The Affordable Care Act and Women

By Desiree Hoffman
YWCA USA Director of Advocacy and Policy

March 23, 2011, marked the first anniversary of the Affordable Care Act (ACA). Yet polls show that less than 47% of Americans know how it affects them.1 Lack of understanding was highest among low-income households and the uninsured.  When asked, “Do you feel you have enough information about the health reform law to understand how it will impact you personally?,” 61 percent of households with incomes less than $40,000 per year said “no;” 60 percent of uninsured individuals responded “no.”

Today, many households are struggling in a difficult economy and rightly feel a sense of disconnection between their own lives and politics.  It isn’t surprising that many people don’t feel they have enough information about the ACA, let alone feel they have accurate information.

Recently I had the chance to speak to a room full of seniors and retirees about the ACA.  What stood out to me was the audience knew more about how the law protected their grandchildren than they did about how ACA helps them.  Under the new law, the audience knew that insurers could no longer discriminate based on a child’s preexisting condition, and that dependent children under the age of 26 could remain on their parent’s health care plans.  What the mostly female audience did not know, however, was that they would no longer be charged co-pays for preventative services such as mammograms, cervical cancer screenings, immunizations, and annual physical exams.

Retirees and seniors were not aware that the ACA:

  • provides free mammograms every one to two years for women aged 40 and above, and patients identified as high-risk candidates for breast cancer can receive consultation on chemoprevention, and genetic evaluation;
  • makes it illegal for insurers to deny coverage to women based on pre-existing conditions, including cesarean sections, breast cancer, chronic conditions like high blood pressure or diabetes and even domestic violence; and
  • ensures that low-income and moderate-income women and families are able to afford health care by expanding Medicaid and offering new affordability credits to families — between 133 percent to 400 percent of the federal poverty level (Example: The range is between $29,328 to $88,000 for a family of four based on 2009 HHS guidelines) — to help pay for health care premiums.

Most shocking to me was that the audience of primarily women had no idea that, before ACA, insurers refused to cover survivors of domestic violence. Before the law, insurers defined domestic violence as a pre-existing condition since many victims often had higher utilization rates of the emergency room and, thus, were viewed as “high risk” or more costly to insure, providing the basis for refusal of health care coverage at all. Under ACA, an insurance company can no longer discriminate against  — and re-victimize — a domestic violence survivor by denying health insurance coverage.

From the provisions that help children and grandchildren, to the measures that address breast cancer and help domestic violence survivors obtain health care insurance, the ACA clearly makes healthcare more affordable for women and their families. While the affordability credits do not kick- in until 2014, they are important components of the law that help low and moderate income families. People are struggling with rising healthcare costs and stagnant wages in an economy where unemployment remains high; expanding Medicaid and providing subsidies to help pay for health care premiums will help tremendously.

Despite these benefits, there are intensifying efforts to repeal or weaken the ACA.  At the beginning of the 112th Congress, bills were introduced to repeal the entire law, but they did not muster enough votes to pass.  Now, there is a flurry of amendments to halt agencies from fully implementing key provisions of the ACA, and bills to restrict comprehensive reproductive health care services.

This month is declared both national Breast Cancer Awareness Month and Domestic Violence Awareness Month. Knowing the important benefits that ACA means for breast cancer prevention and treatment and for survivors of domestic violence, there is no better way to commemorate this month than by speaking out in support of the ACA to your Senators and Representative or by educating yourself and your loved ones on the benefits of the new law.

To learn more about the new law visit:

1 Kaiser Health Tracking Poll, The Henry J. Kaiser Family Foundation, March 201

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