-It is a sad reality that women, over half of the population of the United States, are regularly denied health insurance because of pregnancy or preexisting conditions such as breast cancer.
On top of that, women have historically been subject to higher health insurance premiums than men simply because of their gender. Fortunately, the Affordable Care Act aims to fix these problems and more for women.
The Affordable Care Act requires all health insurance plans to include coverage for medical services in 10 categories of so-called essential health benefits. These categories include everything from emergency coverage to prescription drugs. Of particular interest to women among the essential benefits are coverage for maternity care, newborn care and pediatric care.
Preventive medical care is also an essential benefit category that helps women in particular. In addition to annual physicals, every plan must cover such female-specific services as annual well-woman visits and routine mammograms with zero out-of-pocket costs at the doctor’s office.
What you have to know about the essential health benefits categories is that they are just that: categories, meaning that the specific medical services in each section are not written in stone.
The federal government left it to each state to figure out what exact medical services will be covered as essential benefits within its borders, rather than impose a national standard. For example, things that might be considered part of maternity coverage in one state may not be such in another, and vice versa.
Each state determined its essential health benefits by choosing an existing health insurance plan that then became the benchmark for essential benefits. Every plan sold under the Affordable Care Act has to match the medical services established by the state’s benchmark plan. To find out what your state’s benchmark plan looks like check out the Kaiser Family Foundation’s list here.
Historically women in America would often be charged higher premiums than men because of a number of factors, not the least of which is a potential pregnancy. Under the Affordable Care Act women cannot be charged higher premiums than men when buying insurance as an individual. This is sure to provide a welcome relief to many freelance and self-employed women looking for health insurance.
The fact that people can’t be denied health insurance because of a preexisting condition is great news for everyone and for some women in particular. Women with breast cancer, or a history of it, can rest easy knowing they won’t be denied an insurance plan because of their condition.
Insurers have in the past also been quite fond of denying coverage to pregnant women because of their pregnancy. While you might not think “preexisting condition” is the best term for pregnancy, its classification as such by the Affordable Care Act means that pregnant women don’t have to worry about being rejected from getting insurance.
Whatever your overall opinion of the Affordable Care Act, there is no denying that it is going to help women receive fairer treatment from health insurance companies.
Premiums will be more affordable and a number of costly services will be easier to pay for. We can hope that as the years go on, the health care situation for women will only continue to improve.