How Repealing Obamacare Could Hurt Women

January 29th 2017

Danielle DeCourcey

If Congress repeals the Affordable Care Act without an adequate replacement, critics are saying that could spell big problems for women, and especially moms. 


"Insurance companies could reject applicants for a variety of reasons and we know they did it for women who were pregnant, received a cesarean section during labor, were raped, or survivors of sexual," Gretchen Borchelt, vice president for reproductive rights and health at the National Women’s Law Center, told ATTN:. "Some states have better protections than others," she said, "so it depends on what your state has done in the past, before the ACA."

The ACA, which rolled out in 2013, currently has protections against insurers denying coverage or making coverage more expensive in the individual market because of pre-existing conditions: health issues that are diagnosed before a new health insurance plan starts.


These conditions could make healthcare access more difficult for everyone, but advocates say they were particularly difficult obstacles for women's healthcare before the ACA. 

Here are three ways denying coverage or charging more due to pre-existing conditions can hurt mothers and other women: 

1. Maternity care and breastfeeding may not be covered. 


Before the ACA, pregnancy could be counted as a pre-existing condition in most states; Obamacare forbids that, and requires care for their babies. If scrapped, though, breastfeeding consultations and breast pumps may not be covered, either.

"Women have never had insurance coverage for breast pumps and lactation consultants, and this has made a difference for them," said Borchelt. 


Insurance companies also didn't have to provide health care coverage for adult children before the ACA. Now, moms can provide healthcare for their kids until they're 26 years old by keeping them on their insurance plans; previously, companies could unenroll children from a health plan around the age of 19. 

2. Women can be charged more for their insurance plans simply because they're women. 

The implementation of the ACA was heralded as the end of "gender rating," or charging men and women different rates for the same healthcare services. Borchelt's concerned a repeal could bring that practice back. 

"This was widespread in the market before the Affordable Care Act," she said. "The justification was that women go to the doctor more often and they live longer."


Women were paying up to 1.5 times more for health insurance than men before the ACA. And more expensive types of birth control, like IUDs that previously cost about $1,000 out-of-pocket, now have to be covered by insurance companies.

Earlier this week ATTN: reported on the potential cost spike for IUDs if Obamacare is repealed. 

3. Sexual assault and domestic violence could be considered pre-existing conditions. 

X-ray of bones in a hand

In 2009, eight states allowed insurance companies to consider a history of suffering domestic violence as a pre-existing condition, according to a report by the NWLC. Women also lost coverage after getting medical care for a sexual assault. 

“It’s difficult enough to make sure that rape victims take the drugs,” Diana Faugno, a forensic nurse and board director of End Violence Against Women International, told the Huffington Post in 2010. “What are we supposed to tell women now? Well, I guess you have a choice - you can risk your health insurance or you can risk AIDS. Go ahead and choose.”

doctor's office

Borchelt's not sure what to tell women who may have a pre-existing condition. No one knows exactly what a repeal will look like or if protections against pre-existing condition exclusions will be included in an ACA replacement. 

"I certainly wouldn't want people to not get treatment for a condition they might need," Borchelt said. For now, however, "I think it's all up in the air."

RELATED: This State Just Showed What Insurance Without Obamacare Might Look Like