In honor of International Women’s Day, last week the Protect Our Care coalition celebrated Protect Women’s Care week, outlining the achievements made in women’s care under the Affordable Care Act and highlighting the ongoing threats from the Trump Administration and its Republican allies in Congress to roll back this progress. Here are the biggest gains made under the ACA, the worst attacks from Trump, and the grassroots action standing up to the sabotage of women’s care:

WOMEN’S HEALTH HAS IMPROVED TREMENDOUSLY UNDER THE ACA

As study after study shows, the Affordable Care Act has increased women’s access to health care and improved women’s health outcomes. New data show the improved health and economic outcomes women are experiencing now that the Affordable Care Act has covered more women than ever before, improved breast cancer and maternity care, guaranteed copay-free access to birth control, and stopped insurance companies from charging women more. These are some of the gains in women’s health care that President Trump and his Republican allies want to reverse through repeal and sabotage:

Historic Gains in Women’s Coverage

ACA Brought Women’s Uninsured Rate To All-Time Low. “By 2016, the number of working-age women…lacking health insurance had fallen by almost half since 2010, from 19 million to 11 million.” [Commonwealth Fund, 8/10/17]

After Medicaid Expansion, More Women Of Reproductive Age Have Health Coverage. “ACA Medicaid expansions decreased uninsurance among women of reproductive age with incomes below 100% FPL by 13.2 percentage points.” [Women’s Health Issues Journal, 2/28/2018]

With Pre-Existing Discrimination Ban, More Women With Cancer Histories Now Have Coverage

Women With Gynecologic Cancer More Likely To Be Insured Following ACA. “Between 2011 and 2014…uninsured rates decreased by 50% for those diagnosed with uterine and ovarian cancer…and by 25% in cervical cancer.[Gynecologic Oncology, June 2017]

Better Access to Contraception

Under ACA, Women Saved $1.4 Billion On Birth Control Pills Alone In 2013. Prior to the ACA, co-pays as low as $6 deterred women from obtaining the health care that they needed, and some women chose to forgo birth control because of cost. But data on prescription drug use in 2013, after the birth control benefit went into effect, indicate a nearly five percent uptick in filled birth control pill prescriptionsThe birth control benefit saved women $1.4 billion on birth control pills alone in 2013.[National Women’s Law Center, 5/3/17]

Improved Maternity Care & Newborn Outcomes

Before The ACA, 75% Of Individual Market Plans Did Not Include Maternity Care. “Three in four health plans in the non-group insurance market did not cover delivery and inpatient maternity care in 2013, before the [ACA] essential health benefits requirement took effect.” [Kaiser Family Foundation, 6/14/17]

ACA Improved The Health Of Women And Their Babies. “The dependent coverage provision of the Affordable Care Act (ACA) that allowed young adults to stay on their parents’ insurance until they were 26 was associated with increased use of prenatal care, increased private insurance payment for births, and a modest reduction in preterm births.” [JAMA, 2/13/18]

Infant Mortality Decreased In States That Expanded Medicaid. “New data shows that infant mortality rates decreased in states that expanded Medicaid.” [Newsweek, 1/31/18]

Better Breast Cancer Care & Prevention

Medicaid Expansion Improves The Quality Of Breast Cancer Care. “[The study] found a connection between Medicaid expansion and improved quality of breast cancer care…The number of screening mammograms covered by Medicaid increased from 5.6 percent before expansion to 14.7 percent afterward.” [Daily Kos, 2/21/18]

Following ACA’s Lower Costs, Mammogram Screening Rates Increase.After the [ACA] eliminated cost sharing for screening mammograms, their rate of use rose six percentage points among older woman for whom such screenings were recommended.” [Brown University, 1/17/18]

TRUMP’S 11 WORST ATTACKS ON WOMEN

From restricting women’s access to family planning services to allowing insurance companies to change women more than men for health insurance, the Trump Administration has tirelessly attacked American women’s health. Here are the top 11 ways Trump is setting American women’s health back:

