Health Law and Regulation

Up to 15 Million Women Will Gain New Subsidized Coverage from Health Reform

Thirty million women will benefit from the new health reform law over the next decade, either through new or strengthened insurance coverage, according to a new report from The Commonwealth Fund.

In the first analysis of its kind, the authors report that the law will stabilize and reverse the growing exposure to health costs that women now experience by subsidizing health insurance for up to 15 million currently uninsured women, and strengthening existing coverage for 14.5 million women who are considered underinsured — those who have health coverage that does not adequately protect them from high medical expenses. Provisions important to women will expand eligibility for Medicaid, provide subsidies to purchase insurance, limit out-of-pocket spending, prevent insurers from charging higher premiums or denying coverage based on health status or gender and require new plans to cover maternity and newborn care. These provisions will also help uninsured women who earn too much to qualify for Medicaid or premium subsidies gain comprehensive coverage. Although women are just as likely to be uninsured as men, their healthcare needs leave them more vulnerable to high healthcare costs and problems related to loss of health insurance.

Another important provision that will help an estimated 100,000 uninsured women gain coverage is the Pre-Existing Condition Insurance Plan (PCIP) to provide temporary coverage to adults with pre-existing conditions who are uninsured during 2010 to 2013. Seventeen states and the District of Columbia began enrollment in PCIPs in July, and 12 will begin to enroll adults in August; in the 21 states without a PCIP the federal government began operation of a PCIP July 1.

Women living in states with higher than average uninsurance rates stand to gain the most from the new law: New Mexico and Texas (29 percent uninsured in 2008); Florida and Louisiana (24 percent uninsured); and Alaska, Arizona, Arkansas, California, Georgia, Mississippi, West Virginia, Idaho, Kentucky, Nevada and Oklahoma (at least 20 percent uninsured). Although women will have to wait until 2014 to begin to reap the greatest benefits from expanded and improved insurance coverage, several early provisions beginning in 2010 will also provide important support, the study shows. These include:

• Strengthened and expanded insurance coverage for young adults through policies that allow adult children up to age 26 to come on, or stay on, their parents’ plans, and bans on pre-existing condition exclusions;
• Bans on lifetime benefit limits and phase-out of annual limits;
• Bans on rescissions of insurance policies;
• Coverage of recommended preventive services without cost-sharing including mammograms;
• Eligibility for a new plan that covers uninsured people with pre-existing conditions that currently make it difficult for them to gain coverage; and
• Rebates to women enrolled in Medicare who reach the “doughnut hole” in their prescription drug plans; women, along with people with diabetes and Alzheimer's or other forms of dementia are most likely to reach this gap in coverage.