The last few weeks have been a whirlwind for health reform! In late June, the Supreme Court handed down a decisive victory by upholding the Affordable Care Act (ACA) almost in its entirety. Just a few weeks later, leaders in the House of Representatives continued their two-years-plus assault on the law, voting -- for the 33rd time -- to repeal the signature reform. Not to mention the dozens of federal lawsuits against the law.
With all these competing arguments, it's easy to get confused about what exactly President Obama's signature health reform law means and who it benefits.
What we should not be confused about, however, is the real impact the law is already having, particularly for women and women of color.
The ACA puts an end to a number of practices that insurance companies have used to unfairly single out women, including charging women higher premiums on account of their gender and labeling domestic violence and other health conditions that disproportionately affect women as "pre-existing conditions," effectively preventing these women from accessing coverage.
And that's just the beginning.
On August 1 -- the date the Affordable Care Act's preventive health care services provisions kick in -- women across the nation will have another set of reasons to rejoice. Women will finally have access to essential services without expensive co-payments and deductibles that for too long have stood in the way of women accessing the care they need. Health insurance plans will cover protective and preventive services like screening and counseling for domestic violence. And women will also have access to coverage for all FDA-approved contraception, counseling and screening for HIV and other sexually transmitted diseases, and testing for gestational diabetes and HPV.
Think of this set of services as women getting real value for the health insurance premiums they already pay for, and getting coverage that meets their distinct needs. While in the past, some insurance plans may have covered some of these essential services, the ACA now requires that nearly all insurance plans provide this broad coverage.
Perhaps most importantly, women will have access to these essential services without expensive co-payments and deductibles. The economics of health care particularly affects women, who tend to have lower incomes than men and rely more on employer-sponsored coverage. Just recently, the Commonwealth Fund found that many women have gone without recommended care, including not seeing a doctor when they are sick. Only half of women surveyed felt "confident that they would be able to afford the health care they need if they became seriously ill." This means more women with health problems and worse health outcomes.
These disparities are often times magnified for women of color. Domestic violence affects between 41 to 61 percent of Asian American women. This can lead to a number of adverse health outcomes, including unintended pregnancies, sexually transmitted diseases and other chronic health conditions. Requiring insurance coverage and screening for domestic violence is critical if we are to combat this epidemic and improve the health of minority women and their families.
Another example is the high rate of cervical cancer in some Asian ethnic subgroups, in part due to difficulties in accessing preventive care. In the birth control context, Asian American women tend to have lower utilization rates of oral contraceptives and in fact are less likely than non-Hispanic white women to have ever used birth control. These numbers are important not only because contraception is necessary to prevent unintended pregnancy, but because contraception plays an important role in managing chronic diseases -- where pregnancy can place a woman's health at risk.
By making such preventive and protective services routine, the ACA will take a giant leap forward in eliminating racial, ethnic and gender disparities in health outcomes and health care.
As a health advocate, it's easy to be excited about the many investments and reforms the ACA offers. And as a health advocate for women, I'm particularly thankful that starting this week, our nation will take a giant step towards eliminating health discrimination and disparities for women.
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