The American Health Care Act is a Barrier to Good Health for Moms and Families
As Mother’s Day approaches, children in communities across the country are busy constructing cards and coupons entitled “free hugs” and “will do dishes” while partners place orders for flowers (or mulch – depending how you roll). But this Mother’s Day is different. For moms everywhere, there is heightened anxiety and worry about the health, wellness and economic security of their families.
In early May, House Republicans passed the American Health Care Act (AHCA) bill now sitting at the Senate’s doorstep. The bill dismantles key health coverage programs that support women and children, people with disabilities and older people. It would throw at least 24 million low- and moderate-income families off of their health coverage. While the House bill is multi-generational in whom it harms, it is anti-mother, anti-child and anti-family. AHCA is the Mother’s Day gift that demands a speedy return to sender. The Republican bill to repeal and replace the Affordable Care Act (ACA) undermines women’s health and children’s long-term success. Mothers take notice.
The House bill puts women’s financial security at risk.
AHCA makes deep cuts to tax credits that support people’s purchase of health coverage on the Marketplaces, making premiums less expensive for younger consumers and more expensive for older consumers who would be charged five times more for their coverage. The National Partnership for Women and Families highlights that 6.8 million women and girls enrolled in Marketplace coverage in 2016, many of whom rely on tax credits to make health coverage affordable. Hikes in cost sharing paired with reductions in premium tax credits place women’s health coverage in jeopardy, potentially leading to gaps in coverage and access to needed care. It is worth highlighting that 42 percent of women are the primary breadwinners in their families—and black and Latina women face larger wage gaps relative to white men and are more likely to be single parents providing for families than white women. The ACA’s tax credits are critical to making coverage affordable for working women. Further, working women’s financial security is at risk because AHCA permits states to waive some of the ACA consumer protections. These waivers could include a ban on lifetime limits and caps on out-of-pocket costs; they could give employers increased flexibility in shifting medical costs to their employees—many of them women.
Finally, people with preexisting conditions are at risk of losing coverage and important benefits. While the need for care does not disappear, the cost of that care could shift to women and their families. The Center for American Progress reports that pregnant people could pay as much as $17,000 in surcharges for maternity care thanks to AHCA. Removing preexisting protections once again makes being a woman a pre-existing condition. It is important to pause and highlight the potentially egregious implications for women of the preexisting conditions loophole: sexual assault and intimate partner violence could be considered a preexisting condition, as could pregnancy, C-sections and post-partum depression.
The House bill guts Medicaid – a key coverage program for women and children.
According to the Kaiser Family Foundation, Medicaid provides coverage to 1 in 5 women, and approximately half of Medicaid enrollees are children. Importantly, Medicaid partners with Medicare to provide supplemental coverage to 1 in 5 senior women. The House bill guts Medicaid in three important ways: 1) it caps funding to state Medicaid programs; 2) eliminates the Medicaid expansion; and 3) adds a work requirement. Capping Medicaid and reducing federal funding by $839 billion will lead to rationing of services for vulnerable people due to strains on state budgets. This will translate into reduced services to support children with disabilities, reduced access for women to post-partum depression screening and treatment and reduced access to family planning services.
The ACA also offers a new and important pathway for women to continue to have access to needed services through Medicaid expansion—particularly following 60 days post-partum when new mothers lose traditional Medicaid eligibility. Elimination of the expansion places mothers and babies’ health at risk by restricting access to coverage. An added work requirement directs women to return to work 60 days after giving birth, placing both their health and their babies’ health at risk at a critical time of mother-infant bonding. The Center for American Progress highlights that the 60-day requirement does not even align with the 90-day standard the Families and Medical Leave Act (FMLA) established. Medicaid is critical to maternal and infant health. Denying women, particularly black women who die at a rate of more than three times of white women, access to prenatal care and robust post-partum access to care place both mothers and infants at great risk of harm. Studies show that continuous coverage through the prenatal and post-natal periods are critical in keeping families healthy.
The House bill denies families’ needed health benefits.
Under the ACA, women have access to needed benefits thanks to the essential health benefits (EHB).These benefits include pregnancy, maternity and newborn care, specifically, but also important benefits around mental health, substance use and pediatric care—all of which are vital to maternal and child health. A healthy mom makes a healthy family. The House bill, however, makes EHB negotiable, placing women’s benefits at risk by allowing states to redefine the EHB. According to the National Women’s Law Center, only 12 percent of health plans on the individual market covered maternity care prior to the ACA. Access to robust maternity and pediatric care is particularly important for African American women because they experience rates of infant mortality twice that of non-Hispanic, white women. Creating mechanisms to revise the EHB coupled with defunding Planned Parenthood is a reminder that the AHCA disproportionately affects women—and most notably, low-income women and women of color. Many low-income women rely on Planned Parenthood for important preventive care including birth control. In many places, Planned Parenthood is the sole source of contraceptive care for women – most notably for women living in rural areas.
The AHCA is no match for mothers.
Mothers across this country are not interested in these draconian attempts to vilify poverty and low-income people and deny families needed security and safeguards from medical debt and access to needed health services. Mothers will not stand by while members of Congress – many of who are not mothers – pursue policies that harm children and families. Use this Mother’s Day to take action and share your story as to why coverage matters to your health and that of your family.