Tomorrow, March 23, marks the third anniversary of the Affordable Care Act (ACA) and presents us with a great opportunity to look back at what the law means now to millions of women and families throughout the U.S.—and what is still needed to ensure equal access to affordable, accessible and high quality health care coverage.
Here is a brief look at some of the positive impacts:
THEN: Prior to ACA, health coverage could be rescinded simply because domestic violence, cesarean sections and cancer could be classified as pre-existing conditions.
NOW: Insurance companies can no longer discriminate against women for having a pre-existing condition.
THEN: Children over 18 were required to obtain individual healthcare coverage, unless they were enrolled in college or could remain on their family’s plan.
NOW: Children are now able to stay on their parents’ coverage until they are 26 years old. This is particularly important given our tough economy and the recession, which make it difficult for high school or college grads to find employment.
THEN: Women who were unable to afford private healthcare were often unable to obtain independent coverage for their families and were left uninsured, as very few qualified for Medicaid coverage.
NOW: Starting in 2014, women from middle- and low-income families who are eligible will receive affordability credits to help pay for health insurance premiums. There will also be an expansion of Medicaid, which will cover millions who urgently need the care.
THEN: Before the ACA, women were required to pay a co-pay or deductible for basic, preventive health care services. Unfortunately, this precluded many women from receiving many routine screenings that would have helped identify potentially serious conditions at earlier, more treatable stage.
NOW: New preventive guidelines in ACA allow women of all socioeconomic backgrounds to receive 22 covered preventive services, eight of which must be provided at no out-of-pocket cost.
Thanks to the ACA, women are now better able to access more services that are specifically targeted to their unique health needs. This is crucial for the communities across the country that the YWCA serves each day. While we are extremely optimistic about the progress that has been made, we know that, even with the many advances in healthcare coverage contained in the law, there is still so much more work to be done.
One unique challenge is the fact that certain states are opting out of participating in the ACA’s expansion of Medicaid, an insurance option for Americans under 65 whose family income is less than $15,282 per year. Medicaid beneficiaries are primarily women, children, seniors and people with disabilities. In these tough economic times, more individuals are relying on Medicaid and many states are feeling the fiscal squeeze. State exchanges must be developed that address these most pressing needs if the law is to be effective.
Another challenge to ACA is the congressional politics that continue to threaten the law. Last week, Paul Ryan, chairman of the House Budget Committee, reintroduced his FY2014 Budget. This budget assumes the repeal of the ACA, and makes harmful changes to both Medicare and Medicaid. In addition, many very vitally important programs are facing budget cuts, including Medicare, Medicaid and the Children’s Health Insurance Program (CHIP). These programs are critically important for many of the women and their families we serve to help them manage the cost and accessibility of health care.
The YWCA played a very active role in advocating for the passage of the ACA. When the ACA was first enacted in 2010, its fate was unknown for some time, with lively “repeal and replace” legislative actions in Congress. When concerns about its constitutionality reached the U.S. Supreme Court, the YWCA spoke out publicly about the need for this coverage to be upheld. YWCAs across the country reached out to mobilize our more than 70,000 employees and tens of thousands of volunteers throughout the U.S. We asked them to help educate women about how the ACA would decrease significant health disparities and make healthcare more affordable and accessible.
Now, three years later, this law has helped to make real and necessary advances to improve the health and safety of all women, including those who could not afford insurance before ACA took effect and those who previously paid more for coverage solely because of their gender. Many of the advantages of this relatively new health care law are still being implemented, and they have the potential to directly impact the women and families that the YWCA serves.
A full three years after its enactment, the ACA and entitlement reform still have a big spotlight. We need to use this spotlight to ensure that the health of women and their families is not compromised as part of the many efforts to achieve a balanced budget.
Dara Richardson-Heron, M.D., is CEO of the YWCA USA.