May 13-19 is National Women’s Health Week, an event spearheaded by the U.S. Department of Health and Human Services’ Office on Women’s Health. Ironically, although women use the health care system the most, they are casualties of the “affordability barrier” to the requisite tests, treatments and medications that they need.
In June, the Supreme Court will make a decision about whether the Affordable Care Act (ACA) is “constitutional.” The term Obamacare has been used derisively by opponents, yet the advantages are so far-reaching for women that there is an obvious disconnect between the realities of the benefits and an understanding the law.
Katherine B. Waddell, former member of the House of Delegates in Virginia, told me, “Many Americans don’t know what’s in the act and how it will affect them.” Waddell is president of Women’s Strike Force, a non-partisan organization that has formed a PAC to defeat representatives supporting anti-women legislation. Expressing her concern she told me, “As someone who has been struggling for many years to remain a Republican, it has become more difficult with the assault on women’s health care.”
The top three benefits of the ACA are:
- It ensures coverage of preventative and necessary services for women
- It eliminates gender discrimination by health insurance companies
- It makes health insurance more reasonably priced and accessible
In the event that Obamacare is overturned, there would be a loss of the health insurance coverage statutes that have already been put in place, as well as protections that are slated to begin within two years. Some of the services that have already reached 45 million women through Obamacare without deductibles or co-pay fees include:
- Pap smears and Mammograms
- Pre-natal care
- Well-baby and Well-child care
Slated to begin in August, other services without additional costs will include:
- Annual gynecological visit
- Contraception visit and method device
- Gestational diabetes testing
- Breastfeeding counseling and supplies
--Screening for sexually transmitted diseases
The issues around health care for women go deeper than the nuts and bolts of what will and won’t be covered. At stake is gender discrimination that is evidenced in higher premiums for being a woman, lost maternity coverage, and denial of coverage due to gender-related pre-existing conditions. These may include health concerns ranging from breast cancer and Caesarean sections to traumatic mental health services for domestic violence and rape.
Women in their childbearing years spend 68 percent more on health care than men. Coverage for maternity care is regularly excluded in the individual insurance market, with many plans instituting maternity deductibles of up to $10,000. The ACA would assure that 8.7 million women gain coverage for maternity care beginning in 2014.
Economic factors and earning power are an integral part of the equation. Women, on average, are paid less than men — but have higher medical expenses. They are less able to afford needed care and are at greater risk for medical bankruptcy. They have larger out-of-pocket expenses than their male counterparts. If they are married, their insurance status hinges on the status of the relationship to their partner who could lose his job, die — or the marriage could end in divorce.
A look at the stats that drive up the bills of women show that as a group, 38 percent of women suffer from chronic conditions compared to men. They use prescription medicine in higher numbers than men and utilize mental health services more than men.
Women who are in the work force are often employed part-time because of caretaking responsibilities, or they work for small businesses that don’t offer coverage. Women in the ranks of individual payers spend one billion dollars more in premiums for the same benefits as men because individual market plans engage in “gender rating.” This gender rating also accounts for the prices charged to “womencentric” businesses such as hair salons, day care facilities, and non-profits.
Fifty percent of women put off getting medical care because of economic factors. One third of women pay their medical bills by trimming back on basic needs such as food. Understanding what the ACA offers gives women a window into what will transpire if it is defeated. Gender bias will continue. No-cost preventative services will come to a halt. When you consider that screening for cervical cancer can reduce the number of new cases by 89 percent, it is a disconcerting prospect.
Health care disparities between underserved populations and those who can afford care would widen dramatically. The Center for American Progress had compiled several reports on “Women and Obamacare.” In “The Top 10 Benefits Women of Color Are Seeing Under Obamacare,” it underscored that “while women of color represent 36.3 percent of the U.S. female population, they account for 53.2 percent of uninsured women.” Protection under the insurance umbrella will be a step in eliminating inequities. Expanding Medicaid eligibility will provide services that reduce the “disproportionately higher rates” of illness in women of color — from hypertension to diabetes. It should be noted that 70 percent of Medicaid recipients are women.
I spoke with Cindy Pearson, Executive Director of National Women’s Health Network. Her organization is showcasing the Countdown to Coverage Campaign, which gives bite-size information while clarifying that “starting on August 1, insurance companies will have to begin covering women’s preventive care without extra charges.”
Pearson discussed the worst-case scenario of the ACA being overturned. “Women could be charged more for less,” she said, “and the coverage without co-pays that was promised as of August 1 would disappear.”
Pearson added emphatically, “For women, the Affordable Care Act is not about the politics. It’s about the services.”
Edited by Jody Smith