“If the court rules to strike down the entire ACA, there will be devastating consequences for everyone,” Jamille Fields Allsbrook and Sarah Coombs explained in a recent report for the Center for American Progress, “but these negative outcomes will be most pronounced for the millions of women with preexisting conditions and, in particular, for women of color and women with low incomes, whose health and economic security would be most at risk.”
With the Affordable Care Act once again under attack—in this case, due to a case going before the Supreme Court challenging the landmark law’s constitutionality—Allsbrook and Coombs, the director of women’s health and rights for the Women’s Initiative at the Center for American Progress and the senior health policy analyst at the National Partnership for Women & Families, respectively, dug into the data to figure out what was at stake for women and girls.
What they found was that women and girls likely have the most to lose.
Without guaranteed issue protections, women could be denied coverage based on their medical history, their age, and their occupation, among other factors. Without community rating, they could be charged more, or priced out of the insurance market altogether, based on their health status or other factors. Moreover, if the entire ACA is repealed, insurance companies could try to reinstate gender rating, a common pre-ACA practice in which insurance companies charged higher premiums for women than they did for men…
The authors of this column estimate that more than half of nonelderly women and girls nationwide—nearly 68 million—have preexisting conditions. There are also approximately 6 million pregnancies each year, a commonly cited reason for denying women coverage on the individual market before the ACA. The table below provides state-level detail for the number of women and girls with preexisting conditions and the number of pregnancies.
A large share of women have insurance through an employer or Medicaid, and therefore, their coverage would protect them from discriminatory practices such as medical underwriting or denials based on health conditions. But the data make clear that allowing insurers to return to pre-ACA practices could lead to millions of women and girls being denied coverage or charged more based on their health status if they sought coverage in the individual market.