Women in the Crosshairs of ACA Repeal

06/22/2015 12:06 am ET | Updated Jun 21, 2016
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There's an old saying "be careful what you wish for, because you just might get it." That applies in spades to Republicans who have voted over 50 times to overturn Obamacare. It was a fool's errand, because even if they had been successful, President Obama would have vetoed any such bill.

But now the GOP's fondest wish may be granted by the Supreme Court, set to rule by the end of the month in King v. Burwell, a case that experts say could gut the Affordable Care Act if the plaintiffs prevail. That has Republican lawmakers up for election next year in a bind. A favorable opinion from the Supremes would declare the federal insurance exchange illegal, and rule that only state exchanges may offer insurance subsidies. It would effectively wipe out coverage for the estimated 3 ½ million people living in the 37 states that have refused to establish exchanges on their own.

Republicans are already floating stopgap schemes such as temporary subsidies or block grants to avoid utter chaos, but they're hardly without significant strings. For example, the mandates that most Americans obtain insurance and most employers provide it would be repealed by a bill by Senator Ron Johnson (R-WI). If they're willing to do away with that, there's nothing stopping them from doing away at other provisions, especially those that have to do with women's health.

Women will be hit hardest if Obamacare goes away. Here's how:

Preventive services like mammograms and birth control are provided without deductibles or co-pays under Obamacare. If the system is dismantled, get ready to pay up or lose these benefits altogether. Speaking of paying, before Obamacare, insurance companies could and did charge women more for the same coverage men got for less money -- a practice called "gender rating."2014-04-01-yourvoicesmallest3.JPG It's more profitable, so you can guess the direction that one will go.

Under the Affordable Care Act women can't be denied coverage for pre-existing conditions. Without the law, insurance companies could revert to their old ways and declare such things as a past Caesarean, having acne as a teenager, or being the victim of domestic violence pre-existing conditions.

In pre-Obamacare days, some insurance companies refused to provide maternity coverage at any cost. Now they're mandated to offer maternity coverage -- but that would surely be wiped out too.

In short, if Republicans get their way, the government would no longer have any control over what insurance companies can and can't do. The much maligned "big government bureaucracy" would be forced to hand complete control back to the for-profit insurance bureaucracy.

The GOP now fears if the Supreme Court grants its wish, the backlash could be bad for their election prospects. Let's hope so, because it will be worse for women's health.

Listen to the 2 minute radio commentary here: