As an all-male working group of 13 Republican senators works to give the nation’s health care system a conservative makeover, women’s advocates are using Mother’s Day to illustrate how replacing the Affordable Care Act could disproportionately hurt more than half the country’s adult population.
Under the GOP plan that narrowly passed the House of Representatives, funding for Medicaid, which pays for about half of U.S. births, would be slashed. Women with individual insurance in some states could lose guaranteed coverage of maternity and newborn care. States could also terminate mandatory coverage of mental health services, like counseling for depression, which hits women at a higher rate than men.
Even coverage for prescription drugs, which women also utilize more than men, could lose its designation as an essential health benefit under the House bill.
On Thursday, at a gathering on Capitol Hill, female congressional Democrats used the upcoming Mother’s Day holiday to accuse President Donald Trump and other Republicans of pushing legislation that hurts women in order to pander to their conservative base.
Once again, women are left to wonder and worry about what will happen to their health care and their families’ health care.
Sen. Patty Murray, D-Wash.
“Once again, women’s health is being used as a political football, and moms and families are being put at risk,” said Sen. Patty Murray, D-Wash., the ranking member of the Senate Committee on Health, Education, Labor and Pensions. “And once again, women are left to wonder and worry about what will happen to their health care and their families’ health care.”
The bill would also ban Planned Parenthood from receiving federal Medicaid funds for a year and bar all health plans sold on the individual insurance marketplace from covering abortions. It would prohibit the use of federal tax credits to buy non-marketplace insurance that covers abortion.
But restricting abortion and its funding doesn’t mean the legislation is “anti-woman,” said Gail Wilensky, a senior fellow at Project HOPE who ran Medicaid and Medicare from 1990 to 1992 under President George H.W. Bush.
Wilensky, a registered Republican, said liberal critics of GOP health policy mistakenly assumed that one must be “pro-abortion” to be “pro-woman.”
“Women are also disproportionately small business owners. So (political) parties that are in favor of small entrepreneurs and promoting small businesses are also ‘pro-women,’ ” Wilensky said of Republicans. “It just depends on how you define what it takes to be pro-female. It is not only about, or necessarily about, where you are on abortion.”
The GOP proposal would cause 24 million to lose health coverage by 2026, according to the Congressional Budget Office. The real-world consequences of life without health coverage were reported this week in new research that found uninsured women with breast cancer are more than twice as likely to get late-stage diagnoses and 60 percent more likely to die from the disease than women with private insurance.
Among the uninsured, black, single and younger women had the lowest rates of survival five years after being diagnosed, according to researchers at Washington University in St. Louis.
Because they are generally paid less and have higher poverty rates than men, women are at a disadvantage medically because they have greater health needs, particularly in their reproductive years.
The findings underscore the importance of health insurance gains and new consumer protections for women under the Affordable Care Act. The law requires insurers to cover mammograms as a preventative service – with no patient cost-sharing or co-payments.
The study also helps amplify growing concerns about how women will fare under health policies being crafted by Trump and congressional Republicans.
“The study brings home the kind of fear that we hear from our members every day,” said Kristin Rowe-Finkbeiner, Seattle-based co-founder and executive director of MomsRising.org, a national advocacy organization for women and families. “Last night alone, we had nearly 500 stories (emailed to our website) from women who are worried about losing health care coverage for themselves and for their kids.”
Along with cutting federal subsidies for marketplace coverage, the Republican House bill would let states weaken or eliminate certain coverage guarantees in the Affordable Care Act. Senate Republicans have just begun work on their own legislation.
Because they are generally paid less and have higher poverty rates than men, women are at a disadvantage medically because they have greater health needs, particularly in their reproductive years, said Janel George, director of federal reproductive rights and health at the National Women’s Law Center.
Researchers from the law center and The Commonwealth Fund, a private health research foundation, found that nearly 40 percent of women have chronic conditions that require regular treatment, compared with 30 percent of men.
Women’s groups have been united in their opposition to Republican proposals to replace the Affordable Care Act.
Because the GOP House proposal would let states waive Obamacare requirements that insurers cover maternity and newborn care, many fear a return to the days before the health law, when only 12 percent of individual plans covered maternity care, George said.
Many saw it as a slight from the GOP when Senate Majority Leader Mitch McConnell appointed no female senators to the 13-member team that will draft the upper chamber’s legislation to replace Obamacare.
“This is an instance where we’re absolutely seeing the old saying ‘If you don’t have a seat at the table, you’re on the menu,’ ” Rowe-Finkbeiner said.
The House bill also allows states to let individual insurers charge higher rates for people with pre-existing conditions, a practice outlawed by the Affordable Care Act.
Before the Affordable Care Act became law, women typically faced higher rates for individual coverage than men based on their gender. Others could be denied coverage for pre-existing conditions if they were pregnant, had had previous cesarean births or had health problems stemming from domestic abuse or sexual assault.
It helps explain why one year before Obamacare insurance marketplaces began operating, 26 percent of women postponed or did without medical treatment, compared with 20 percent of men, the National Women’s Law Center reported. Twenty-eight percent had difficulty paying for health care, compared with 19 percent of men, and 22 percent of women didn’t fill prescriptions because of the cost, compared with 12 percent of men.
The Affordable Care Act made it illegal for insurers to charge higher rates based on gender. But policies being considered by Republicans would jeopardize that.
Wilensky said her larger concern with the GOP’s House proposal was the nearly $900 billion cut in Medicaid funding that would finance a number of tax cuts that disproportionately benefited the wealthy. She called them “bad for the Medicaid” and “just wrong.”
“That to me is a huge concern,” Wilensky said. “Way, way, way more than the (potential loss of) essential health benefits and the (return of) pre-existing conditions.”