The Affordable Care Act and Women
The Affordable Care Act is working in terms of affordability, access, and quality for women. This includes women who were previously uninsured and those who had insurance that didn't provide them with adequate coverage and financial security. Middle-class women have more security, and many of those who already had insurance now have better coverage. Fewer women are uninsured than before the Affordable Care Act. At the same time, as a country, we're spending our health care dollars more wisely and we're starting to receive higher quality care.
Health insurance coverage is now more affordable and accessible for millions of American women. The Affordable Care Act invests in prevention and wellness, and gives individuals and families more control over their care. In addition, the law addresses disparities in access to quality, affordable health coverage.
Background on Women’s Health in America
Women have unique, and sometimes costly, health and medical needs.
- Some disease and health conditions, such as cardiovascular disease and cancer, affect women at roughly the same rates as men. Women also have special needs related to the health conditions that affect their reproductive organs such as breast, uterine, and cervical cancer.
- Prenatal care and delivery, while essential to the health of both mother and baby, are nonetheless expensive, coming at an average cost over $20,000 in 2011 for an uncomplicated birth.1
Women are more likely to live in poverty at all ages, but differences are especially pronounced in middle and older ages.2
- Among adults ages 18-64, the poverty rate for women was 15.3 percent compared to 11.8 percent for men.
- Among adults 65 and older, women are almost twice as likely to be in poverty: 11.6 percent of women and 6.8 percent of men.
Before the Affordable Care Act, women faced unique challenges in the health insurance market.
- In 2012, a 25-year-old woman could be expected to pay 81 percent more for health insurance than a man, even for a policy that did not include maternity coverage.3
- Prior to Affordable Care Act, 92 percent of health insurance plans in the individual market were gender-rated, for example, charging 40-year-old women more than 40-year-old men for coverage.4
- In 2011, 62 percent of individual market enrollees did not have maternity coverage.5
- Women are more likely to be covered as dependents, which made them more vulnerable to losing their insurance coverage prior to the Affordable Care Act.6
Improved Benefits for Women under the Affordable Care Act
Under the Affordable Care Act, women can no longer be charged more than men for health insurance premiums or denied coverage for pre-existing conditions, and the Affordable Care Act gives women access to maternity benefits and preventive services.
- Private plans in the Health Insurance Marketplace as well as most individual and small group plans outside the Marketplace are now required to cover 10 essential health benefit categories, including maternity and newborn care. An estimated 8.7 million American women with individual insurance coverage gained coverage for maternity services because of the health care law.
- An estimated 48.5 million women with private health insurance are benefiting from recommended preventive services with no cost sharing, including mammograms, cervical cancer screenings, prenatal care, flu and pneumonia shots, and regular well-baby and well-child visits. Almost 30 million of those women did not have access to preventive services without cost-sharing before the Affordable Care Act. The Affordable Care Act also now requires most health plans to cover additional preventive services with no cost-sharing, such as well-woman visits, screening for gestational diabetes, domestic violence screening, breastfeeding supplies and contraceptive services.7
Improvements to Medicare under the Affordable Care Act are particularly beneficial to women.
- Women make up more than half of the Medicare population (56.9 percent).
- Under the Affordable Care Act, the 26.8 million women who have coverage through Medicare now receive preventive services without cost-sharing including the annual wellness visit, a personalized prevention plan, mammograms, and bone mass measurement for women at risk of osteoporosis.8
Additionally, millions of women across the country are benefiting from the better coverage and consumer protections made possible by the Affordable Care Act:
- During the first annual enrollment period, more than 8 million Americans signed up for coverage through the Health Insurance Marketplace, including more than 4.3 million women.
- 1.1 million women between ages 19 and 25 who would have been uninsured now have coverage under their parent’s employer-sponsored or individually purchased health insurance plan.
- Nearly 40 million women no longer face lifetime limits on their health coverage.
- As many as 65 million women with pre-existing conditions can no longer be discriminated against or charged higher premiums for their health coverage.
- Enrollment in Medicaid and the Children’s Health Insurance Program is open year round and is providing comprehensive coverage for lower income women who were previously only eligible for coverage while pregnant, thanks to the Medicaid expansion.
The next open enrollment period for the Marketplace begins on November 15, 2014 and ends on February 15, 2015. For more information on the Marketplace, Medicaid, and CHIP visit HealthCare.gov. If you have questions or need to find someone who can help you in person, find local help at: Localhelp.healthcare.gov/. Or call the Marketplace Call Center at 1-800-318-2596. TTY users should call 1-855- 889-4325. The call is free.
1 ASPE Computation using 2011 Medical Expenditure Panel Survey (MEPS).
3 Danielle Garrett, National Women’s Law Center, Turning to Fairness: Insurance Discrimination against Women Today and the Affordable Care Act, (March 2012). Accessed at: http://www.nwlc.org/sites/default/files/pdfs/nwlc_2012_turningtofairness_report.pdf
6 Women’s Health Insurance Coverage Factsheet. http://kaiserfamilyfoundation.files.wordpress.com/2013/11/6000-11-womens-health-insurance-coverage-factsheet1.pdf
8 Section 4104. Enrollment data from http://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/MedicareMedicaidStatSupp/Downloads/2012_Section2.pdf#Table2.2
Content last reviewed on November 5, 2014