President Obama signed the 2,409–page health-care reform act into law yesterday, and the analyses of its effects are beginning to come out. Some provisions go into effect immediately, others in 3-6 months, others in 2014. Here’s how we know it will affect women:
- Contraceptives are covered, which means millions more women will gain access to family planning.
- Basic benefits include preventive care such as PAP tests and mammograms—without any co-pays or deductibles—as well as maternity coverage, not currently in most individual policies.
- “Gender rating,” the practice of charging women more for the same coverage (48 percent in some cases), will be eliminated for individuals and workplaces with under 100 employees.
- Discrimination in favor of higher-paid employees will also be banned, so employers will not be able to give lesser plans to lower-paid workers, who are more likely to be women and people of color.
- The executive order that President Obama promised to sign in order to gain the votes of Rep. Bart Stupak (D-MI) and other anti-choice Democrats will implement the “compromise” abortion restrictions proposed by Sen. Ben Nelson (D-NE). Abortions cannot be covered by any federal subsidy or funding (in accordance with the longstanding Hyde Amendment), but individuals may buy insurance plans that offer abortion coverage as long as they pay for it with their own money. To “segregate” the money, the policyholder must make two payments, one for the bulk of the coverage and a second minimal amount to an allocation fund that would include the abortion coverage. In addition, individual states may pass a law to “opt out” of allowing abortion coverage.
And here are the major provisions that will affect everyone, women included:
- Denial of coverage for pre-existing conditions will be eliminated for children. Right away, there will be a high-risk pool created to enable adults with pre-existing conditions to obtain affordable coverage. Insurance denials for adults with pre-existing conditions will be banned in 2014.
- Lifetime caps on coverage will be eliminated immediately, and restrictive annual limits will be capped. When the insurance exchanges begin operating in 2014, no caps will be allowed.
- The practice of dropping an insurance policy as soon as an illness is diagnosed or a claim is made, known as rescission, will be banned immediately.
- Young people can remain on their parents’ health insurance policy until age 26 if they are not covered through an employer plan.
- This year the “donut hole” in Medicare prescription drug coverage will begin to close, beginning with a modest payment of $250 for those who are in the donut hole.
- Beginning in 2014, about 15 million people will gain access to coverage through Medicaid. Today, Medicaid only includes pregnant women, children under 8, the elderly, blind and disabled living under the federal poverty level. Under the new act, all people living at less than 133 percent of the federal poverty level (e.g. $18,310 for a family of three in 2009) will have health care through Medicaid.
- An additional 17 million people will be able to purchase insurance at group rates through the to-be-established state insurance exchanges. The program will require most citizens and legal residents to purchase health insurance coverage, but it is estimated that initially about 90 percent of those purchasing insurance through an exchange will receive federal subsidies or premium credits to make it affordable. These credits will be available to those whose income is between 133 percent and 400 percent of the federal poverty level (approx. $55,000 for a family of three).
- Employers with more than 50 employees will be obligated to provide insurance coverage for their employees, or pay a penalty of $2000 per employee.
- There will be a formal appeal process for consumers to challenge claim rejections and other unfair insurance practices, with funding to help consumers protect their rights.
What do you think of these pending changes in our health-care system?