident is that the GOP plan does not support Medicaid expansion and may probably eliminate health care benefits that have helped women gain access to maternal care other types of essential care.
Some GOP senators have expressed their concerns over the issue. While they agree that Medicaid needs some ‘tweaking,’ the changes should not disrupt access to health care for America’s sickest and most vulnerable groups. They have expressed these views firmly.
3 Soon Only Those Who Are Financially Able To Buy Health Care Plans Will Have Them
Obamacare has expanded affordable health and has made it possible to access quality, affordable care to almost all walks of life. In fact, statistics claim that 9.5 million gained health coverage through Obamacare. Also, through Obamacare, 55 million women now have access to preventive care, free of charge.
Obamacare has provided benefits that go beyond physical health. For example, if a woman does not have to pay $1000 for an intrauterine device, the money can be used to purchase household items or can be saved and used in other important projects.
But if the ACA is repealed, the insurance rates for women will increase since their health services are costly, most of the times. In addition, women could be denied health coverage due to pre-existing conditions.
What this means is that only those who are financially able will access proper health care. In fact, women will not have much control over their health. They may need a referral to see their gynecologist and may not be able to choose their primary care physician or their child’s pediatrician.
2 The AHCA Is Going To Repeal Cost-Sharing Subsidies And Change How Tax Credits Are Issued
Around 84% of Marketplace beneficiaries get a premium tax credit that reduces the cost for them. Keep in mind that a bigger portion of ACA marketplace enrollees are women (54%).
Under ACA, the subsidy structure favors those who have a low-income, those who are older, and those living in areas with expensive coverage. However, AHCA takes a different direction. First, it reduces the amount that the federal government would give to subsidies then it provides a flat tax credit based on age. This means that older Marketplace enrollees will have fewer tax subsidies.
With AHCA in place, people who have lower incomes are going to receive less compared to what they get under ACA. Sadly, women are the majority of those who fall in the low-income bracket. Compared to men, women are paid less and take frequent breaks from their jobs to care for their children, aging parents and to attend to other household tasks.
As a result, the changes are going to affect women. But that is not all. AHCA also plans to remove the cost-sharing subsidies that have prevented the insured from paying more. This means things could get worse for women.
1 Women In Troubled Or Abusive Marriages May Not Receive Care Because Trumpcare Is Not As Flexible As Obamacare
Since spouses can have different health plans under Obamacare, it has allowed spouses to file differently for tax credits. Though to take advantage of subsidies, spouses need to be treated as a single unit when their income is being determined.
The GOP plan requires a joint return if a taxpayer is married, regardless of whether the taxpayer is in an abusive or troubled marriage. According to the Republican plan, a taxpayer will not receive credit if the taxpayer files separately/individually. This is a big issue, especially when you consider the high number of failed and troubled marriages in America.
The rule ignores the fact that there may be a pending divorce, domestic abuse, or a spouse who is behind bars. For such cases, filing jointly may not be safe or even possible. A good example is if a woman is in an abusive marriage and the spouse has refused to grant a divorce.
Filing jointly, for such a scenario, would mean that the abusive husband is going to have access to personal information that the abused may not want to reveal. This creates a dilemma.
The current government not only lusts to terminate the ACA, but it also plans to defund Planned Parenthood, and to restrict women from accessing reproductive health care. How Congress intends to rework the ACA remains unclear, but experts believe the changes are going to be a roadblock for females who want to plan their reproductive lives. These changes will likely affect women because they have much at stake, whether they are under private insurance or Medicaid.
The AHCA (nicknamed Trumpcare) plans to cut Medicaid benefits, restrict private insurance coverage for abortion, and defund Planned Parenthood. Even though it may not scrap all of ACA’s major policies, there is no guarantee that those policies will remain under President Trump. And women will be on the losing end.
Reproductive freedom and good physical health are part and parcel of a woman’s ability to stay productive and to contribute to the wellbeing of her family. But repealing ACA means all these will be in jeopardy. The passing of Trumpcare could leave millions of women without proper pregnancy, maternity, or newborn health care.
Resources: Slate.com, Vox.com, Elle.com, Healthcare.gov