Benefits to Women through the Affordable Care Act

The Affordable Care Act (ACA) has been highlighting the national news recently when the government shutdown over whether or not to fund it with the continuing resolution stalled in Congress.  In honor of the upcoming International Day of the Girl this October 11th; GlobalWA would like to highlight many benefits that the Affordable Care Act provides to women in the United States.

In the past, insurance companies reserved the ability to raise premiums on women based on gender or a pre-existing condition.  More than half of women report delaying care for treatable medical conditions because of balancing finances of paying for treatment and normal cost of living expenses.  Under the ACA women can no longer be denied coverage, and places a cap on what insurance companies can charge women out of pocket, thus taking the burden off women on affording medical treatment.  If an insurance company does increase premiums they are required to submit justification as to why premiums have raised allowing consumer’s access to changes in their coverage.

Preventative health care services for women are now required to be covered by the ACA without co-pay or deductable.  Preventative services that are covered include: annual checkups, gestational diabetes screenings, HPV testing, STI and HIV screening and counseling, contraception methods and counseling, breastfeeding support and supplies, and screening and counseling for interpersonal and domestic violence.  Contraception coverage was allowed a one year extension for religious based organizations to adopt policy or opt-out, but the insurance companies have to provide contraception coverage directly with no cost to women.

Children also get extended coverage under the ACA.  Starting 2014, children require basic pediatric coverage in addition to oral and vision needs.  On top of that, children also cannot be denied coverage because of a pre-existing condition or charged more because of health status or gender.

The ACA lowers premiums for families by reducing cost-shifting (where medical providers pass costs to private insurers when uninsured patients are treated).  By requiring everyone to have insurance health premiums decrease, where families can save up to $1,000 a year.  Additionally, the ACA cracks down on excessive insurance overhead by creating standards on non-medical costs (i.e. bureaucracy, executive salaries, marketing, etc.).  If the non-medical costs are too high the consumer receives a rebate from their insurance provider.

Women, 65 and older, also receive many benefits from the ACA.  By 2020 the Medicare Part D “donut hole” will be phased out by providing those that access the donut hole a $250 rebate this year and a 50% discount on name-brand prescription drugs.  The ACA invests in testing, evaluating, and expanding new care delivery models for home-based primary care.  Also, Geriatric Education Centers (GECs) will support training in geriatrics, chronic care management, and long-term care for family caregivers, with the incorporation of mental health and dementia care practices provided.

Medicaid will be expanded in the states to incomes up to 133% above the Federal Poverty Level, where states also have the option of creating Basic Health Plans to limit cost-sharing up 200% above the Federal Poverty Level.  On top of that, states have to provide family planning services to low-income families.

Sex education is another service provided by the ACA.  Evidence-based, comprehensive sexuality education is provided to states with a $75 million grant a year for five years to fund comprehensive approaches to sex education.  Abstinence-only funding was also passed in the ACA, with the reauthorization of the Title V abstinence-only-until-marriage program.  Additionally, employers must also provide a time and space for mother’s breastfeeding besides a bathroom under the ACA.

Abortion funding remains a women’s health service not provided or funded through the ACA.  Abortion funding has to be segregated from state-based health insurance exchanges, leaving states with the ability to ban abortion coverage from insurance providers.