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If at First You Don’t Succeed . . . Try an Executive Order That Allows Health Insurance Companies to Discriminate Against Women

After conceding defeat of congressional attempts to dismantle the Affordable Care Act (ACA), the Trump Administration is now using executive action to try to undermine and gut the law. Today, the Administration issued an executive order (EO) directing the Departments of Health and Human Services, Labor, and Treasury, to figure out ways to allow insurers to undermine the ACA.  In particular, the EO asks the departments to reexamine rules to extend the duration of short-term plans from a three-month maximum to up to a year and permit the sale of association health plans. Many short-term and association plans generally do not include the ACA’s consumer protections.

The bottom line is that today’s EO is bad for women – it jeopardizes access to health coverage for the more than 89.6 million women ages 18-64 nationwide who—thanks largely in part to the ACA—now have health insurance coverage. Do not be fooled—today’s EO is not about consumer choice or more coverage options, it is a politically calculated attack on the ACA.

So, why is this EO bad for women’s health?

Because women have benefitted from key ACA consumer protections like prohibitions against discriminating against people with pre-existing conditions and requirements that plans cover basic health services, like preventive care. The EO would allow insurers to return to pre-ACA discriminatory practices that harmed women and limited their access to health coverage.

So, here’s the rundown of some of the key ways today’s EO would allow insurers to harm women’s health:

  1. The EO tasks the departments with extending short-term plans, previously limited to three months in duration under the Obama Administration, to up to one year. Short-term coverage is intended as stop-gap coverage. For example, one might purchase short-term coverage while in between jobs. Extending these plans to offer coverage up to one year could have devastating effects for women who rely on such plans as their primary sources of care. Here’s why:
  2. The EO also tasks the departments with figuring out how to permit the sale of association health plans, which often do not offer robust health coverage that helps to meet women’s health needs. While these plans may initially seem attractive for small businesses seeking to group together to offer coverage, experience shows that such plans don’t result in strong coverage or consumer protections. States, like Washington, that have tried to sell association health plans know they don’t work—Washington’s own Insurance Commissioner notes: “Association health plans often shun the bad risks and stay with the good risks.” This means that those with significant health needs would likely not be able to secure the coverage that meets their needs under these plans.  And, leaving women without coverage for the health services that they need means high out-of-pocket costs, which are especially burdensome for women struggling to make ends meet.

We simply cannot return to a time when discrimination was commonplace on the health insurance market. The ACA’s protections have changed the landscape for women’s access to health care and coverage, particularly women struggling to make ends meet, women of color, and LGBTQ individuals who experienced widespread discrimination in the health sector prior to its passage. We must continue to resist this and other heartless attacks on vital health coverage and services for women.