Why threatening Obamacare disproportionately threatens women's health

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Judge Reed O’Connor, who was appointed by George W. Bush and currently serves in the U.S. District Court in Fort Worth, Texas, struck down the entire Affordable Care Act (ACA) on December 14. He did so on the grounds that it is unconstitutional to compel citizens to purchase health insurance.

President Obama enacted the Affordable Care Act, which is also popularly known as “Obamacare,” in 2010. The act, which required 30 million uninsured Americans to either obtain health insurance or pay a fee, sought to provide millions of uninsured Americans with an affordable option for health care. The act did this by creating health insurance marketplaces that offered lower premiums designed to be more accessible to less financially secure Americans. In 2012, the Affordable Care Act was challenged by the National Federation of Independent Business, but the Supreme Court upheld the act as constitutional because it falls within Congress’ taxing prerogative.  

Before the ACA, health insurance costs were increasing at a faster rates than were incomes for middle- and low-income families. In 2003, for example, the average annual premium was about 15 percent of the median household income for non-seniors, according to The Washington Post. A large part of this high price was due to premiums put in place for people with pre-existing conditions. These conditions include not only pre-existing health issues, but gender, race, disability, age, and place of birth. This means that if the ACA is overturned, women and other marginalized people will no longer have equal access to health care.

Should the ACA be overturned, however, it would be the latest development in a long history of discrimination against women in the health care industry. Due to a system of “gender rating,” women are often charged up to 181 percent of what a man pays for insurance because women are associated with higher health risks due to their reproductive organs. While many insurance companies effectively replace women’s status as “person” with that of “mother,” the ACA determines that the capacity to have a child should not devalue a person in any way compared to those who can’t.

This discrimination is just one part of a much bigger problem regarding women’s health in the United States. On December 19, the Commonwealth Fund released a report examining the status of women’s health and health care in the United States in comparison to 10 other nations, including Australia, Canada, France, and the United Kingdom, among others. This report ranked the United States last among all these nations, meaning that women in the U.S. are the unhealthiest even though the average American pays more for insurance than citizens of other developed nations. According to the report, over 25 percent of American women spend at least $2,000 out of pocket a year for medical expenses, compared to the under 5 percent of women in most of the other nations studied. Because of these expenses, over 33 percent of American women don’t purchase the medical care they need.

It’s also worth noting that American women’s health is clearly suffering. The United States has one of the worst rates of maternal mortality in the developed world. There are more obese women than men in the United States, and women constitute 68 percent of patients with osteoporosis and 78 percent of patients with autoimmune diseases. Women suffer from depression at twice the rate of men and now commit suicide at rates comparable to men.

It seems it’s time for a movement to call out the pain and degradation women experience in the health care system in the same way the #MeToo movement has called out the normalized pain and degradation women experience in the workplace. As Lili Loofbourow wrote in The Week regarding #MeToo, “Women are enculturated to be uncomfortable most of the time. And to ignore their discomfort. This is so baked into our society I feel like we forget it’s there. To steal from David Foster Wallace, this is the water we swim in.”

The notion that women are expected to be in pain is applicable not only to sexual harassment, but to all life experiences. Loofbourow specifically mentions how this pain is normalized in health care, citing the fact that “PubMed has almost five times as many clinical trials on male sexual pleasure as it has on female sexual pain.” In fact, gynecologist Dr. Jessica Vaught recently pointed out in a U.S. News health report that a lot of women “don’t realize that painful cramping, pain during sex and heavy or long-lasting periods aren’t normal.” A lot of women don’t realize that these symptoms are dangerous, and likewise, a lot of doctors don’t take these sorts of symptoms seriously. For instance, as Loofbourow mentions in her piece, it takes a woman an average of nine years to be diagnosed with endometriosis after experiencing vaginal pain.

The Affordable Care Act has helped 8 million women receive health insurance since 2010, reducing the number of uninsured women by nearly half. In other words, the Affordable Care Act has helped 8 million women have their health taken seriously. The new attempt to repeal the ACA, which is being pushed by 20 plaintiff states led by Texas, will undermine the 133 million Americans with pre-existing conditions, especially women. Now more than ever, therefore, it’s time for American women to question the pain and suffering we’ve normalized, and advocate for our entitlement to better health care.

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More articles by Tag: Discrimination, Equality, Law, Medicaid, Medicare, Reproductive rights



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