WebMD Medical News
Laura J. Martin, MD
July 30, 2010 -- The new health reform law, the Affordable Care Act, bodes well for as many as 30 million women -- a number that includes 15 million women who are uninsured, according to a new report issued by the Commonwealth Fund, a private health research firm in New York City.
This new report is the first in a series that will look at how health care reform will affect specific populations.
"While women as a group are just as likely as men to be uninsured, they are more likely to have medical debt, bill problems, and have trouble getting insurance," Karen Davis, the Commonwealth Fund president, said during a telephone conference. "This report brings good news to all women who will now be more likely to get the care they need with a reduced risk of incurring the unaffordable medical bills that have affected so many Americans."
Seventeen million working-age women were uninsured in 2008, and 14.5 million women had such high out-of-pocket costs that they were effectively underinsured, report author Sarah Collins, PhD, a vice president for affordable health insurance at the Commonwealth Fund, said during the teleconference. "Given the high unemployment rate, this number has likely increased," she says.
"Women have more contact with health care because of their reproductive needs and the central role they play in coordinating the health care of their families," she says. The Affordable Care Act "will have a huge impact on women who are uninsured and large effects on women who are currently underinsured."
The new law takes full effect in 2014, but certain early provisions will be in place in the next three years, Collins says.
Such transitional benefits include provisions that allow young adults (up to age 26) to remain on or join their parents' insurance plan, she says. "One million uninsured adult children will gain coverage as a result," she says.
There will also be bans on the cancellation of an insurance policy when a person is sick. "This will affect a number of women who could have had their health insurance rescinded," Collins tells WebMD.
What's more, there will be full coverage of preventive tests such as mammograms, cervical cancer screening, genetic counseling, testing for breast cancer genes BRCA1 and BRCA2, and other screening exams under the new plan.
About 7.3 million women aged 19 to 64 were turned down when they tried to buy an insurance plan, charged a higher rate than men, or had a pre-existing condition excluded when they tried to buy in, she says. But in 2014, insurers must say yes to all and can't charge higher premiums based on health status or gender.
Health plans sold through states must also cover maternal and newborn care, she says.
The new plan also does away with limits on how much insurers can pay out if a person becomes ill, and phases out the dreaded "doughnut hole," or coverage gap where Medicare no longer pays for medications and consumers must pay full price for their drugs until they spend a certain amount. The new plan will offer $250 rebates to those in the doughnut hole starting this year.
"Women are among the most likely to reach the doughnut hole," she says.
Not everyone is sold on the benefits of Obamacare, particularly as they pertain to women.
"It is nowhere near as good as it looks," says Michael D. Tanner, senior fellow at Cato Institute, a nonprofit libertarian think tank based in Washington, D.C.
For example, 46% of newly insured will be put on Medicaid, not a private insurance plan. Medicaid is the federal health plan for low-income families. "Medicaid provides very poor quality care and people on Medicaid have a hard time accessing a primary care doctor," he says, adding that about one-third of such doctor's don't accept Medicaid.
Commonwealth Fund's Collins says that the new act also sweetens the pot for health care providers, offering them more incentives to take Medicaid patients, she says.
"Getting rid of co-payments for mammograms and other screening tests are of marginal benefit, but that comes at a cost to taxpayers or insurance premium payers," Cato says.
Along the same lines, parents who want their young adult children on their insurance will have to pay about $3,400 per child, per year, he says.
"There is no free lunch. Nobody is giving away health care."
SOURCES:Commonwealth Fund: "Realizing Health Reform's Potential: Women and the Affordable Care Act of 2010."Michael D. Tanner, senior fellow, Cato Institute, Washington, D.C.Karen Davis, president, Commonwealth Fund, New York City.Sarah Collins, PhD, vice president, affordable health insurance, Commonwealth Fund, New York City.
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