On May 4, the U.S. House voted to pass the worst bill for women’s health in a generation: the American Health Care Act (AHCA). This bill not only seeks to repeal the Affordable Care Act (ACA), but also to “defund” Planned Parenthood by blocking Medicaid patients from care at its health centers. As such, the bill would undermine health care access for women and impose additional costs on them — particularly women who already face systemic barriers to care, including women with low incomes and women of color. But that’s only if the bill gets through the Senate and to the president’s desk.
As the bill heads to the Senate, here’s what it actually does — and what it doesn’t do.
What Thursday’s Vote Did NOT Do
It Didn’t Change the Law. Yet.
The ACA repeal bill passed the House by a narrow margin, and now it faces an uphill battle in the Senate. We can expect more changes to the bill that will impact women’s health.
It Didn’t Close Planned Parenthood.
All Planned Parenthood health centers are open as usual, and staff are doing what they’ve always done: getting up in the morning; opening the health center doors; and providing high-quality, affordable health care to all people who need it. That includes patients who rely on Medicaid coverage.
It Didn’t Cancel Your Insurance.
The benefits of the ACA are still here for you. The majority of people can still purchase a plan for $75 or less. If you have health care coverage, it is still in effect until there is an actual change in the law, which takes time. This includes people who are 26 or younger and on their parents’ plan. Make your medical appointments, and get the care you deserve and are entitled to under the law.
What the AHCA Threatens to Do to Women’s Health
The bill is still an extreme threat to health care access — particularly women’s. Below are just a few of the women who will be impacted if the bill becomes law.
Women Seeking Birth Control and Other Preventive Services
The bill would block people who have Medicaid insurance from receiving health care at Planned Parenthood health centers. Every year, 2.5 million people rely on Planned Parenthood for essential health care services, like birth control and lifesaving cancer screenings.
Overall, 24 million people would lose coverage and access to no-cost preventive services, including birth control. More than 55 million women have gained access to no-copay birth control and women have saved more than $1.4 billion per year on birth control due to the ACA. Under ACHA, fewer people would be able to afford private insurance coverage and fewer people would be eligible for the Medicaid program — which means fewer women with birth control coverage.
Women Seeking an Abortion
The bill would create a nationwide ban on private insurance coverage of abortion. At least 870,000 women will lose access to ACA Marketplace insurance plans that include abortion coverage, and millions more could lose access to abortion coverage in other plans.
Women Needing Essential Health Benefits
The bill would completely gut the essential health benefit (EHB) requirement, impacting:
maternity coverage for 13 million women,
mental health coverage for 4 million people,
substance abuse treatment for 7 million people, and
prescription drug, hospitalization, rehabilitative, emergency, and ambulatory services for millions more.
Under the ACA, plans are required to cover certain benefits including maternity care, prescription drugs, mental health treatment, and others. Under the AHCA, if a woman lives in a state that waived the EHB, she may no longer have an insurance plan that covers the EHBs.
Gutting the EHB takes us back to the days before the ACA when women in need of maternity services were forced to purchase a separate maternity rider that could cost up to $1600 a month. Further, a state would be permitted to undermine coverage of substance abuse treatment — at a time when the country is experiencing an opioid epidemic. Coverage for services we all need at some point, such as emergency services and prescription drugs, could also be on the chopping block.
Women with Pre-Existing Conditions
The bill backpedals on the consistently repeated promise of House leadership — that any effort to repeal the ACA would protect people with pre-existing conditions. Before the ACA, it was common practice for insurers to charge women and anyone who had ever been sick more for coverage, and the majority of states allowed this practice. Under AHCA, insurers could again decide what is a pre-existing condition and charge women more if they have had a C-section or experienced domestic violence. The 65 million women who have a pre-existing condition will likely be faced with a “sick tax” — a woman with breast cancer could be charged $28,230 more per year; a woman experiencing depression could be charged $8,490 more annually; and even a woman who has had a pregnancy, without complications, could see her premiums increase $17,320 annually!