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Eight Health Reform Provisions That Could Improve Women’s Health Coverage

Janice Simmons, for HealthLeaders Media, March 29, 2010

The healthcare reform legislation approved by Congress last week created one of the largest changes in American social policy in more than 40 years—making a major impact for one population group: women.

Aside from their own healthcare needs, women also make a majority of the healthcare decision affecting their families and—with their reproductive needs and longevity—may use the healthcare system more than men.

Late in the House's healthcare reform debate, House Speaker Nancy Pelosi (D-CA), speaking from the House floor, specifically cited how healthcare reform would impact women: "It's personal for women. After we pass this bill, being a woman will no longer be a pre-existing medical condition."

Kirsten Sloan, vice president of the National Partnership for Women & Families, in Washington, says about the impact of health reform, "First and foremost, you've got 31 million who are going to be covered—a big chunk of those who are women. That is top of the list for everybody, but looking down from there, you've got benefit issues ... that are of particular interest to women now being covered."

Here are eight provisions that will impact women:

Preventive care: Both private plans and Medicare now will cover the full cost of providing preventive services, such as screening services (mammographies and Pap smears) and immunizations.

Pre-existing conditions. Under the new reform legislation, insurers cannot deny individuals because of pre-existing conditions, such as a previous Cesarean section birth. In the past, insurers could refuse to pay for future C sections (which now account for one in three births) or reject the woman's application for health insurance coverage altogether. Some insurers also had rejected coverage for women who were involved in domestic violence situations, according to critics.

Maternity care. Insurers will now have to cover maternity care in basic insurance policies. According to the National Women's Law Center (NWLC), many individual plans did not cover maternity care, and in most states, insurers were not required to provide maternity coverage. When available, as through insurance riders, the cost of the coverage was not regulated—and beneficiaries could end up with large out of pocket expenses. Caps on maternity coverage, seen in some areas, will also be lifted.

Expanded young adult coverage. Parents will be able to keep their children under their insurance plans until the age of 26. This affects a large number of younger women, Sloan says.

Expanded coverage. More women are either uninsured or underinsured than men: 45% of women, compared to 39% of men, were uninsured or underinsured in 2007, according to the NWLC. Under healthcare reform, families making up to 400% of poverty (or about $88,000 for a family of four) will be eligible for subsides to help them pay insurance premiums. For 4.5 million low income American women who are uninsured, they will be eligible for Medicaid and have access to a comprehensive set of benefits.

Assistance for small businesses. "Most people don't realize that most small businesses are owned and operated by women," Sloan says. "So you've got a small businesswomen who wants to provide her employees with health insurance, she's now going to be able to that" with the provisions offering federal tax credits.

Improved conditions for working mothers. Employers will be required to provide a reasonable break time for nursing mothers, along with appropriate space for those mothers to pump breast milk.

Gender rating removed. Gender rating will be eliminated in the group and individuals markets with the introduction of insurance exchanges. While 11 states had banned gender rating in the individual health market, according to the NWLC, insurance companies in the remaining areas charged women up to 84% more than men for the same coverage for individual policies.


Janice Simmons is a senior editor and Washington, DC, correspondent for HealthLeaders Media Online. She can be reached at jsimmons@healthleadersmedia.com.

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