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New Version Allows States To Deny Women No Co-Pay Birth Control

Planned Parenthood: “Graham-Cassidy-Heller is still a cruel piece of legislation”

Washington, DC –Today, the U.S. Senate introduced new bill text for the unpopular and widely criticized Graham-Cassidy-Heller proposal. The new version of the bill will allow plans not to cover birth control and other important preventive services -- cutting off access to critical care for women. This reverses the protections under the ACA that required virtually all health insurance plans must cover the full range of FDA-approved birth control without copay.

The Graham-Cassidy-Heller proposal continues to be the worst ACA repeal proposal yet. It would gut protections for people with pre-existing conditions, put maternity care for 13 million women at risk, could leave at least 32 million people without health insurance, slash Medicaid funding, and prevent millions of people from getting basic care at Planned Parenthood health centers.

Statement by Dawn Laguens, executive vice president at Planned Parenthood Federation of America:

This bill goes even further to devastate women and families by allowing states deny women birth control coverage, slashing Medicaid, and punishing women with pre-existing conditions including women who have had a baby. The Graham-Cassidy-Heller is the worst bill for women’s health in a generation. It’s a cruel piece of legislation that would leave 32 million people without health care and devastate Planned Parenthood’s patients. Don’t be fooled: Graham-Cassidy-Heller means Americans will pay more but get less, and women will pay the biggest price of all.

“The Graham-Cassidy-Heller bill puts maternity care for 13 million women at risk, would allow insurance companies to charge women more just because they gave birth or had breast cancer, and blocks anyone enrolled in Medicaid from coming to Planned Parenthood for preventive care. Republican Leadership is trying to jam this bill through the Senate without even understanding what it would do or how many people it would hurt. That’s not the way you make good legislation, and that’s not the way you decide the fate of healthcare for millions of Americans.

“The majority of the American people oppose the Graham-Cassidy-Heller bill, as do major medical associations and health insurance groups. Congress should listen to experts and the American people, reject efforts to take away care, and focus on bipartisan fixes to expand access to care.

The Graham-Cassidy-Heller bill is opposed by non-partisan groups representing nearly every facet of the health care industry, including insurance companies, doctors, patients, hospitals and other patient-provider groups -- such as AHIP, ACOG, AMA, the President and CEO of the Robert Wood Johnson Foundation, Blue Cross Blue Shield Association and the American Heart Association.  Americans have repeatedly rejected every other version of Trumpcare.  

Background: Graham-Cassidy-Heller Bill Goes Further In Attacking Women’s Health

[NEW] States can deny women access to no-copay birth control.

  • The new version of the bill will allow plans not to cover birth control and other important preventive services -- cutting off access to critical care for women. Under the ACA, virtually all health insurance plans must cover the full range of FDA-approved birth control without copay.

  • This comes at a time when the Trump administration is also threatening to scale back the birth control benefit. Now, Congress would permit states to completely eliminate this benefit.

  • Because the bill makes it harder for people to access health care coverage, millions of women will no longer be able to access birth control without co-pay. It also means that women will no longer have access the birth control method of her choice since cost could get in the way. For example, without insurance, an IUD could cost more than $1,100 out-of-pocket.

  • It is critical that women be able to determine when to start a family and that couples be able to plan for the families they want. Price and politics shouldn’t get in the way of personal family decisions.

  • And let’s not forget that a recent medical study found that waiting 18 months between pregnancies reduces the likelihood of premature birth and pregnancy complications. Access to birth control is critical to healthy birth spacing and the health of moms, moms-to-be, and babies.

[NEW] Women with pre-existing conditions, which includes pregnancy, will be charged more. The “new” version of the bill is even more harmful for people living with pre-existing conditions. The bill would also allow states to have one risk pool for the sick and another risk pool for the healthy. This could lead to even higher costs for people with pre-existing conditions.

  • Insurers get to unilaterally decide what is considered a pre-existing condition and thus, who they can charge more for coverage. Before the ACA, people who had a baby, whether vaginally or by C-section, could be deemed to have a pre-existing condition. Sixty-five million women were considered to have a pre-existing condition prior to the ACA.

  • Insurers would charge pregnant women about $17,320 more, according to estimates from the Center for American Progress. Four out of five women will give birth in her lifetime.

  • For many, the Graham-Cassidy proposal could mean that your health insurance isn’t just more expensive, it’s completely out of reach. Insurance companies could charge patients $28,660 more for having breast cancer, and $142,650 more for cancer that has metastasized.

  • Black and Latina women face higher rates of many chronic illnesses, meaning these exorbitant costs will hurt the health and financial security of women of color the most. For instance, Black women are the group of people most likely to die from breast cancer. The ability to charge people more based on pre-existing conditions would permit insurers to charge a breast cancer survivor $28,660 more annually for insurance coverage. Without healthcare coverage, racial disparities in breast cancer rates could persist or even widen.

  • As Haywood L. Brown, M.D., president of the American Congress of Obstetricians and Gynecologists (ACOG), said in a statement: “This bill is an assault on women’s health…  Prior to the ACA, women were routinely charged more than men for the same coverage, a practice that cost women approximately $1 billion annually. Graham-Cassidy would allow states to return to this practice. It also allows states to define a prior C-section, depression, breast cancer, and experiencing domestic violence as pre-existing conditions, and reason to deny coverage. Being a woman is not a pre-existing condition.”  

Patients will be blocked from care at Planned Parenthood.

  • Under this bill, low-income patients would be prohibited from coming to Planned Parenthood health centers for care — leaving many women with nowhere to go for basic care such as cancer screenings, birth control, STI treatment, and more. We’ve seen what happens at the state level when policies like this are put in place, and they’re devastating. For example, in Texas, maternal mortality rates have doubled roughly since the state cut Planned Parenthood from key public health programs.

  • Many women already have limited options for care such as birth control, cancer screenings, and regular checkups. Preventing them from coming to Planned Parenthood would leave many with nowhere to go for basic reproductive health care.

  • 2.4 million people who rely on Planned Parenthood health centers for essential health services. One in five women in America have relied on Planned Parenthood in her lifetime.

  • More than half of Planned Parenthood’s patients rely on Medicaid for care, and 56 percent of Planned Parenthood’s health centers are in rural or otherwise medically underserved areas.

  • The American Medical Association (AMA) said that parts of the bill that block access to care at Planned Parenthood health centers “violate longstanding AMA policy on patients’ freedom to choose their providers and physicians’ freedom to practice in the setting of their choice.”


Planned Parenthood is the nation’s leading provider and advocate of high-quality, affordable health care for women, men, and young people, as well as the nation’s largest provider of sex education. With more than 600 health centers across the country, Planned Parenthood affiliates serve all patients with care and compassion, with respect and without judgment. Through health centers, programs in schools and communities, and online resources, Planned Parenthood is a trusted source of reliable health information that allows people to make informed health decisions. We do all this because we care passionately about helping people lead healthier lives.