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Health Care Reform:

Health Insurance & Affordable Care Act

Voter Guide: Women's Health

The Issue:

Getting good health insurance and paying for medical care may be more challenging for women than men.

An estimated 18.7 million U.S. women ages 19 to 64 were uninsured in 2010. An additional 16.7 million women with health insurance didn't get care because they couldn't afford the out-of-pocket costs, according to a Commonwealth Fund report.

Women face higher health care costs in part because they use more health care services than men, especially during their childbearing years. They’re also charged more for insurance when they buy a health plan on the private insurance market (rather than getting it through work). Unlike health benefits gained through an employer, insurance companies selling plans directly to women are able to charge them higher premiums based on their sex.

Women who have health insurance through their jobs are also more likely to lose that insurance. More women than men rely on their spouse for their health benefits. That leaves many women without coverage if they divorce or their husband dies.

Most private health plans don't cover all of women’s medical needs. For instance, the National Women’s Law Center reported in 2009 that 87% of individual health plans sold on the private insurance market did not include maternity care. Those that do cover it are often very expensive.


Cutting Women’s Health Care Costs

Under the Affordable Care Act, all new private insurance plans, and Medicare, are now required to cover certain preventive health services for free (no copayment, coinsurance, or deductible). That free preventive care started in September 2010 and includes:

  • A yearly wellness checkup
  • Cholesterol and blood pressure screening
  • Mammogram, colonoscopy, and cervical cancer screening
  • Depression screening
  • Certain vaccinations
  • HIV screening
  • Help quitting smoking

The full list of preventive services is posted on the U.S. Department of Health and Human Services web site.

Coverage for Birth Control

The law also requires health insurance companies to cover the cost of FDA-approved contraceptive methods, as well as contraceptive education and counseling, for women who seek it.

Employers that provide health benefits to workers are now required by law to cover the full cost of contraceptives. However, churches and other religious employers are exempt from this requirement. In the case of employers with a religious affiliation that object to paying for contraception, it is the responsibility of insurance companies, rather than the employer, to cover the full cost of contraceptives. 

Religious institutions will ultimately be required to comply fully with the law, but have until August 2013 to do so. 

Repeal the Affordable Care Act

If the Affordable Care Act is repealed, it is not clear what would happen to these provisions.

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