June 20, 2012 — If the Supreme Court strikes down all or key parts of the federal health reform law (PL 111-148), it would have significant repercussions for women's access to health services and affordable coverage, Kaiser Health News reports.
In addition to the much-debated provision that eliminates copayments and deductibles for contraceptive coverage, the overhaul includes several changes aimed at eliminating discrimination in the health insurance marketplace. Beginning in 2014, insurers will be prohibited from charging women higher premiums than men. The law also bars insurers from denying coverage for pre-existing conditions, including pregnancy, a previous caesarean-section birth, or a history of sexual or intimate partner violence.
According to a report by the National Women's Law Center, without these protections, nearly one-third of major insurance plans charge women ages 25 to 40 at least 30% more than men for the same coverage. Although 14 states have already prohibited charging women more for the same coverage, the overhaul will make the protections consistent across the country. Judy Waxman, vice president for health and reproductive rights at NWLC, said a ruling against the health reform law would allow insurers to continue charging "whatever they want in the individual market, as they do now."
In addition, the Medicaid expansion under the health reform law is expected to extend health insurance to 10 million more women in 2014, according to NWLC. Furthermore, health plans offered through state-based exchanges will be required to include maternity coverage and preventive services, including mammograms, to women without cost-sharing.
Kirsten Sloan, a vice president of the National Partnership for Women & Families, said these provisions -- as well as pilot programs to control health care cost by changing provider reimbursement procedures -- make the law "the most important advance for women's health in decades." She added that the law "makes it easier for women and families to buy insurance, keep insurance and afford that insurance" (Appleby, Kaiser Health News, 6/19).
KHN Interviews CHA President Keehan
In related news, Kaiser Health News recently interviewed Carol Keehan, president of the Catholic Health Association, which on Friday announced that it would not support the Obama administration's plan to accommodate religiously affiliated employers who object to the federal contraceptive coverage rules. CHA represents more than 600 hospitals and 1,400 long-term care and other health providers across the country.
In the interview, Keehan maintained that CHA has consistently supported the health reform law, especially its preventive services provisions. The law's improvements in coverage represent "a huge step forward for women who are low-income" and for the "economics of health care, because you catch a problem early, often times you save a life," she said.
When asked why CHA announced its opposition to the accommodation after Keehan initially suggested she was satisfied with it, she said, "I wouldn't say as much as we withdrew support. What we said very clearly was that it is just too cumbersome." She said that many Catholic employers found that insurance companies said the cost of contraceptive services would still be passed on to the employers. Keehan said this is "the reality of the marketplace" and "not the fault of the White House" (Carey, Kaiser Health News, 6/19).