Researchers with The Commonwealth Fund report the healthcare reform law will "stabilize and reverse" the growing healthcare costs faced in the past decade by 15 million women who are uninsured and 14.5 million women considered underinsured.
"This new law marks a dramatic departure from the past in women's ability to gain affordable and comprehensive health insurance coverage," said Commonwealth Fund Vice President Sara Collins in a telebriefing.
While women are just as likely to be uninsured as men, their healthcare needs often leave them more vulnerable to high healthcare costs and problems related to loss of health insurance, Collins says.
For instance, an estimated 7.3 million women (38%) who tried to buy health insurance in the individual market in the past three years were turned down, charged a higher premium, or had their condition excluded from their health plan because of a pre-existing health condition. Currently, rating on the basis of gender is permitted in the individual market in 42 states—with some plans charging as much as 84% more for women than men in the same age group for the same insurance policy, the report notes.
This will change by January 2014 when all insurance carriers are required to accept every individual who applies for coverage (guaranteed issue and renewability), and are prohibited from charging higher premiums on the basis of health status or gender. Premiums can reflect age, but cannot vary by more than a ratio of three-to-one.
"While 18% of women are uninsured nationally, the rate is higher than that in 17 states, so women in those states stand to make substantial gains in coverage as a result of that expansion," Collins says.
Women living in states with higher than average uninsurance rates, stand to gain the most from the new law: New Mexico and Texas (29% uninsured in 2008); Florida and Louisiana (24% uninsured); and Alaska, Arizona, Arkansas, California, Georgia, Mississippi, West Virginia, Idaho, Kentucky, Nevada and Oklahoma (at least 20% uninsured).
In an analysis of health insurance plans sold in the individual market, the National Women?s Law Center found that just 13% of the plans studied included maternity benefits—though substantial variation was found across states, according to the report.
All health plans in Massachusetts, New Jersey, and Oregon were found to include maternity benefits, but 22 states reported no plan-covered costs related to pregnancy. Also, other studies have shown that when individual market plans do include maternity benefits, they often severely limited in the amount of costs covered or have long waiting periods before coverage begins.
Beginning in 2014, all health plans sold through the new state insurance exchanges, as well as the individual and small?group markets, will be required to include coverage of maternity and newborn care, as part of a federally determined essential benefits package.
Grandfathered plans or those in existence on March 23, 2010 in those markets will not have to comply with that standard. Instead, the benefits package will be similar to packages offered through employer plans and will include:
- ambulatory patient services;
- emergency services;
- hospitalizations;
- mental health and substance use disorder ser vices, including behavioral health;
- prescription drugs;
- rehabilitative services and devices;
- laboratory services.
Janice Simmons is a senior editor and Washington, DC, correspondent for HealthLeaders Media Online. She can be reached at jsimmons@healthleadersmedia.com.