Affordable Care Act is an historic advance for women and the most important advance in nearly 40 years. The Affordable Care Act protects the lives and health of millions of women and their families each year and makes our nation stronger and healthier. This is what women will gain from the full implementation of the Affordable Care Act: Some 32 million people (a majority women) will gain access to health care insurance coverage including 16 million people (also a majority women) who will gain access through Medicaid. Subsidies to purchase coverage
- About three-fourths of people who purchase through the insurance exchanges (those with incomes between 133% and 400% of poverty) will receive a federal subsidy to help pay for the coverage.
- By 2014 at the latest, insurers will be banned from “gender rating,” or charging women higher premiums than men for the same coverage, both for individual policies and for employer group plans with fewer than 100 employees. In most states, women with individual plans pay on the average some 48% higher premiums than men for the same health insurance coverage.
No Co-Pays or Deductibles for Preventive Care including Birth Control
- Every new insurance policy is required to include the basic preventive health care package without any co-pays or deductibles. As recommended by the Institutes of Medicine, this includes pap smears, mammograms, birth control, STI/STD testing, well woman checkups, immunizations and other preventive care.
Discrimination Based on Pre-Existing Conditions Eliminated
- Exclusions for pre-existing conditions were immediately eliminated for children in 2010, and will be eliminated in 2014 for adults. This will prevent the exclusion of coverage for women who have “pre-existing conditions” such as pregnancy, prior injuries caused by domestic violence, the second or subsequent Caesarian delivery, re-occurrence of breast cancer, etc. A temporary high risk insurance pool program is available to cover eligible adults with pre-existing conditions until 2014.
Bans Insurers from Dropping Coverage Because of Illness Mandatory Coverage of Maternity Care and Specific Health Services
- Beginning January 1, 2014, individual and small employer plans must cover at a minimum a comprehensive package of “essential health benefits” including, for example, pre-natal and maternity care, prescription drug coverage, mental health care, and pediatric care (including oral and vision care). Currently 87 percent of individual health insurance plans exclude maternity coverage.
Mental Health Parity Benefits for Older People
- Medicare guaranteed benefits are not reduced.
- Beginning in 2011, Medicare now covers the full cost of preventive care, including cancer screenings, annual physical examinations and immunizations.
- The Medicare prescription drug “Donut Hole” will be gradually eliminated, starting with a $250 payment to beneficiaries in 2010 and a 50% discount on Medicare Part D prescription drug costs. By 2020, payments by beneficiaries will be reduced to 25% of drug costs in the gap.
Ban on Discrimination against Lower Paid Employees
- Employers will not be allowed to provide inferior plans with less coverage to their lower-paid workers, who are more likely to be women and people of color.
Addresses National Nursing and Primary Care Physicians Shortage
- The law increases the numbers of nursing education slots, providing loan repayments and retention grants and offering grants for employment and training of family nurse practitioners. It provides scholarships, loan programs and bonus payments to private care physicians and general surgeons. It also expands health accessibility by doubly the capacity of community health centers. New programs will increase support for school-based and nurse-managed health centers.
- Sources: U.S. Department of Health and Human Services, Healthcare.gov; The Affordable Care Act and Women,
- ; U.S. Department of Health and Human Services, Women’s Preventive Services: Required Health Plan Coverage Guidelines,