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ACA has greatly improved access to sexual and reproductive health care, but gaps remain

WASHINGTON — For the past 11 years, the Affordable Care Act (ACA) has put affordable health care within reach for people across the country — 20 million people have gained access to health insurance, and persistent disparities in coverage among communities of color, people with low incomes, and those living in rural areas have begun to narrow. The historic legislation has been a huge advancement for women’s health: Previously, pregnancy or domestic abuse could be considered a pre-existing condition, and women could be charged at higher rates or even denied coverage completely. Access to sexual and reproductive health care has grown significantly due to the ACA’s coverage expansions — birth control, breast exams, PAP tests, maternity care, and breastfeeding supplies are available with low to no co-pays. 

Despite the ACA’s many successes over the past decade, politicians continue to try to dismantle it. Last November, the Supreme Court heard oral arguments in a case, brought by a group of state attorneys general, that could dismantle the ACA. During arguments in November, several outlets — including the New York Times and NPR — noted that “the justices appeared inclined to uphold the bulk of the sprawling law.” 

But with a divided court, the risk remains. And still through it all, there is work to be done to make the promise of this health care law a reality for all, by ending health inequities brought on by systemic racism, sexism, homophobia, classism, and ableism. 

Statement from Alexis McGill Johnson, president and CEO, Planned Parenthood Federation of America: 

“As we celebrate the 11th anniversary of the Affordable Care Act, we must recommit to doing everything in our power to ensure health care is a right for all people. There are millions who would not have health care coverage, including access to essential reproductive health care like birth control, cancer screenings, maternal care, and STI testing and treatment, if the ACA didn’t exist. Yet, the law still faces despicable and continuous attacks from state and federal politicians alike. As COVID-19 continues to expose the gaps that remain in our health care system, ensuring equity in our health care system — for kids, for elderly people, for the millions of women of color who disproportionately compose our essential frontline employees — must be our main priority moving forward.” 

A year into this pandemic, there is no denying that access to health care is fundamental — COVID-19 has only exacerbated the need for quality, affordable, and equitable health coverage. Nearly 15 million people have lost employer-provided health care coverage in the first six months of the pandemic. Thankfully, the Biden-Harris administration’s decision to reopen the ACA health insurance marketplace at the beginning of the year has given people who lost their jobs and health insurance coverage during the pandemic an opportunity to enroll in an affordable insurance plan. In addition, the recently passed American Rescue Plan Act improves the ACA by incentivizing states to expand Medicaid coverage and reduces monthly health insurance premiums for individuals and families with low and middle incomes. The law provides desperately needed funding to help those most harmed by the pandemic get the care they need to stay healthy and to build their own futures — during this pandemic and beyond. 

The ACA has provided millions of Americans with health care, including: 

  • Providing care to more than 20 million previously uninsured Americans

  • Allowing nearly 133 million people with pre-existing conditions the chance to remain on their plans and receive affordable premiums. 

  • Narrowing the gap in access to health care; due to systemic barriers and inequities, people with low incomes who are covered by Medicaid are disproportionately women, Black, Latino, and members of the LGBTQ+ community. 1 in 5 people in the United States is covered by Medicaid, and many more would be covered if the remaining states were to expand Medicaid and eliminate discriminatory barriers to coverage, such as work requirements.

  • Eliminating co-pays for essential preventive services, including birth control, STI screenings, and life-saving preventive services such as breast cancer screenings and Pap tests.

  • Providing financial assistance for free or low-cost monthly premiums to make sure that coverage is affordable every month. Currently, 9 in 10 Healthcare.gov enrollees qualify for this support, and 75% found plans for less than $50/mo


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 organizations 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.