  1. Letting Insurance Companies Charge Women More Than Men: Prior to the Affordable Care Act, 92 percent of plans in the market charged women up to 1.5 times as much as they charged men, in a practice known as gender rating. The Trump Administration is taking us back to the days when women could be charged more. Under the Trump Administration’s recent “short-term” rule, insurers would be able to skirt the ACA’s gender rating provision that banned insurers from charging different rates for men and women.
  2. Letting Insurance Companies Charge More For “Pre-Existing Conditions” Like Pregnancy & Being A Woman: The Affordable Care Act prevents insurers from denying, dropping, or charging more because of a pre-existing condition like cancer, or even, having a C-section. But, the Trump Administration’s new “short-term” plan rule allows insurers to deny coverage because someone has a pre-existing condition, and will raise costs and jeopardize coverage for nearly 30 million women who have a pre-existing condition.
  3. Making Maternity Care More Expensive: Before the Affordable Care Act, 75 percent of non-group plans did not cover delivery and inpatient care for maternity care. The ACA The Trump Administration and its Republican allies continue to advocate for policies, such as short-term and association health plans, that are not required to cover “essential health benefits,” and can thus force women to pay the nearly $20,000 it costs to give birth out of pocket.
  4. Defunding Planned Parenthood:  In January 2018, the Trump Administration announced it would roll back Obama Administration guidance that warned states not to carve Planned Parenthood out of their Medicaid providers, signaling its willingness to place even higher barriers in the way of women’s access to health care.
  5. Making Women Pay More For Birth Control: The Trump Administration’s proposed rule to let any employer opt out of offering health insurance that covers birth control rolls back the ACA’s guarantee that women may access copay-free contraception.
  6. Cutting Medicaid: President Trump’s calls to cut Medicaid put women’s lives and jobs at risk. The Trump Administration’s recent budget slashed Medicaid funding by more than $1 trillion over the next decade. These cuts will jeopardize the care of the nearly 13 million women of reproductive age who rely on Medicaid, including 31 percent of African-American women and 27 percent of Hispanic women in this age group. Moreover, 22.8 percent of women in the workforce are employed in the health industry, meaning their jobs may be at risk as well.
  7. Making New Moms Choose Between Working Or Losing Coverage: Almost two-thirds of those who would lose Medicaid coverage as a result of work requirements are women, and disproportionately women of color. This is in part because women are more likely to be caregivers for sick family members and children. Under these rules, a new mom would have 60 days to find health coverage after giving birth or risk their family’s health coverage.
  8. Stacking Federal Courts With Anti-Choice Judges: The next generation of American women will face a growing threat posed by an increasingly anti-choice federal judiciary. Twelve of Trump’s judicial nominees were appointed to circuit courts during his first year – more than any other first-year president in American history.
  9. Reversing Progress Against Breast Cancer: Republicans’ repeated attempts to undermine the Affordable Care Act’s essential health benefits threaten landmark progress in women’s preventive health. New research finds that the ACA requirement that plans (including Medicare) must cover recommended preventive care without a copay led to a significant increase in the number of women receiving mammography screenings.
  10. Cutting Funding For Teen Pregnancy Prevention Programs: The administration slashed two years off of five-year grants dedicated to teen pregnancy prevention research, which have already been promised to organizations across the country.
  11. Allowing States To Defund Clinics That Offer Abortion Care: Trump signed a bill allowing states to withhold Title X family planning funds from health care providers that offer abortion-related care. Thirteen states used to withhold the Title X money from abortion providers before the Obama administration blocked them. (Because of the Hyde Amendment, federal funds can’t be used to pay for abortions, so the Title X money went to other health services at those clinics.) The legislation allows them to withhold the funds again and redirect them to providers that don’t offer abortion care.

MEDICAID CUTS DISPROPORTIONATELY HURT WOMEN

Republicans are waging a war on Medicaid, and it’s hurting American women the most. Proposed cuts to Medicaid disproportionately impact women, who make up over two-thirds of adults with Medicaid coverage.

MEDICAID CUTS TAKE WOMEN’S ACCESS TO COVERAGE AND CARE

Millions of Women Rely on Medicaid for Health Care. More than 16.3 million women in the U.S. are enrolled in Medicaid. [Kaiser Family Foundation, 2017]

Medicaid Helps Pay For Long-Term Care, Mostly For Elderly Women. 69 percent of the 9 million people covered by both Medicare and Medicaid are women. [Center on Budget and Policy Priorities, 5/11/17]

MEDICAID CUTS RESTRICT REPRODUCTIVE & MATERNITY CARE FOR WOMEN

Medicaid Is The Largest Single Payer Of Pregnancy-Related Services. Medicaid financed 48 percent of all U.S. births in 2010. [Kaiser Family Foundation, 6/22/17]

Medicaid Is The Largest Financier Of Publicly Funded Family Planning Services. Medicaid accounts for 75 percent of all public expenditures on family planning services. [Kaiser Family Foundation, 6/22/17]

Women With Medicaid Are More Likely Than Those With Private Insurance To Have Discussed Sexual Health With Providers.  “In 2013, women with Medicaid coverage were more likely than women with private insurance to report they had spoken with a provider about sexual history, HIV, and intimate partner violence.” [Center on Budget and Policy Priorities, 5/11/17]

The Administration’s Attacks On Medicaid Jeopardize Women’s Access To Cancer Screening, Maternity Care, And Birth Control. “Fewer people on Medicaid means fewer women accessing health and reproductive services that do things like cover cancer screenings, improve access to birth control, and make sure moms and babies have health care throughout a pregnancy and in the months after a baby is born.” [Vox, 1/31/18]

NEW MEDICAID REQUIREMENTS MAKE IT HARDER FOR WOMEN TO GET COVERED

Nearly 2 In 3 People Who Would Lose Medicaid Coverage Because Of Work Requirements Are Women. “Almost two-thirds (62 percent) of those who could lose Medicaid coverage due to work requirements are women.” [Planned Parenthood, 1/11/18]

