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Counting the Cost: Women’s Health Without Obamacare

By Sarah Bagge,


As we await the Supreme Court’s ruling on the Affordable Care Act coming in June, Families USA and other organizations are tallying up the benefits the law has provided so far-and the potential costs if the law is overturned. Last week, the Center for American Progress released Women and Obamacare, a report summarizing everything women stand to lose if the Supreme Court rules against the law-and it’s not pretty.

In the pre-Affordable Care Act world, women faced high health care costs and routine discrimination in the health insurance market. Women’s reproductive health needs mean that they require more examinations and prescription drugs, and women of reproductive age ended up spending 68 percent more on health care than men. The cost of critical preventive care kept millions of women from getting mammograms, pap smears, and prenatal care. When seeking to purchase health insurance, women could be denied for gender-related pre-existing conditions, including breast cancer, Caesarean sections, rape, and domestic violence. Those approved for coverage usually ended up paying significantly higher premiums than men, even though most individual health insurance plans didn’t cover maternity care.

The Affordable Care Act is changing all that. Forty-five million women have already taken advantage of important preventive services that now cost them nothing, including screenings for breast and cervical cancer, and prenatal, well-baby, and well-child care. In August, women will also be able to get annual well-woman check-ups, screening for gestational diabetes, breastfeeding support and supplies, and screening for sexually transmitted infections at no cost. And in 2014, we can say goodbye to health insurance discrimination. Plans will have to cover maternity services and premiums will be gender neutral.

These changes are particularly critical for reducing health disparities. Women of color are less likely to be insured and have higher rates of chronic diseases, certain forms of cancer, maternal mortality, and adverse birth outcomes, including premature birth and low birth weight. The Affordable Care Act not only helps women of color obtain the care they need,but also improves data collection on race, ethnicity, sex, disability, and primary language in order to track disparities and support more targeted and effective interventions in the future. Lesbian, gay, bisexual, and transgender Americans, who experience many similar health disparities, will also benefit from improved coverage and efforts to end discrimination based on sexual orientation and gender identity in the new state-based health insurance exchanges.

But all of these key gains could be lost in June if the Supreme Court overturns the Affordable Care Act. A ruling that overturns the law could send us back to a time when half of all women delayed seeking medical care because of cost, when millions went without potentially life-saving cancer screenings, and when gender-based higher insurance premiums cost women an additional $1 billion a year.