Thirty million women will benefit from the new health reform law, according to a new report from The Commonwealth Fund. In the first analysis of its kind, the authors report that the law will stabilize and reverse the growing exposure to health costs that women now experience.
Over the next ten years, more than 15 million women will benefit by subsidized health insurance. And, another 14.5 million women who are considered underinsured (those who have health coverage that does not adequately protect them from high medical expenses), will also benefit.
Women are just as likely to be uninsured as men. However, their health care needs leave them more vulnerable to high health care costs and problems related to loss of health insurance. Because insurance carriers consider women, particularly those of reproductive age, higher risk than men, women report greater difficulties gaining coverage in the individual insurance market and are charged much higher premiums for the same benefits than men of the same age. And, currently most individual policies do not cover pregnancy.
An estimated 100,000 uninsured women will gain coverage in the Pre-Existing Condition Insurance Plan (PCIP), which will provide temporary coverage to adults with pre-existing conditions who are uninsured during 2010 to 2013. Seventeen states and the District of Columbia began enrollment in PCIPs in July, and 12 will begin to enroll adults in August; in the 21 states without a PCIP the federal government began operation of a PCIP July 1, 2010.
Beginning in 2014, Medicaid coverage expansions and subsidized coverage through state health insurance exchanges could assist 15 million working-age women who currently lack insurance. The majority of these gains come from Medicaid coverage expansions that may affect up to eight million currently insured women who earn up to $14,000 or are in families with incomes up to $29,000.
Women living in states with higher than average un-insurance rates will gain the most from the new law: New Mexico and Texas (29 percent uninsured in 2008); Florida and Louisiana (24 percent uninsured); and Alaska, Arizona, Arkansas, California, Georgia, Mississippi, West Virginia, Idaho, Kentucky, Nevada and Oklahoma (at least 20 percent uninsured).
Although women will have to wait until 2014 to begin to reap the greatest benefits from expanded and improved insurance coverage, several early provisions beginning in 2010 will provide important support, the study shows. These include:
• Strengthened and expanded insurance coverage for young adults, through policies that allow adult children up to age 26 to come on, or stay on, their parents' plans
• Bans on pre-existing condition exclusions
• Bans on lifetime benefit limits and phase-out of annual limits
• Bans on rescissions of insurance policies
• Coverage of recommended preventive services without cost-sharing including mammograms
• Eligibility for a new plan that covers uninsured people with pre-existing conditions that currently make it difficult for them to gain coverage
• Rebates to women enrolled in Medicare who reach the "doughnut hole" in their prescription drug plans; women, along with people with diabetes and Alzheimer's or other forms of dementia are most likely to reach this gap in coverage.
Nearly two in five women (an estimated 7.3 million) between the ages of 19 and 64 who tried to buy individual insurance plans over a three-year period were turned down, charged a higher price or had a pre-existing condition excluded from their plan.
Beginning in 2014, all insurers must accept everyone who applies for coverage and cannot charge higher premiums based on health status or gender.
In addition, all health plans sold through new state insurance exchanges in both the individual and small group markets will have to cover maternity and newborn care as part of the federally determined benefit packages described below.
Uninsured women who earn too much to qualify for Medicaid will be able to purchase policies through state–run exchanges that will offer federally determined essential benefit plans with four levels of cost-sharing with an annual cap on out-of-pocket costs of $5,950 for individuals and $11,900 for families, beginning in 2014. Women with incomes under 400 percent of poverty (or $88,000 for a family of four) will be eligible for subsidies to offset their premiums and out-of-pocket costs. Up to 7 million currently uninsured women may gain subsidized coverage through the exchanges.
Women who own businesses with fewer than 50 or 100 employees, depending on the state, will also be able to purchase a health plan through the exchanges.
Source:
The Commonwealth Fund
MC Ortega is the former publicist for the late Walter Payton, Coca-Cola and Dunkin’ Donuts. Ortega is a senior communications and messaging executive specializing in media relations, social media, program development and crisis communications. Also, Ortega is an avid traveler and international shopper. Ortega resides with her partner, Craig, dog, Fionne and extensive shoe collection. Ortega also enjoys jewelry design/production and flamenco dancing.