How the Senate health care bill will affect women

ByMaryalice Parks and Saisha Talwar
June 23, 2017, 9:50 PM

— -- Senate Republican leaders are planning to move fast now that legislation was revealed on Thursday to dismantle the Affordable Care Act (ACA) -- otherwise known as ObamaCare -- and drastically change the current healthcare landscape.

Senate Majority Leader Mitch McConnell has said he ambitiously hopes to pass the bill before the July 4 recess -- but in order to do so, Republicans would need to bypass the traditional committee process and forgo public hearings.

While advocacy groups argue the effects of the bill are complex and demand debate, many health care providers argue that women's health in particular could be greatly impacted if the bill were to pass.

Here are some of the ways the legislation could potentially impact women in the U.S.:

Medicaid

One program the bill contains significant cuts to is Medicaid, which currently provides health insurance for 74 million Americans. Experts argue that the Medicaid cuts proposed in the bill could impact women in particular, because of the disproportionately large number of low income women and women of color who depend on the program -- particularly for maternity care.

“Women are much more likely to work in low wage jobs and be tip workers. All of those jobs are more likely to come without health insurance,” Andrea Flynn, an economic policy fellow at The Roosevelt Institute said.

The Kaiser Family Foundation, a nonprofit focusing on major healthcare issues, reported in 2015 that about half of all births in the U.S. were covered through Medicaid.

By cutting federal funding to states to cover Medicaid, states would then have to decide to either cover fewer people, provide less substantive coverage or find alternative ways to shoulder the costs.

Women of color could be particularly affected by such Medicaid cuts. According to the Center for Global Policy Solutions, one in four black women of reproductive age is on Medicaid.

The bill also states that in order to remain eligible for Medicaid, a woman must return to work 60 days after she gives birth. Judy Lubin, a project director for Allies for Reaching Community Health Equity at the Center for Global Policy Solutions, notes that as there is currently no work requirement to be on Medicaid, the inclusion of this clause underscores the “false narrative” that “people on Medicaid do not work.”

Maternity Care

Under the proposed bill, states would also be able seek a waiver from Obamacare rules and specifically permit insurance companies to offer plans that don’t meet the current baseline benchmarks for care and coverage.

For example, under current law, all plans must cover so-called essential health benefits, including maternity care, prescription drugs and ambulances. Under the Senate bill, states could do away with those regulations. Supporters argue that this makes the bill amenable to distinct, individual needs -- namely, those of men who do not want to pay for plans that cover maternity care. The ACA precisely aimed to prevent the uneven opportunity and cost disparity between men and women.

Flynn argued that when men buy into the same pool, costs equalize.

“We all pay into a system, and some of us use some benefits and some of us use some others," Flynn said. “Not a women's issue. It’s a family issue.”

Under the Senate bill, insurers cannot outright charge someone more for insurance based on gender, but experts worry that by changing plan requirements, the costs of individual plans that cover maternity care could skyrocket. According to Flynn and several other health care experts, the price of maternity care coverage for women buying their own insurance in individual marketplaces was prohibitively expensive prior to the ACA.

“What could happen under this bill is that some states will continue to mandate the coverage and others wouldn’t and you would see some plans that stop offering that coverage or charge much much more for it,” Flynn added.

The National Women’s Law Center reports that a hospital bill for childbirth care ranges on average from $30,000-$50,000.

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