Download Report

FACT SHEET
Why the Affordable Care Act Matters for
Women: Improving Health Care for
Women of Color
SEPTEMBER 2014
Women of color have much to gain under the Affordable
Care Act (ACA). By making private insurance more
affordable, expanding Medicaid, creating partnerships
with communities of color, and supporting important
care-delivery and system reforms, the ACA is helping to
improve access to more affordable health coverage for
all women and decrease health disparities that
disproportionately harm women of color.
Expanding and Improving Medicaid
Medicaid provides essential health care for women of
color, who represent one of the largest populations of
Medicaid beneficiaries. Women are more than 70
percent of the Medicaid population and women of color
disproportionately qualify for and receive Medicaid
benefits, as compared to white women.
1
The ACA allows states to expand their Medicaid
programs to cover millions more women and families.
Why the ACA Matters for Women
Fact Sheets
Summary of Key Provisions (pdf)
Requirement to Have Health Insurance (pdf)
Health Insurance Marketplaces (pdf)
Affordability and Choice in the Insurance Marketplace
(pdf)
Expanding Access to Health Insurance (pdf)
 Premium and Cost Sharing Assistance (pdf)
Improving Health Care for Older Women (pdf)
Improving Health Care for Women of Color (pdf)
Improving Health Coverage for Lower-Income
Women (pdf)
Better Care for Pregnant Women and Mothers (pdf)
Coverage for Lower and Moderate Income Pregnant
Women (pdf)
Expanding Medicaid Family Planning Services (pdf)
Preserving Access to Women’s Health Clinics (pdf)
Comprehensive Sex Education for Teens (pdf)
Restrictions on Abortion Coverage (pdf)
Health IT: The Foundation for Health Reform (pdf)
Also available at www.nationalpartnership.org
 Under the ACA, states are permitted to expand Medicaid eligibility to individuals
with incomes up to 138 percent of the Federal Poverty Level (FPL). With this change,
millions more women, many of whom are women of color, are now eligible for
Medicaid’s comprehensive health coverage with strong out-of-pocket cost (costsharing) protections. Unfortunately, not all states have chosen to expand their
Medicaid programs, leaving millions of otherwise eligible women and families without
affordable coverage options.
2
3
 Within Medicaid, coordinated care and family-centered care models are now better
equipped to address the needs of low-income women of color. For example, a woman
with HIV who receives Medicaid benefits could access combined housing, childcare,
and nutrition support with treatment or prevention services.
4
1875 Connecticut Avenue, NW | Suite 650 | Washington, DC 20009
202.986.2600 | www.NationalPartnership.org
Making Coverage More Affordable
When shopping in a health insurance marketplace, women of color can compare health
insurance plans and find the one that best meets their health care needs and their
budgets. Health insurance marketplaces are one-stop-shops that enable apples-to-apples
comparisons of health plans based on price, benefits, quality and other features that are
important to women and families. Unlike in the past, information about qualified health
plans sold in state marketplaces must be in plain language that makes sense to consumers.
All insurance plans offered in state marketplaces must be designated as qualified health
plans (QHPs) — which means that they, among other requirements, are guaranteed to
include a set of minimum essential health benefits, comply with limits on cost-sharing
(including limits on out-of-pocket costs) for these benefits, and meet all applicable privatemarket reforms specified in the ACA.
Premium and cost-sharing subsidies are now available to help make coverage more
affordable. For women and families who don’t qualify for Medicaid, but who still struggle to
make payments on their health plans, premium subsidies and cost-sharing assistance may
be available to help make coverage more affordable. Women and families earning between
100 and 400 percent of the Federal Poverty Level (up to $94,200 for a family of four or
$45,960 for an individual) will be eligible for subsidies that will help reduce the cost of their
monthly health-insurance premiums.
5
Women can no longer be charged more than men for health insurance. Before the ACA,
insurance companies could charge women higher premiums simply because they were
women — a practice known as “gender rating.” Under the ACA, gender rating has been
banned, meaning women will pay the same amount as men for the same health insurance
plan. This represents an important victory for women of color, who tend to have lower
incomes, as compared not only to men but to white women as well.
