Remember when the Republican health care bill was defeated earlier this spring without a single vote being cast? Well, I have bad news: The American Health Care Act has surfaced once again after significant revision, but the plan will still hurt women more than men — which means it's time to dust off your arguments explaining how the AHCA is anti-woman. Of course, it's not the first time women have gotten the short end of the health care stick, and it's not likely to be the last. However, the amended version of the AHCA appears to be even more draconian than the original, thanks in large part to efforts to appease the ultra-conservative Freedom Caucus. UPDATE: The AHCA has officially passed the House with a majority of votes, 217 to 213.
There have been two major changes to the AHCA since House Speaker Paul Ryan yanked the bill from the floor in March. First, there's the MacArthur amendment, which allows states to apply for waivers weakening protections for those with pre-existing conditions and redefining what constitutes "essential benefits." Needless to say, this is likely to result in a huge hike in cost for Americans who are already ill. To mitigate this potential rise in premiums, Rep. Fred Upton proposed a last-minute amendment adding $8 billion to pay medical costs for those who would lose coverage. However, given that this money is to be paid out over the course of five years and cover millions of potentially unwell people, the Upton Amendment has been criticized as a paltry effort.
With the AHCA being put to vote on Thursday, it's important to have an idea of how the bill could affect the lives of everyday Americans — particularly some of our most vulnerable groups. If you find yourself struggling with what to say to people who don't understand how the bill is particularly harmful for women, here are seven arguments to explain it:
1Redefining Essential Benefits Will Leave Women-Centered Issues Behind
Under the Affordable Care Act, all health insurance plans are required to cover 10 essential benefits, such as hospitalization and prescription drug coverage. Some of these areas directly benefited women, but the AHCA could let states toss these benefits by the wayside.
For example, before the ACA, insurance companies weren't required to cover maternity care, so most individual plans didn't include it. After the ACA was passed, though, pregnancy and maternity care were required on all policies, saving women (and people of all genders who are able to get pregnant) thousands of dollars.
However, the MacArthur amendment allows states to apply for waivers redefining those benefits. In 2013, the National Women's Law Center reported that only 12 percent of individual insurance plans covered maternity care; it's not unreasonable to assume some states will no longer consider this coverage essential.
2Sexual Assault Could Be Considered A Pre-Existing Condition
Before the ACA was passed, it wasn't illegal to consider the result of sexual assault a pre-existing condition. Seriously. Survivors could be denied coverage for developing PTSD or contracting a sexually-transmitted disease. As New York Magazine points out, other issues affecting women that could be considered "pre-existing conditions" included cesarean sections, postpartum depression, and the toll taken by domestic violence. Thanks to the ACA, though, insurance companies can't deny women coverage in those cases.
This brings us back to the MacArthur amendment. By allowing states to waive bans on turning away people with pre-existing conditions, we could go back to the days when sexual assault could be grounds for higher premiums.
It should go without saying that no, women are not the only people who can suffer from sexual assault, intimate partner violence, and other forms of sexual violence. Women are, however, disproportionately affected by it, according to RAINN, which means that women are at particular risk for having their health care coverage denied due to a "pre-existing condition" like assault.
3Gutting Medicaid Disproportionately Affects Women
According to the Health Resources and Services Administration, women make up the vast majority of those covered under Medicaid, the government program covering low-income and disabled individuals. Furthermore, according to the Kaiser Family Foundation, 13.5 million women enrolled in the program in 2011 were in their potentially-childbearing years.
The GOP's health care bill slashes the expansion programs put in place by the ACA, and it caps how much states would be reimbursed for the number of enrolled residents. Furthermore, in 2020, the program would no longer have to offer the 10 basic benefits. Given how many women rely on Medicaid for insurance, this is bad news.
4Special Education Funding Could Suffer
Like it or not, women still bear the brunt of child care in the United States, and that means issues affecting kids tend to affect the women raising them. Unfortunately, the AHCA isn't looking good for children with special needs. By cutting Medicaid funding so drastically, the GOP health care plan is expected to force schools to slash their funding for special education in turn, leaving a generation of children with special needs under-served, and their caretakers will have to pick up the slack.
5Mental Health Coverage
As the Kaiser Family Foundation points out, many rely on Medicaid for behavioral health services, like substance abuse or mental health programs. I already pointed out that Medicaid cuts will disproportionately affect women in general, but gender is a huge factor in mental illness. According to the World Health Organization, women are more likely than men to experience the more common mental disorders: anxiety, depression, and somatic complains.
Unfortunately, many mental health services may not survive the AHCA's cuts to Medicaid funding. The Kaiser Foundation notes that because coverage for enrollees with behavioral health conditions tends to cost quite a bit, states may restrict their eligibility. "These changes could lead to decreases in access to behavioral health services, increases in societal costs resulting from untreated behavioral health conditions, and greater uncompensated care costs for providers," the foundation wrote on its website.
6The Bill Threatens Family Planning
Despite polls indicating that the majority of voters oppose cutting funding for Planned Parenthood, the AHCA includes provisions banning federal funding from organizations providing abortions. (Of course, the Hyde Amendment already bans government money from being spent on abortions.) Between this ban and the recent law allowing states to deny Title X funding for Planned Parenthood, many low-income women may have to turn elsewhere for their reproductive health services. Unfortunately, that's far easier said than done, especially in rural areas.
7Women Don't Support The Bill
Finally, and perhaps most tellingly, a Quinnipiac poll found that just 13 percent of women supported the AHCA the first time around, compared to 22 percent of men. When there's that stark a drop in support among women, there's clearly something wrong with the way the GOP's bill treats women's health. If it truly benefited women, don't you think we would support it wholeheartedly?