(Washington D.C.) A new report released today by the National Women’s Law Center (NWLC) reveals various exclusions in health insurance plans from more than 100 insurers in 16 states that particularly affect women’s health and economic security. The report, funded by The Commonwealth Fund, highlights the tremendous advances of the Affordable Care Act (ACA) for women but also examines important services that are excluded from many plans in the health insurance marketplaces, including genetic testing and fetal reduction surgery.
Highlights of the report, “Women’s Health Coverage Since the ACA: Improvements for Most, But Insurer Exclusions Put Many at Risk,” and examples of services that are excluded by the insurers reviewed, include:
- 42% exclude coverage of services arising from or related to non-covered services
- Example: An allergic reaction to preventative drugs given to a woman after sexual assault
- 27% exclude coverage of “maintenance therapy” or other ongoing medical treatments that “prevent regression of functions in conditions that are resolved or stable.”
- Example: Taking medication following breast cancer treatment to slow or avoid the cancer from returning
- 15% exclude coverage of genetic testing not expressly required to be covered by law.
- Example: Genetic testing if a pregnant woman’s heritage places her at high risk to be a carrier for sickle cell anemia
- 14% exclude coverage for fetal reduction surgery.
- Example: Surgery to reduce the number of fetuses if the pregnancy or woman’s health is at risk because of a multiple pregnancy with complications
“The Affordable Care Act has undoubtedly helped millions of women by banning discriminatory insurance practices and providing access to many vital reproductive services,” said Dania Palanker, NWLC Senior Counsel for Health and Reproductive Rights, who authored the report. “However, it is clear that gaps still exist that result in the denial of coverage for services that disproportionately affect women. These exclusions may not explicitly violate the ACA, but they undermine its goal of eliminating discrimination in health care.”
The report calls for state insurance regulators to ensure increased transparency so that women can make informed decisions about which health plan to buy and don’t find out about these exclusions at the time that the service is denied.
Contact: Olympia Feil (firstname.lastname@example.org); 202-588-5180