6
The ACA protects access to coverage for people with pre-existing conditions and/or
chronic illnesses. Under the ACA, insurance companies may not discriminate against
people with pre-existing conditions, nor can they take away coverage from people who get
sick while enrolled in health plans. Insurance companies can no longer turn women away
because of certain experiences, such as pregnancy or being a victim of domestic violence,
that have previously been categorized as “pre-existing conditions.” This provision is of
particular importance to groups that face higher rates of chronic illness. For example,
Asian and Pacific Islander women experience higher rates of breast, cervical, liver and
stomach cancers. Thanks to the ACA, women with chronic illnesses no longer face annual
or lifetime caps on essential health benefits, enabling them to receive the care they need
when they need it.
7
8
9
10
11
12
Working with Communities of Color
The ACA takes steps to improve health outcomes not just for individuals of color, but for
entire communities.
NATIONAL PARTNERSHIP FOR WOMEN & FAMILIES | FACT SHEET | IMPROVING HEALTH CARE FOR WOMEN OF COLOR
2
Through Fiscal Year 2015, community health centers (CHCs) will receive $11 billion in
increased funding. CHCs disproportionately serve people of color; more than one-third of
the patients they serve are Latino and one-quarter are African American. The ACA’s
funding for CHCs is going to projects such as adding services in medically underserved
areas and creating patient-centered medical homes that coordinate preventive and primary
care to help reduce health disparities affecting people of color.
13
14
15
The ACA improves access to culturally appropriate care. Language or literacy barriers —
particularly for recent immigrants — can make it more difficult for women of color to
receive the care they need. Under the ACA, insurers must increase access to health care
information (including providing language services at no cost) for people with low literacy
levels or limited English proficiency. Health care providers will receive additional training
on providing culturally competent care. Employers may take advantage of incentives built
in to the ACA to hire more people of color in the health care sector.
16
17
18
Decreasing Health Disparities
Women of color have unique health issues and often suffer from higher rates of certain
illnesses and diseases, including diabetes, heart disease, obesity, some forms of cancer, and
hypertension. The ACA attempts to reduce these health disparities.
19
Increased access to preventive care can help stop health disparities before they happen.
Greater access to preventive care for communities of color could decrease health disparities.
For example, African American women have higher mortality rates from breast cancer than
white women. Receiving earlier and more preventive care could allow African American
women to be diagnosed and begin receiving treatment sooner. Under the ACA, many
preventive services — including mammograms — are covered with no cost-sharing.
Furthermore, because African American and Latina women account for 80 percent of
women living with HIV, women of color will benefit from no-copay screening and
counseling for HIV and other sexually transmitted diseases.
20
21
22
No-cost family planning care gives women the opportunity to decide for themselves if
and when to have children. Timely access to contraceptive services can improve maternal
and child health by providing women with essential services to plan their pregnancies.
With no copay for FDA-approved contraceptives, insured women are now able to access
many forms of contraception without cost-sharing.
Better tracking of health disparities will help improve health outcomes. With the
demographics of the country rapidly changing, data collection systems that measure health
disparities need to keep pace. The ACA orders the U.S. Department of Health and Human
Services (HHS) to define data collection categories by race, ethnicity, sex, disability and
primary languages. With this change and others, HHS will better be able to determine
what health disparities exist across populations and to decide how to allocate resources to
improve access and health outcomes.
1
Reid, D. (2013, July 23). Using the Affordable Care Act and other opportunities to address maternal mortality. Retrieved from http://www.healthlaw.org/issues/health-care-
reform/Maternal-mortality#.U5HGfXJdXTo
NATIONAL PARTNERSHIP FOR WOMEN & FAMILIES | FACT SHEET | IMPROVING HEALTH CARE FOR WOMEN OF COLOR
3
2
In 2014, Medicaid eligibility will be expanded to individuals and families with household family income at or below 133% FPL. However, a standard 5% income disregard used
when determining eligibility effectively raises the limit to 138% of FPL.
3
Kaiser Family Foundation. (2012, January). Medicaid’s role for women across the lifespan: Current issues and the impact of the Affordable Care Act. Retrieved from
http://www.kff.org/womenshealth/upload/7213-03.pdf
4
The 30 for 30 Campaign. (2012, July). Affordable Care Act priorities and opportunities for addressing the critical health care needs of women living with and at risk for HIV.
