On June 28, 2012, when the Supreme Court upheld the Patient Protection and Affordable Care Act known familiarly as “Obamacare,” women around the nation breathed a sigh of relief. Planned Parenthood reports that in the two years since the law’s passage, 20 million women have received preventative health care services.
It was Nancy Pelosi who first publicly stated that under this law, “being a woman is no longer a pre-existing condition.”
It is one of my favorite political sound bytes of all time (besides maybe Sojourner Truth asking “Ain’t I a woman?”–sadly they didn’t have sound recording devices back then). But it takes more than rhetorical flourishes to convince American women–especially conservative ones–that health care reform is their law.
Therefore, in honor of the four generations of women in my family, I’ve put together this anatomy of the ACA in four acts.
I. The Little Ones
My big Italian family is growing in 2012. One of my cousins had twins in June, and another will have her second baby in October. Under the ACA, it will be illegal for a health insurance provider to deny my baby cousins, and all children, coverage because of a pre-existing condition. Meanwhile, their mothers are guaranteed full coverage of their maternity costs, including neo-natal care for premies like the twins. When Medicaid expansions go into effect in 2014, families making up to 133% of the federal poverty level ($29,700 for a family of four in 2011) will have maternity costs covered for up to 60 days post-partum, according to the Kaiser Foundation. Other great improvements for children’s health include mandatory vision and oral coverage for kids under all plans, effective in 2014.
II. The Big Kids
My sister and I are in our twenties and still covered under our parents’ private insurance until we are 26, thanks to the ACA. Whereas once my healthy 21-year-old sister, newly an R.N. (congrats, Hannah), could be discriminated against by insurance providers simply for being a woman, under the reform she and a healthy 21-year-old man will have the same premiums. As both of us establish financial independence, we will not be burdened by high co-pays, nor will we be forced to dish out for basic needs like birth control and annual exams. (Did I mention free birth control?)
III. Middle-Aged Mamas
My mom’s nest may be empty, but she still deals with and worries about the logistics of her family’s health care, in addition to her own. According to a study from the White House, she is among the majority of American women who plan for their children as well as their parents, and sometimes even extended family. Women are the most important consumers. One of the most significant–and least discussed–aspects of health care reform is its emphasis on improving competitiveness by making health plans more transparent to the consumer. Under the law, your provider is obligated to provide reciprocal services within your region if your family’s needs aren’t met under its plan. Information about competing providers must be clear and accessible. Women–mothers–will benefit most from this pro-consumer policy.
In addition to improved and more transparent access to family-friendly coverage, middle-aged women like my mother will have their own preventative care covered no matter what: that is, a woman will no longer have to forgo a mammogram because her plan has reached its annual limit; she will not have to delay a medical visit or a trip to the pharmacy (see Figure 13). More women in my mother’s home state of Connecticut will be insured overall: starting in 2014, 42% of the currently uninsured in CT will be eligible for coverage under Medicaid. (In New York, that number is 49%, or half a million women.) Every member of the community will have access to preventative care, reducing long-term state spending on health care overall.
All in all, for my mom this law means “peace of mind.” In terms of positive impacts of the ACA, that belongs at the top of the list.
IV. The Young-at-Heart
Finally, women of advanced years are protected in new ways under the Affordable Care Act. Lifetime and annual limits are no longer legal as of 2014. Additionally, discrimination based on age and medical history is banned as of 2014, and if you get sick, your provider is prohibited from dropping you. “It finally allows coverage for those with a pre-existing condition, something my parents didn’t have when my mom found out she had cancer,” my mom recalls. Until the law takes full effect in 2014, a temporary subsidized program protects adults in a “high-risk pool”–predominantly the elderly.
Health care reform also works to close what is called the “doughnut hole” gap in Medicare coverage. (Google search “doughnut hole” and instead of glazed or jelly the first link you get is the Wikipedia page for “Medicare Part D coverage gap.”) If a person on Medicare has prescription drug costs between $2,700 and $6,154, she must pay for everything out-of-pocket. Below $2,700, 75% of the costs are covered, and above $6,154, 95% is covered. Thanks to the ACA, in 2010 seniors in the doughnut hole received rebates of $250. In 2011, they became eligible for 50% discounts on brand name drugs. The law claims to phase the gap out by 2020.
If there is a pre-existing condition of womanhood in the United States, it is that the burden of finding and paying for health care most frequently falls to her. Obamacare is legislation that benefits all women– though above all, it serves the most vulnerable women and girls. Its physical, psychological, social, and economic advantages for women run the gamut of age, health, and income level. This controversial and oft-misunderstood law is more than a political talking-point; it is a giant leap forward that the women in my life–and yours–cannot afford to lose.
Emma Staffaroni is a second year graduate student in Women’s History at Sarah Lawrence College and co-edits this magazine. Her heroes include Frieda Kahlo, Adrienne Rich, Octavia Butler, and Barbara Kingsolver. Emma enjoys post-it notes, board games, and museum gift shops. She can be reached at estaffaroni[at]gm[dot]slc[dot]edu.
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