AAUW Issues: Health Care

The American Association of University Women believes that everyone is entitled to high-quality, affordable, and accessible health care.

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Download Printable Quick Facts on Health Care

Health care security is intrinsically tied to economic security, and this relationship is particularly true for women who earn less than men on average and are therefore less able to afford insurance or care. Despite massive spending, health care outcomes in the United States continued to lag behind many other western nations.

Broken, Expensive, and Outdated

There was a definite and compelling need for health care reform:

  • In 2009, 43.4 million Americans were uninsured — nearly 15 percent of the nation — and a 60 percent increase since 2003.
  • Middle-class families were the fastest growing segment of the uninsured, reflecting the cost increases that have far exceeded wage increases in recent years.

Health Care Reform is a Women’s Issue

While all Americans benefit from meaningful health care reform, the issue has particular resonance for woman. According to the Department of Labor, women make approximately 80 percent of all family health care decisions, and about 60 percent of women report that they assume primary responsibility for decisions regarding family health insurance plans.

When it comes to their own health care, women face unique challenges. Women earn around 77 cents for every dollar men earn, but women also utilize more health care services than men. As a result, women face a high level of health care insecurity. These factors add up to too many women and their families with unpaid medical bills and long-lasting debt problems as a result of health problems.

Affordable Care Act

The health care reform law enacted in 2010 will have significant impacts on women’s health.

  • Ending the practice of “gender rating.” Gender rating is the process by which insurance companies charge men and women different premiums for individually-purchased health care plans. Under the ACA, gender rating will be banned for plans offered in both the individual and small group markets (defined as organizations employing 100 or fewer persons) beginning in 2014. Unfortunately, insurance companies may continue to pursue this discriminatory practice under plans offered in the large group market.
  • Requiring coverage of women’s reproductive health services. The ACA requires insurance companies providing abortion coverage to collect two separate payments from each enrollee: one for the portion of the premium covering abortion care, and one for the remainder of the premium itself.  This awkward compromise could endanger women’s health care access.
  • Ensuring access to and coverage of preventive services and care. The law contains a specific women’s health provision under which insurance companies will be required to cover additional preventive health care and screenings for women – such as contraceptives, mammograms, gestational diabetes screening, and pap smears – at no additional premium or co-payment cost

Medicaid and Medicare

Medicaid is the national health insurance program for low-income Americans. It is a partnership jointly funded by the federal government and states. More than 41 million women are enrolled in Medicaid, which accounts for nearly 70 percent of the program’s total adult beneficiaries. One out of every 10 women in the United States receives her health care through this program.

A major part of the 2010 health care law was an expansion of Medicaid eligibility to people under age 65 with income of up to 133 percent of the poverty line. In its 2012 decision on the constitutionality of the law, the Supreme Court ruled that the federal government cannot make states’ current Medicaid funds contingent on participating in Medicaid expansion. Many states have cited the modest increase in state funding needed for Medicaid expansion as grounds to reject it.

Medicare is the national health insurance program for seniors, though it also covers younger people with certain conditions. In 2010–2011, Medicare covered approximately 25 million women, comprising more than 55 percent of all program beneficiaries. Women live longer and on average have greater need for the services Medicare covers. For instance, more than 60 percent of enrollees in the prescription drug program are women.

At their core, Medicaid and Medicare represent two crucial elements of the social safety net. They, along with the federal-state State Children’s Health Insurance Program that has covered millions of previously uninsured children since its inception in 1997, are bedrocks of our health care system. Americans, especially women, rely heavily on the protections they offer and the services they provide. As implementation of health care reform begins, these programs must continue to be maintained and strengthened.