Retrieved from http://www.taepusa.org/Portals/0/30-for-30-ACA-Exec-Summary.pdf
5
Calculations by the National Partnership based on data from the U.S. Department of Health and Human Services. Retrieved at http://aspe.hhs.gov/poverty/14poverty.cfm
6
U.S. Bureau of Labor Statistics. (2013, February). Women in the labor force: A databook. Retrieved from http://www.bls.gov/cps/wlf-databook-2012.pdf
7
The White House. (n.d.). Affordable Care Act: The new health care law at two years. Retrieved from http://www.whitehouse.gov/sites/default/files/uploads/careact.pdf
8
The White House. (n.d.). The Affordable Care Act helps women. Retrieved from http://www.whitehouse.gov/sites/default/files/docs/the_aca_helps_women.pdf
9
Futures Without Violence. (2012, June). How the Affordable Care Act (ACA) affects victims of domestic, sexual, and dating violence. Retrieved from
http://www.futureswithoutviolence.org/userfiles/file/HealthCare/ACA%20and%20DV%20final.pdf
10
National Asian Pacific American Women’s Forum. (n.d.). Affordable health care under attack – What’s at stake? Retrieved from http://napawf.org/wp-
content/uploads/2011/04/WhatisatStake.pdf
11
National Asian Pacific American Women’s Forum. (n.d.). Affordable health care under attack – What’s at stake? Retrieved from http://napawf.org/wp-
content/uploads/2011/04/WhatisatStake.pdf
12
The White House. (n.d.). Affordable Care Act: The new health care law at two years. Retrieved from http://www.whitehouse.gov/sites/default/files/uploads/careact.pdf
13
Ridley-Kerr, A. & Wilf, R. (2012, May 2). The top 10 benefits women of color are seeing under Obamacare. Retrieved from
http://www.americanprogress.org/issues/race/news/2012/05/02/11570/the-top-10-benefits-women-of-color-are-seeing-under-obamacare/
14
Countdown to Coverage. (n.d.). The Affordable Care Act is helping women of color get the health care we need. Retrieved from
http://www.raisingwomensvoices.net/storage/fact-sheets/CtC_Checklist_WoC.pdf
15
Health Resources and Services Administration, U.S. Department of Health and Human Services. (n.d.). The Affordable Care Act and health centers. Retrieved from
http://bphc.hrsa.gov/about/healthcenterfactsheet.pdf
16
Kaiser Commission on Medicaid and the Uninsured, Kaiser Family Foundation. (2012, August). Overview of health coverage for individuals with limited English proficiency.
Retrieved from http://kaiserfamilyfoundation.files.wordpress.com/2013/01/8343.pdf
17
Ridley-Kerr, A. & Wilf, R. (2012, May 2). The top 10 benefits women of color are seeing under Obamacare. Retrieved from
http://www.americanprogress.org/issues/race/news/2012/05/02/11570/the-top-10-benefits-women-of-color-are-seeing-under-obamacare/
18
Andrulis, D., Jahnke, L., Siddiqui, N., & Cooper, M. (2013, March). Report no. 1: Implementing cultural and linguistic requirements in health insurance exchanges. Retrieved from
http://www.texashealthinstitute.org/uploads/1/3/5/3/13535548/implementing_cultural_and_linguistic_requirements_in_health_insurance_exchanges_march_2013.pdf
19
Ridley-Kerr, A. & Wilf, R. (2012, May 2). The top 10 benefits women of color are seeing under Obamacare. Retrieved from
http://www.americanprogress.org/issues/race/news/2012/05/02/11570/the-top-10-benefits-women-of-color-are-seeing-under-obamacare/
20
Health Resources and Services Administration, U.S. Department of Health and Human Services. (n.d.). Women’s preventive services guidelines. Retrieved from
http://www.hrsa.gov/womensguidelines/
21
The 30 for 30 Campaign. (2012, July). Affordable Care Act priorities and opportunities for addressing the critical health care needs of women living with and at risk for HIV.
Retrieved from http://www.taepusa.org/Portals/0/30-for-30-ACA-Exec-Summary.pdf
22
Health Resources and Services Administration, U.S. Department of Health and Human Services. (n.d.). Women’s preventive services guidelines. Retrieved from
http://www.hrsa.gov/womensguidelines/
The National Partnership for Women & Families is a nonprofit, nonpartisan advocacy group dedicated to promoting fairness in the workplace, access to quality health care and
policies that help women and men meet the dual demands of work and family. More information is available at www.NationalPartnership.org.
© 2014 National Partnership for Women & Families. All rights reserved.
NATIONAL PARTNERSHIP FOR WOMEN & FAMILIES | FACT SHEET | IMPROVING HEALTH CARE FOR WOMEN OF COLOR
4