Facts About ACA

The Affordable Care Act (ACA) is the greatest advance in women’s health in a generation. Thanks to the new health care law millions of women, have improved access to quality, affordable health care. Specifically, around 22 million Americans have gained insurance coverage as a result of the ACA. Below are just a few things the health care law does to improve women’s health.

Preventive services without co-pays.

The ACA requires that health plans cover important preventive services without any co-pays for enrollees. These services include birth control, breast and cervical cancer screenings, and annual well-woman exams. Since the policy went into effect, over 55 million women gained guaranteed coverage of these additional preventive benefits without cost-sharing. This shift in access saves women an average of $269 annually.

Further, the ACA established certain Essential Health Benefits, a minimum level of coverage that most health plans have to provide. The Essential Health Benefits include important services, such as prescription drug coverage and maternity care. Prior to the ACA, only 12 percent of individual market plans covered maternity care.

Women have direct access to OB/GYN providers.

Access to OB/GYN providers is an essential component of women’s health care. Prior to the ACA many insurance plans required that women see another doctor before they were able to receive a routine check-up with an OB/GYN provider. Now, under the ACA, women are guaranteed access to their OB/GYN provider without another doctor’s referral or approval from the insurance company.

The health care law creates affordable health insurance options.

The ACA made great strides in improving access to health care. Over 12 million individuals enrolled through the Marketplaces for coverage in 2016. Nearly 14 million people are expected to select a marketplace plan for 2017 coverage. Further, an additional 16 million have already enrolled in Medicaid since the first open enrollment period and gained access to affordable health insurance coverage.

• Medicaid: Medicaid eligibility increased under the ACA, and states that have elected to expand Medicaid have increased access to the nation’s largest source of reproductive health care. Medicaid guarantees coverage of critical primary and preventive women’s health services such as family planning services and pregnancy-related care, including pre-and post-natal care. Also, women enrolled in Medicaid can go to the provider of their choice to receive family planning services, such as birth control.

• Federal or State Marketplaces: The health insurance Marketplace has increased access to private insurance coverage. The majority of Marketplace enrollees qualify for credits that will reduce the cost of their health insurance plan. For 2017 coverage, almost 12 million Americans can gain financial help to purchase a private plan.

Young adults can now stay on their parent’s health insurance until age 26.

Young adults can now stay on their parents’ health plan until age 26, even if they are married, not living with their parents, or not in school.

Women can no longer be discriminated against in health insurance.

Prior to the ACA, women were often charged much higher rates for health insurance coverage just because they are women. For example, a healthy 22-year-old woman can be charged premiums 150 percent higher than a 22-year-old man. The ACA ended this practice in 2014.

Women can no longer be denied health care coverage because of a pre-existing condition. The ACA stops health insurers from denying people health insurance coverage because of pre-existing conditions including cancer, high blood pressure, or diabetes. This is especially good news for women, who have even been denied coverage because some health insurers have claimed that having a C-section or being a survivor of domestic violence is a pre-existing condition.

A few other important protections under the health care law:

• Health insurance companies no longer are able to take away your health coverage after you get sick. The law also prevents health plans from turning people away when they apply for health coverage.

• Health insurance companies are prohibited from setting certain limits on coverage — such as annual or lifetime limits, whereby health plans put a restriction on how much health care they will pay for in a given year or lifetime.

• There are new limits on how much people will have to pay in overall out-of-pocket costs, such as deductibles and co-pays.