During the last week of 2017’s Women’s History Month, we are looking at women’s access to healthcare.
Just this past week, the Patient Protection and Affordable Care Act of 2010 survived a political battle that would have repealed the landmark legislation, stripping health insurance away from 24 million Americans, according to the Congressional Budget Office.
The Affordable Care Act (ACA), for the moment, shall remain the law of the land. However, while it emerged unscathed from the new administration’s recent efforts to dismantle it, the ACA suffered a huge setback after a 2012 Supreme Court decision changed a critical part of the healthcare reform—the expansion of Medicaid coverage to low-income, uninsured adults—from a federal requirement to a state option. This meant the part of the ACA that was supposed to help those who are most in need almost certainly would not because of Mississippi’s political opposition to the ACA.
Unsurprisingly, Mississippi has remained stubbornly opposed to the expansion of Medicaid coverage to low-income, uninsured adults, and tens of thousands of women fall into the health insurance coverage gap—meaning they earn too much to qualify for Medicaid under current rules, yet too little to receive tax credits to purchase private insurance through the ACA Marketplace, which is what makes it affordable to low- and moderate income people.
While Mississippi’s refusal to expand Medicaid harms women in Mississippi, the ACA made sweeping policy changes that benefit women who have health coverage. The ACA doesn’t allow women to be charged more for health insurance, it prohibits denial of health coverage for pre-existing conditions like pregnancy or chronic illness, it allows women to choose from any OB-GYN or pediatrician in their health plan network without a referral, and it requires plans to offer free preventive care like mammograms, well-woman visits and contraception. https://www.healthcare.gov/blog/here-s-how-the-health-insurance-marketplace-helps-women/
Women’s access to healthcare is so important because good health means a single mom can have a productive day at work and be present for her children when they need her. Good health means a single mom has the energy and focus to care for her children, to maintain a home, to work and to take on all of life’s curve balls. When bad health is persistent and when moms go uncared for, stress, anxiety, illness and exhaustion can have a ripple effect that touches every aspect of a family’s wellbeing.
While the ACA improved health insurance policy for women, it also led to huge gains in health insurance coverage.
During the most recent ACA enrollment period, 108,672 Mississippians selected a plan, of which 63,000 were women. Nearly half (46%) of plan selections during the 2016 open enrollment period were new enrollees. This shows that the ACA is still reaching primarily women and getting new people to sign up for coverage. https://aspe.hhs.gov/health-insurance-marketplaces-2016-open-enrollment-period-final-enrollment-report
Census data shows the difference the ACA started to make in 2013 and the difference it continues to make:
By and large, women between the ages of 18 and 64 represent most of uninsured women, but this number is trending downward as the ACA continues to take full effect:
But women who need help most are still left in a coverage gap. Mississippi’s refusal to expand Medicaid to uninsured, low-income adults leaves a total of 103,000 uninsured Mississippians languishing in the health care coverage gap, and 50,400 of those in Mississippi’s coverage gap are women. http://kff.org/uninsured/issue-brief/the-coverage-gap-uninsured-poor-adults-in-states-that-do-not-expand-medicaid/
Medicaid expansion is so critical for Mississippi’s women. Working women in Mississippi are clustered in low-wage jobs that don’t offer health coverage. While women are half the state’s workforce, they are two-thirds of the state’s minimum wage earners. A mom with two kids earning minimum wage and working full-time still earns a poverty level wage. But even a poverty level wage is too much to qualify under the state’s current Medicaid rules, yet too little to qualify for tax credits to purchase private insurance through the ACA marketplace.
While the ACA is changing the healthcare coverage landscape for women, many continue to lack any kind of health coverage and Mississippi’s refusal to expand Medicaid and its prevalence of low-wage work are to blame.
Mississippi must expand Medicaid coverage so more women can get the health coverage they need to support families so all Mississippians can thrive.
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