Thursday marked the seven-year anniversary of the Affordable Care Act, the landmark law that expanded healthcare access to millions of Americans. To honor the occasion, former President Barack Obama released a lengthy letter defending the strides ACA has made, especially when it comes to women's health. But that progress is now threatened by President Donald Trump's American Health Care Act, the GOP's weak replacement bill that the U.S. House will vote on Friday afternoon. With so much at stake, Barack Obama's statement on the ACA highlights its problematic differences with Trump's plan.
The Affordable Care Act covered a lot of ground in the way of firsts for healthcare. The bill allowed children to stay on their parents' plans until age 26 and prohibited carriers from denying insurance based on pre-existing conditions. But the ACA achieved an incredible amount when it came to advancing women's health. Not only did the law make essential services like maternity and newborn care mandatory benefits, it also eliminated discriminatory gender rating practices in insurance premiums. Before the Affordable Care Act, cisgender women shelled out up to 50 percent more for a health insurance plan than cisgender men, according to the Denver Post. Under Obama's healthcare law, though, carriers could no longer rate policies based on sex.
The former beloved president reminded everyone of these points in his statement. Here's a snippet, according to Glamour:
Thanks to this law, the days when women could be charged more than men and Americans with pre-existing conditions could be denied coverage altogether are relics of the past. Seniors have bigger discounts on their prescription drugs. Young people can stay on their parents’ plans until they turn 26 years old. And Americans who already had insurance received an upgrade as well—from free preventive care, like mammograms and vaccines, to improvements in the quality of care in hospitals that has averted nearly 100,000 deaths so far.
Trump's American Health Care Act would flush these achievements down the toilet. According to the Hill, gender rating would come roaring back with a vengeance if the AHCA were to pass. Women would once again be forced to pay astronomical premiums just for being assigned female at birth while men enjoyed lower premiums if the ACA were successfully repealed. And this would mean many more women would go without health insurance because it would no longer be affordable to them.
Not only that, the American Health Care Act—a.k.a. Trumpcare—would also get rid of the essential health benefits instituted under the ACA. Pregnancy, maternity, and newborn care would no longer be mandatory services that insurance companies and Medicaid would have to cover for new parents, according to NBC News. Preventive services like mammograms, birth control, and vaccines would also be on the chopping block. And to add insult to injury, House Republicans introduced the "manager's amendment" that would force new mothers enrolled in Medicaid to find work within 60 days, otherwise their benefits would be threatened, according to Fortune.
Sixty days, by the way, is not enough time to recover from giving birth.
Although the Affordable Care Act barred gender rating in health insurance, the practice is still allowed in the auto, long-term care, and life insurance industries. Cis women tend pay higher premiums for long-term care plans, while cis men shell out more for auto and life insurance. Insurance carriers also determine rates based on race and genetic predisposition, according to the Cornell Law Review; if you're black or have a family history of disease, you can expect to pay higher premiums for life or disability insurance.
Why do insurance companies rate cis women and cis men differently? Two reasons: One, carriers claim each gender presents a different set of liabilities; for example, the Insurance Institute for Highway Safety has found that men get into more car accidents, so insurers charge them higher premiums to guard against risk. Women, on the other hand, tend to live longer than men, research has shown; according to the American Association for Long-Term Care Insurance, this means LTC carriers are more likely to pay out claims filed by cis women. Vis-à-vis, women pay higher LTC premiums to cover their share.
Second, most states don't prohibit gender rating. Insurance companies are allowed to discriminate when it comes to premiums because lawmakers aren't stopping it. The ACA provided a framework on how the country could eliminate sex discrimination in the insurance industry by leveling the playing field between women and men. Trumpcare would undo that progress, which would signal to insurance carriers that gender rating is not only OK, but the government encourages it. And that's not only awful for women, that's also bad for men.
But, hey, all's fair in insurance and money, amiright?