There is a saying that the definition of insanity is doing the same thing over and over again and expecting a different result. Well . . . Senate Republicans have introduced yet another bill to repeal the Affordable Care Act (ACA), which once again would be disastrous for women’s health, and here’s hoping that it meets the same fate as all of the other failed ACA repeal attempts:
The bill, introduced yesterday by Senators Cassidy and Graham, includes many provisions that we’ve seen in prior repeal efforts that would harm women’s health and some new ones. Here is a sampling of some of the ways that the bill hurts women’s access to health care and coverage:
- It slashes federal support that helps women afford health care services and coverage: The bill would eliminate the ACA’s cost-sharing reductions and tax credits that make health insurance affordable, which would be devastating for the over 9 million women who, as of 2014, were eligible to benefit from the tax credits and would otherwise have gone without affordable health insurance, including a large number of women of color.
- It would end Medicaid as we know it, allowing states to convert the program into either a per capita cap or block grant program starting in 2020. Either of these options means less federal money for the Medicaid population and a shifting of costs to already cash-strapped states that will be forced to cut benefits or enrollment. This threatens health care coverage and benefits for tens of millions of individuals—and would hit women, who comprise two-thirds of Medicaid adult enrollees, especially hard. A loss of insurance would be especially devastating for low-income women who are more likely to go without care because of cost, are less likely to have a regular source of care, and utilize preventive services at lower rates than low-income women with health insurance.
- It would end Medicaid expansion. This would devastate coverage for millions of women who have obtained health care due to Medicaid expansion. Since the implementation of the ACA, 3.9 million women ages 18-64 have gained Medicaid coverage, a growth of 29% nationally.
- It would allow states to eliminate Medicaid benefits for non-disabled, non-elderly, non-pregnant adults, beginning October 1, 2017, who do not fulfill punitive work requirements. This includes penalizing a woman who does not meet work requirements just 60 days after the end of the month her pregnancy ends, as little as a mere 8½ weeks after delivery. Not only are work requirements based on false and harmful stereotypes, they threaten low-income women’s health and economic security.
- It bars individuals enrolled in Medicaid from accessing critical health care services at Planned Parenthood health centers for one year. This includes important preventive care, like birth control, cancer screenings, and testing and treatment for sexually transmitted infections. Doing so would devastate access to care for millions.
- It restricts abortion coverage: The bill includes restrictions on abortion coverage, including preventing women from using their own funds put in Health Savings Accounts (HSAs) to pay for abortion. The bill would also impose penalties on plans that do cover abortion if they do not follow arbitrary and burdensome accounting requirements. Taken altogether, the goal of these provisions is to eliminate insurance coverage of abortion altogether. When a woman is denied insurance coverage of abortion, she may be forced to forgo other basic necessities like paying rent or utility bills to pay for the procedure, or she may be forced to carry an unwanted pregnancy to term.
- It allows states to receive waivers to drop coverage of benefits important to women’s health: The bill provides waivers to states, allowing them to drop coverage of a package of health services required under the ACA’s essential health benefits (EHB) provision, like maternity care or mental health services. Loss of maternity coverage could leave women shouldering high costs for maternity services, like hospital bills ranging from $32,093 for vaginal births (without complications) and up to $52,125 for caesareans or more complicated births. Maternity coverage is particularly vital for black women who are twice as likely to suffer from severe maternal morbidity than white women. In 2012, only 9 states required all insurers on the individual market to cover maternity care. Making coverage of these benefits optional also threatens the ACA’s bar on annual or lifetime limits—which could mean higher cost coverage or denial of coverage for the 65 million women with pre-existing conditions.
To sum it up — this is yet another all-out attack on women’s health and we must continue to resist and let our senators know that enough is enough. It’s time to move on and work towards strengthening, not dismantling, women’s access to the health care that they need!