Millions of women across the United States would lose access to the health care they need if the Affordable Care Act (ACA) is repealed. Texas vs. United States, also known as the Health Care Repeal Lawsuit, threatens to upend the lives of over 6.8 million women enrolled in insurance marketplace plans, and millions more who have employer-sponsored health insurance or coverage under Medicaid expansion.
The plaintiffs in the case, a group of Republican state attorneys general who are supported by the Trump administration, argued that the entire ACA became unconstitutional when Congress eliminated the penalty for individuals who fail to obtain health insurance. A lower-court judge agreed in a decision that was immediately appealed by a group of Democratic state attorneys general. In a 2-1 decision, the 5th Circuit Court of Appeals tossed the individual mandate, while no decision was made about the remaining aspects of the ACA. In a ping-pong move, the case was sent back to the conservative district court judge who previously ruled to overturn the entire ACA.
Since then, there has been no movement in the lower courts and the health care of millions of women continues to hang in the balance. Recently, a coalition of Democratic state attorneys general and members of the U.S. House, petitioned the Supreme Court to hear the ACA case, sooner rather than later.
Community Catalyst and other consumer health organizations are warning of the dire consequences for patients, including women and families, if the ACA were repealed. Our Women’s Health Program is urging women to speak out about the necessity of preserving the ACA’s many historic gains for women’s health coverage and access. Here are six ways a repeal of the ACA could negatively impact women:
1. Maternity Care Coverage
One of the important Essential Health Benefits under the ACA, is maternity care. This benefit stipulates that all health insurance plans must include coverage of prenatal care, labor and delivery. Prior to the enactment of the ACA in 2010, plans did not have to cover childbirth, or they sometimes charged extra fees for coverage.
Access to maternity care coverage is especially important to Black women; without this care, women can die. According to the Center for Disease Control (CDC), Black women are three to four times more likely to die from pregnancy-related complications than their white counterparts. Taking away maternity care coverage only exacerbates a growing maternal health crisis across the United States.
2. Birth Control Coverage
Under the ACA, approximately 55.6 million womenwith private insurance are now guaranteed coverage of recommended preventive services. These include: birth control, annual well-woman exams, cervical cancer screenings and other women’s preventive care with no out-of-pocket costs. Paying for preventive care quickly adds up. In fact, according to a 2015 Health Affairs study, in 2013, the ACA contraceptive mandate saved women $483 million in out-of-pocket spending on birth control pills.
3. Protection from being denied coverage for a pre-existing condition
Before the implementation of the ACA, women could be denied coverage, have their insurance cancelled or be charged more because of a pre-existing condition that requires expensive medical treatment.
Women with one or more disabilities – including, but not limited to muscular dystrophy, depression, bipolar disorder – could be denied health coverage. So too, could active military personnel, pregnant women, or those taking fertility medication. Insurers were even denying coverage to women who have been victims of sexual assault or domestic violence.
Prior to 2010, one-third of women who had a health plan or tried to buy one in the individual market had either been denied health insurance, charged a higher premium because of their health, or had a specific health problem excluded from coverage plans.
4. Gender rating
Before the ACA, insurance companies often charged women more in premiums than men for the same individually-purchased insurance. Big business for insurers, means back-breaking costs for women: nationally, the practice of gender rating was costing women approximately $1 billion per year.
5. Loss of the ACA’s Section 1557 non-discrimination provision
The ACA provision was the first major federal law to outlaw sex discrimination in health care. If the law is repealed, some of the terrible things that could happen to women include denials of needed reproductive health care by providers who disapprove for moral or religious reasons and weakening necessary access to interpretation and translation services for those with limited English proficiency.
6. Loss of affordable health coverage
Medicaid expansion and the availability of premium subsidies to lower the cost of ACA health plans have meant that millions of women and our families have finally been able to get coverage for the care we need.
How can we can take action?
We must continue to fight to protect the health care of millions of women and families across the country. Recent polling, shows that the Texas lawsuit is opposed by a majority of the American people at a time when the Affordable Care Act is more popular than ever..
You can take action by contacting your AG, attending or organizing constituent town halls and public forumsasking for your Senator’s input and participation, and by using Community Catalyst’s digital advocacy tools to continue state-specific work. Together, we can win