by Joyce Frieden
An estimated 30 million women will be helped by the new health reform law over the next 10 years, according to a report from The Commonwealth Fund.
“While women are just as likely as men to be uninsured, they are more likely [than men] to have trouble buying coverage on the individual market,” Karen Davis, PhD, president of the fund, said in a teleconference announcing the report’s release. “This report provides good news to all women who will be more likely to get care they need while providing [more relief from] medical bills.”
Nearly 17 million U.S. women — 18% — were uninsured in 2008, noted Sara Collins, PhD, vice-president of the Commonwealth Fund.
Collins cited a report released in October 2009 by the National Women’s Law Center that women seeking health insurance policies on the individual market were charged as much as 84% more than men for similar policies. And few individual policies for women come with maternity benefits, she added.
The biggest assist for women from the healthcare reform law will come via expansion of the Medicaid program. Beginning in 2014, Medicaid will cover those with incomes up to 133% of the Federal Poverty Level ($14,404 for a single adult or $29,327 for a family of four).
“Because nearly half of women who are uninsured live in households with incomes under 133% of [the Federal Poverty Level], this provision will potentially have the greatest effect on increasing health insurance among women,” the Commonwealth Fund report notes. “The eligibility expansion has the potential to provide health coverage to up to 8.2 million uninsured women ages 19 to 64 in that income range.”
In addition, an estimated 7 million uninsured women with low and moderate incomes will gain subsidized coverage through the new health insurance exchanges currently being set up to start in 2014, according to the report.
Also in that year, new benefits standards will take effect for plans sold not only in health exchanges, but in the individual and small-group markets as well.
Insurers will then have to cover the cost of a pregnancy; only 13% of health plans now do so.
Other elements of the new law that will benefit women are taking effect much earlier, including these provisions that are effective this year:
* Issuing checks for $250 to Medicare beneficiaries who fall into the “doughnut hole” — the gap in Medicare’s drug benefit during which patients must pay all drug costs themselves. About 16% of beneficiaries enter the doughnut hole each year, with women more likely to enter it than men, according to Collins.
* Instituting temporary high-risk insurance pools. Enrollment in the insurance plans provided by these pools, some of which are sponsored by the federal government, began this month in 38 states and the District of Columbia; the remaining 12 states will begin enrolling patients in August. Approximately 100,000 to 200,000 women will benefit from the pools, Collins said.
* Banning lifetime coverage limits. About 102 million people have lifetime limits on how much insurers will cover and approximately 20,000 people exceed their limits each year, so the provision would benefit about 10,000 women.
* Restricting insurers’ use of annual benefit limits. About 18 million people have such limits in their policies; 3,500 people exceed the limits each year, including an estimated 1,750 women.
* Banning carriers from rescinding coverage when patients become ill. Rescissions are most common in the individual market where about 5.5 million women are covered, Collins said. About 10,700 people lose their coverage each year as a result, including an estimated 5,000 women.
* Allowing young adults to remain on or join parents’ plans. An estimated 1 million uninsured adult children will gain coverage under this provision. The report provided no estimate for the number of women that would benefit.
* Requiring insurers to cover recommended preventive services, such as mammograms for women over 40, cervical cancer screening, and counseling and testing for the BRCA-1 breast cancer gene.
Joyce Frieden is a MedPage Today News Editor.