Women's health has been under attack to an unprecedented degree for the past year -- until Thursday. In upholding the Affordable Care Act (ACA), the Roberts Court threw a hand grenade at those who are waging an unrelenting "war on women" using access to health care as the main battering ram. The decision may not stop the war, but it surely feels good to win such a decisive battle.
While preserving the law will benefit virtually all Americans, women will gain the most. Big wins:
Birth control will be covered as a preventative measure, without co-pays. Yes, the U.S. Conference of Catholic Bishops will continue their assault on this basic service, but they're now less likely to prevail. Other very important but less visible preventative services like pap smears, mammograms, and domestic violence screenings will also be covered without co-pays.
The law prohibits denial of coverage for pre-existing conditions. Insurance companies have reached far and wide on this one, refusing coverage for such "pre-existing conditions" as having had a caesarean section or being a victim of sexual assault or domestic battering.
Maternity coverage will now be mandated. A widespread myth about health coverage has been that maternity coverage is generally available -- it just costs more. A corollary myth is that women's coverage costs more because of maternity coverage. Not so. According to the National Women's Law Center, almost 90 percent of policies exclude maternity coverage altogether. They don't provide it at any cost.
Flat-out sex discrimination in coverage and pricing will no longer be allowed. The ACA prohibits the widespread practice of charging women higher premiums than they charge men of the same age for the same coverage. This known as "gender rating," and the usual excuse is that women are more likely to get check-ups. The law makes any kind of sex discrimination in plans getting federal support a no-no, including policies in the new insurance exchanges.
Nursing mothers who work for large employers will also benefit, as they will now be able to have breaks and a private place to express breast milk.
The one place women may lose out is in expanded Medicaid coverage, since the decision said the Feds can't threaten to take away existing Medicaid funding (which primarily benefits women and chlldren) if states refuse to expand their Medicaid programs.
Still, the upholding ACA is a huge victory for women. In a continuing war with no end in sight, it's a welcome one.