This Women’s History Month, we’re celebrating the health gains women have made – and continue to make – since the passage of the Affordable Care Act (ACA), even in the face of ongoing attacks from an administration dead set on undermining our progress.

In addition to being Women’s History Month, March is also the anniversary of the signing of the ACA. After the passage of the ACA, the uninsured rate dropped among women ages 19-64 from 19% in 2013, to approximately 11% in 2017, according to a December 2018 Kaiser report. Women of color experienced particularly large coverage gains under the ACA, helping to narrow coverage disparities.

The ACA also ensures that women have access to the reproductive health services they need, including preventive services like birth control with no cost sharing, as well as guaranteed maternity coverage. In addition, thanks to the ACA, insurers can’t charge women more than men for the same policy, or deny insurance to women with so-called pre-existing conditions, which could mean having had a C-section, or having been a domestic violence survivor.

Despite widespread support for the ACA, as well as evidence that health care was a top issue among women in the 2018 mid-term elections, the Trump administration has continued to attack the ACA and women’s health. Trump’s appointment to the U.S. Supreme Court have endangered Roe v. Wade, as well. Fortunately, advocates in the states are fighting back against Trump’s harmful agenda by pushing for policies that secure at the state level the coverage gains and protections provided by the ACA, as well as Roe v. Wade.

Protecting the Title X family planning program

Women across the country have been speaking out against the Trump administration’s most recent assault on women’s health, which came in the form of a final rule that undermines the federal Title X family planning program. Advocates in Maryland are fighting back by working to put state-level protections into place that preserve the integrity of family planning services, regardless of what happens at the federal level. In 2017, advocates successfully passed HB 1083 – Family Planning Services – Continuity of Care, which directed state funding to establish a Family Planning Program at the Department of Health and Mental Hygiene, ensuring that patients can continue to access comprehensive reproductive health care at family planning providers, including Planned Parenthood. This year, they’re working on similar legislation, HB 1272/SB 904, which was drafted to specifically address the final rule.

Backing up Roe at the state level

Despite GOP attacks on abortion, there is strong and widespread public support for Roe v Wade – the landmark Supreme Court decision that established the constitutional right to abortion in the U.S. Advocates across the country are making sure state laws reflect existing federal law and its public support.   

In New York, women’s health advocates successfully advocated for the adoption of the Reproductive Health Act, which secures and protects access to abortion in New York by strengthening and updating New York state law and bringing it in line with the standard of Roe v. Wade. It also protects health care providers who perform abortion services, and treats abortion as health care, not a criminal act. Advocates in New Mexico pushed for a similar measure, which unfortunately did not pass this legislative session.

Meanwhile, advocates in Colorado are pushing for the adoption of what could become one of the most progressive reproductive health bills in the country – the Colorado Access to Reproductive Health Equity Act. Also known as the CARE Act, this bill will ensure that everyone in the state can get the full range of reproductive health care they need without barriers due to financial limits, age, immigration status, stigma or personal agendas.

Expanding coverage for pregnant women

In the same month that advocates in West Virginia successfully halted a proposal to impose harmful Medicaid work requirements, they also managed to score a win for women’s health coverage under Medicaid. SB 564 expands Medicaid and CHIP coverage for pregnant women between 185 percent and 300 percent of the federal poverty level, and includes prenatal care, delivery and 60 days postpartum care. In West Virginia, the average cost of childbirth ranges from $10,000 for a vaginal birth, and $14,000 for a C-section, combined with $20,000 for pre- and post-natal care, West Virginia Center on Budget and Policy reports. By expanding access to care before, during, and after pregnancy, SB 564 will help improve the health and wellbeing of West Virginian mothers and children.

Shoring up the ACA’s consumer protections

With an eye on the Texas v. U.S. court case that threatens to overturn the entire ACA, Maine advocates are working to codify many of the ACA’s important consumer protections into state law.  “An Act to Protect Health Care Coverage for Maine Families,” or LD 1, was the first bill introduced during Maine’s legislative session, signaling its importance to progressive lawmakers who campaigned on health care. Among other protections, the legislation would protect women by enshrining the ACA’s requirement that insurers cover the ACA’s 10 Essential Health Benefits, and prohibit insurers from refusing to cover people with pre-existing conditions.

What can you do to celebrate women’s history month?

In addition to supporting advocacy and policy efforts like those outlined above, you can join our Twitter storm marking the 9th Anniversary of the ACA on March 21, 3-4 pm ET.  Along with state partners and over a dozen national partners, we will celebrate the many ways the ACA has improved access to health care in America – especially for women, LGBTQ people, immigrants, people of color, low-income people and those with disabilities. Want to receive the toolkit and join in the Twitter Storm? Email or follow along at @HealthPolicyHub and @RWV4HealthCare