Health care access is on the line, again, as Congressional Republicans push forward with a last-ditch effort to repeal the Affordable Care Act. The latest legislation – known as the Graham-Cassidy bill – was introduced at the last minute in an effort to pass it out of the Senate before the September 30th procedural deadline, when only a simple majority of 50 votes is needed to pass legislation.
While the proposal has been framed as a compromise, it is nothing more than an even more dangerous and harmful version of previously rejected bills to repeal and replace the Affordable Care Act (ACA). And while the Graham-Cassidy bill would be disastrous for Ohio, it would be particularly devastating to women and their families. Here’s how the bill would impact women specifically:
The Graham-Cassidy bill would leave less people insured, while increasing the cost of coverage. It’s estimated that a total of 32 million people would lose coverage by 2026, including over 800,000 Ohioans. Next year alone, nearly 15 million people in the U.S. would have their coverage cut. And the costs of insurance would be raised by 20 percent or more each year for the exact same insurance.
The even more drastic structural and funding changes to the Medicaid program under this bill would have far greater consequences than earlier bills, and women and children would be hit hardest. Medicaid has been a lifeline to women, who make up two-thirds of Medicaid recipients. And with 30 percent of Black women and 24 percent of Hispanic women enrolled in Medicaid, compared to 14 percent of white women, women of color would be disproportionately impacted by the funding cuts to Medicaid services and coverage. Women’s reproductive health would especially suffer under this changes, as Medicaid covers nearly two-thirds of all births in the country and 75 percent of family planning services. States would also be permitted to impose work requirements starting as early as October 1, 2017, which would eliminate Medicaid coverage for non-disabled, non-elderly, non-pregnant adults that do not meet these punitive requirements. Research on other safety net programs with work requirements has found that they are overall ineffective in helping people gain long-term employment and are often based on false stereotypes. What’s worse, these new restrictions would penalize a women who does not meet the work requirement a mere 60 days after the end of her pregnancy.
The elimination of Medicaid Expansion, would also roll back advances made in coverage gains to states like Ohio that have chosen to expand Medicaid under the ACA. In fact, 723,000 low-income individuals have now been able to access coverage through Medicaid Expansion, but their coverage is now at risk. Analyses have found that between 2013 and 2015, rates of uninsured reproductive age women have been cut in half in states that have Medicaid expansion, so the elimination of the program would be especially harmful to Ohio women.
And by blocking federal funds from Medicaid reimbursements from going to Planned Parenthood, hundreds of thousands of Ohio women – particularly low-income women, women of color, and women in rural areas – would be denied access to preventative and primary care, such as HIV testing, cancer screenings, and birth control. For many low-income and rurally located women, Planned Parenthood clinics are the only available option to receive healthcare services.
The Graham-Cassidy bill would also undermine protections that have made coverage affordable for people with pre-existing conditions, sometimes including pregnancy, mental health treatment, and pregnancy. Under the ACA, as many as 65 million U.S. women with pre-existing conditions no longer experience discrimination when enrolling in coverage.
The bill would also jeopardize the Essential Health Benefits (EHB) standard provided under the ACA, which has made groundbreaking advancements for women in healthcare such as maternity coverage and pediatric care. Insurance companies would now be allowed to charge women extra to include EBH in their coverage, forcing pregnant women to pay as much as $17,000 or more for coverage under this bill.
Women would lose access to birth control and other critical preventative services. Under the ACA, women are guaranteed coverage for preventative services such as birth control, cervical cancer screenings, and annual well-woman visits without co-pays, deductibles, or other out-of-pocket costs, which has improved women’s health and in turn helped women achieve better economic security. Under the Graham-Cassidy bill, states would be permitted to eliminate this benefit from insurance plans. This would hit young and low-income women especially hard as paying out-of-pocket for birth control – costing as much as $600 per year for oral contraception and more than $1,100 without insurance for an IUD – is simply unaffordable for many.
The advances for women of color in accessing care and reducing health disparities would be greatly at risk under this latest proposal. Women of color are more likely to be uninsured, yet they experience disproportionally higher rates of diabetes, obesity, and reproductive healthcare disparities. With increased coverage rates under the ACA, women of color have greater access to services to treat these healthcare needs.
The bill would also end subsidies that have made healthcare affordable for many low- and moderate-income women and families. The Graham-Cassidy proposal plans to completely gut the ACA provision that provided tax credits and subsidies to assist in buying affordable coverage, eliminating all tax credits for health insurance funded by block grants. Affordable coverage would now be out of reach for many women and families.
Further impeding women’s access to health care and economic security are the restrictions to abortion access imposed by this bill. The Graham-Cassidy bill would ban abortion coverage for any insurance plans through the ACA exchanges, forcing any private insurance plans to almost immediately drop coverage of abortion from any plans currently offering it. Additionally, starting in 2018, women will no longer be able to use tax credits to pay for a plan that includes abortion coverage, with the exception in cases of rape, incest, or life of the woman.
This last-ditch effort to repeal the Affordable Care Act is a direct attack on women’s health, well-being, and economic security. Raise your voice and help us protect affordable health care access!
Senator Rob Portman is a crucial vote on this bill. Contact him and urge him to publicly reject the Cassidy-Graham proposal, which dismantles critical protections for women and families. Ask him to move away from repeal and come together in a bi-partisan effort to improve health care, not destroy it.
Email Senator Portman your message using this email contact form.
Call his office using the contact information below: