The Affordable Care Act (ACA) includes key provisions of paramount importance to women, including an end to charging women more than men for the same coverage; no-cost coverage for birth control and other preventive health services like cervical cancer screenings and breastfeeding support; and guaranteed coverage of maternity care.
Yesterday, the Obama Administration asked state insurance commissioners to allow consumers currently covered by individual health plans that fall short of the ACA’s standards to keep those plans for one more year. Insurance companies offering noncompliant plans must send letters to consumers identifying which ACA benefits are not available in their current plan and explaining that alternative coverage options are available in the health insurance marketplace.
Looking ahead, it’s important to remember that yesterday’s announcement does not affect consumers’ ability to choose comprehensive health plans in the marketplace and apply for financial assistance to help make coverage more affordable. If you want a comprehensive marketplace plan, you can still choose one. In the marketplace, you’re still guaranteed coverage, even if you have a pre-existing condition, and all plans offered in the marketplace are still guaranteed to cover essential women’s health services. As HealthCare.gov and the consumer experience continue to improve, women and families will find better, more affordable coverage in the new marketplaces that carries more benefits than plans currently available in the individual market.
Indeed, informed consumers have a powerful incentive to buy health plans through the marketplace because they offer guaranteed benefits, consumer protections, and financial assistance that are not available elsewhere. The ACA requires all plans sold in the marketplaces to cover ten categories of essential health care services, including ambulatory care, maternity and newborn care, prescriptions, preventive and wellness services, mental health services, rehabilitation services and more. For women and families, access to comprehensive coverage will have a tremendous impact on their health and wellbeing.
The ACA also ends years of discriminatory practices against women in health insurance pricing. All plans offered in the marketplace are prohibited from charging women more than men for the same health coverage. If you're currently covered by a plan purchased in the individual market, there's a good chance you're paying more for it if you're a woman than if you're a man.
Additionally, plans sold in the marketplaces have strict out-of-pocket limits to ensure that you don’t end up spending a fortune out-of-pocket if you get sick. Prior to the ACA, consumers with skimpy coverage would often find themselves no better off than their uninsured counterparts if they were diagnosed with cancer or another serious condition.
The National Partnership has concerns about the implementation of the Obama administration’s proposal to allow people to keep substandard coverage for another year. The administration’s proposed transitional policy must be implemented in a way that does not harm women and families or hamper their ability to make informed decisions about their health coverage. Along with our allies, we will monitor the situation closely to help ensure consumers in the individual market receive the information they need to make the best choice for them and their families.
Consumers should not give up on the new marketplace. Once HealthCare.gov is functioning well, close examination of the options available inside and outside the marketplace will show that affordable, comprehensive coverage in the marketplaces is the right choice for many families’ health and financial security.