Work Requirements Punish Women Caring For Loved Ones. “It is already challenging for women with health conditions or who are caring for loved ones to work, and Medicaid work requirements will only make this harder…This means, for example, that a woman not covered by the FMLA who is enrolled in Medicaid could lose her job if she takes time away from work to get cancer treatment, and then lose her health coverage due to Medicaid work requirements. Losing Medicaid could be a death sentence for this woman.” [National Partnership for Women and Families, 2/28/18]

Medicaid Work Requirements Pose A Unique Burden On Women Of Color. “Due to racism and other systemic barriers that have contributed to income inequality, women of color are disproportionately likely to be insured through Medicaid: 31 percent of Black women and 27 percent of Hispanic women aged 15–44 were enrolled in Medicaid in 2015, compared with 16 percent of white women. Medicaid pays for nearly half of all U.S. births and is the largest payer of publicly funded family planning services.” [National Partnership for Women and Families, 2/28/18]

MEDICAID CUTS TAKE WOMEN’S JOBS

Medicaid Creates Jobs In The Health Industry, Which Employs Nearly 23% Of All Women In The American Workforce. “Women’s high participation in the health care industry, which employs more than 22.8% of all women in the workforce,4 means that Medicaid disproportionately creates jobs for women. This is especially true because Medicaid covers services that other payors typically do not cover and are more likely to be delivered by women, like long-term services and supports.” [National Women’s Law Center, June 2017]

Threats To Medicaid Are Threats To Women’s Livelihoods. “Women would be uniquely impacted by these changes, not only because women disproportionately are enrolled in Medicaid, but also because women occupy jobs whose funding relies on Medicaid. Such changes would threaten the livelihood of millions of women and families across the country.” [National Women’s Law Center, June 2017]

EXPERTS: CUTTING MEDICAID HURTS WOMEN

Black Women’s Health Imperative: Medicaid Work Requirements Threaten Health Care For Low-Income Black Women.  “There is a clear disconnect between this false and discriminatory narrative and the actual reality that Black women in poverty face every day. The truth is that over 70% of Black women on Medicaid already work hard everyday to support their families but, due to systemic inequalities, they earn less and face unfair barriers to health care. These jobs simply do not pay enough for women to afford health insurance.” [Black Women’s Health Imperative, 1/11/18]

Planned Parenthood: Women Lose The Most Under Trump’s Latest Attack On Medicaid. “With about one in five women of reproductive age relying on Medicaid for their health care and women accounting for approximately 62 percent of Medicaid enrollees who could lose coverage because of this enrollment restriction, this change will especially hurt women, particularly those who already face the highest barriers to care.” [Planned Parenthood, 1/11/18]

National Women’s Law Center: Medicaid Work Requirements Would Reduce Access To Care For Women Without Increasing Employment. “Many of the arguments underlying work requirements are designed to stoke racial resentment about entitlement programs, particularly playing upon harmful stereotypes of women of color…work requirements would endanger individuals’ health and economic security in many cases, with a particularly harsh impact on women.” [National Women’s Law Center, April 2017]

SEN. MURRAY JOINS LEADING WOMEN’S GROUP TO STAND UP FOR WOMEN’S CARE

But despite the rampant attacks coming from the Administration and Republicans in Congress, advocates have refused to back down. Last Thursday, on International Women’s Day, Sen. Patty Murray joined Protect Our Care, the National Partnership for Women & Families, the Black Women’s Health Imperative, and Planned Parenthood Federation of America to demand an end to the Trump administration’s attacks on women’s health and health care. As Kate Martin of the National Partnership wrote:

“‘Over and over again, President Trump and Vice President Pence have made clear they intend to interfere every way they can with a woman’s freedom to make health care decisions that are right for her,’ said Senator Murray. ‘People won’t stop resisting. Women who speak up for their rights are not going away. … We will continue to reject – loud and clear – the partisan, ideological Trump-Pence agenda that hurts women and families.’

The attacks include advancing policies that let insurance companies charge more for “pre-existing conditions” like pregnancy – or just being a woman. The Affordable Care Act (ACA) prevents insurers from denying, dropping or charging more because of a pre-existing condition like cancer, or even having a C-section. It also bans insurers from charging women higher rates than men (before the ACA, 92 percent of plans charged women up to 1.5 times as much as they charged men). But the Trump administration’s recent proposed “short-term” plan rule would allow insurance companies to sell more policies that skirt these protections, ultimately punishing women and all people with pre-existing conditions and destabilizing the health insurance marketplace. It’s just the latest in the administration’s ongoing attempt to sabotage the ACA…

These attacks are as unpopular as they are relentless, and they threaten the health, well-being and economic security of tens of millions of women and families. You can help fight back: Call your members of Congress and urge them to prioritize our health and health care, instead of a partisan political agenda. We all need to speak up now – and #pressforprogress on protecting our health care – before it’s too late!”

WOMEN (AND MEN) ACROSS THE COUNTRY STAND UP FOR WOMEN’S HEALTH

And in states across the country, women held rallies in honor of Protect Women’s Care Week and made their voices heard.

All in all, Protect Women’s Care Week was a smashing success – women, and men, across the country stood up together made their voices loud and clear in support of women’s health. Enough is enough – it’s time for the Trump Administration to end their war on women’s health care.