Employment Data Highlight How Bad ACA Repeal Will Be for Women’s Jobs and Mental Health
Jobs data were released this morning by the Bureau of Labor Statistics (BLS). The economy continues to show sustained growth, adding 211,000 jobs in April. Employment in healthcare increased by 20,000 in April and while we don’t know yet how many of those jobs went to women, we do know that women hold the vast majority of jobs in these industries. While the addition of 20,000 jobs in this sector in April is similar to other months this year, this is well below average gains of 32,000 healthcare jobs per month in 2016. This news comes on the heels of a devastating vote in the House yesterday to repeal the Affordable Care Act (ACA), a vote that took place without a Congressional Budget Office (CBO) score that tells us the economic impact of policies.
These data seem to indicate that the uncertainty of ACA repeal has impacted hiring within the healthcare sector. In particular, one issue that has been largely absent in this debate is the ACA’s expansion of mental health care. The ACA requires that plans on the health insurance marketplace, new plans offered through employers, and plans offered through Medicaid cover behavioral or mental healthcare as part of a package of Essential Health Benefits (EHB). Before the ACA, most plans did not include this coverage and if they did it was offered as an expensive rider that could be purchased on top of your regular plan.
Mental health disproportionately impacts women, who are 40% more likely than men to develop a mental health issue in their lifetime. Because of the essential health benefits in the ACA, the percentage of adults 18-64 with serious psychological distress who were uninsured dropped from 28.1% in 2012 to 19.5% in 2015, and the percentage of adults with a serious psychological distress who needed behavioral healthcare but could not afford it declined significantly between 2012 and 2015. So the benefit is working in getting people the care they need, but how has it impacted the health sector in terms of jobs? As it turns out, quite a bit.
In March 2017, women made up 76.1% of jobs in offices of mental health practitioners, offices of specialty therapists, outpatient mental health centers, and psychiatric and substance abuse hospitals. From April 2016 to March 2017, these were some of the fastest growing industries within healthcare and women accounted for more than 9 in 10 (90.5%) of the job gains in these sectors. These specific industries fall under the larger industry categories of Ambulatory and Outpatient care centers. The median wage across Ambulatory occupations is $19.29/hour and for Outpatient care centers its $22.61/hour. Contrast that with Home healthcare, where women make up 87% of jobs and the median wage is just $12.61/hour.
The expansion of mental health services in the ACA not only improved care for patients, but also expanded opportunities for women working in healthcare to get higher paying jobs. But the repeal bill passed by the House yesterday, and that now heads to the Senate, eliminates these requirements that plans cover mental healthcare—a double whammy for women in terms of their access to critical mental healthcare and the prospect of better paying jobs. Adding insult to injury, the bill takes away protections for people with pre-existing conditions, including post-partum depression and other issues that impact women specifically. You might say ACA repeal is an all-out assault on women’s mental, physical, and even economic well-being. Let’s hope this bill doesn’t make it out of the Senate.