What is the Affordable Care Act (ACA), also known as ObamaCare?
The Affordable Care Act (also referred to as the “ACA”, “ObamaCare”, or “health care reform”) was a piece of legislation passed by President Obama in 2010. Essentially this large reform bill seeks to fix parts of our health care system (specifically, insurance) that were hurting individuals, especially people with enormous health care costs and women. We’ve created a great resource – “ACA 101” – to explain everything about the law!
What is going on in Wisconsin with the law?
As of 2013, the Wisconsin state legislature and Governor Scott Walker have chosen to not to expand Medicaid (“BadgerCare”) or design a state-specific insurance Marketplace. However, the federally-facilitated Marketplace (also called an “exchange”) will still begin accepting applications in October and start coverage January 1, 2014. If the Republican super-majority in the legislature changes in the next elections and the public demands that our Medicaid program (“BadgerCare”) be expanded using federal dollars, there is still time to reverse the decision made in the last budget.
As a woman, how do I benefit from health care reform?
The Affordable Care Act prohibits insurance companies from charging you more just because you’re a woman (“gender rating”), and it won’t allow them to deny you coverage or charge you more because you have gone through a pregnancy or survived domestic violence, because these are no longer allowed to be considered “pre-existing conditions”. Also, many women-specific preventative services are now available for no additional costs – you won’t pay co-pays or deductibles for birth control, breast feeding equipment or counseling, mammograms, cervical cancer screenings, and more. Also, one well-women visit is included in your premiums each year, so you can prevent problems because they get worse without having to worry about the cost.
Want more information on how you benefit?
With all these ‘free’ preventative services, won’t my insurance coverage cost more?
It’s a small possibility. Until the Marketplace opens in October, exact premium prices can only be estimated. However, several states have published findings that most individuals will not see a rise in premium costs, especially because of the tax credits and subsidies which will be available for a large percentage of people. Also, think about it over the lifespan – even though there is a chance premiums will cost more than before when you’re young and healthy, you won’t go bankrupt if you get sick, your preventative health care is covered for no additional cost, and insurance companies can no longer charge you upwards of 5x the cost of a younger person’s coverage when you are older and have more health issues to deal with.
Check out this factsheet for more reasons why the ACA is good for your wallet:
“Premium Sticker Shocks Good News for Women”
Should I get insurance through the Marketplace?
It depends! In order to get insurance through the Marketplace, you need to make sure you aren’t eligible for other sources of insurance such as through your employer, Medicaid, or military coverage. However, all individuals must have insurance by January 1, 2014 or else pay a penalty. Without this requirement – the individual mandate – the whole affordable insurance thing crumbles because only people who really need insurance will buy it, making costs soar. With the individual mandate, even if you are buying insurance when you are young and healthy, you feel secure in knowing that when you are older, you will still be able to afford all of your health care.
Here’s a chart to determine whether you should buy insurance through the Marketplace!
How is Wisconsin BadgerCare/Medicaid changing?
The original version of the Affordable Care Act which was signed into law in 2010 mandated that all states expand their Medicaid programs to include all adults (both parents and non-parents) up to 133% of the Federal Poverty Level (FPL). However, while the Supreme Court affirmed most of the ACA, this mandate was struck down and made optional for states. Even though the federal government would fund 100% of the costs of the expansion for several years, and eventually lower to covering 90% of the costs, the Wisconsin government chose not to expand our BadgerCare program.
More details available below:
I work for a religious-affiliated employer (church, hospital, etc.). Do I still get my birth control for no out-of-pocket costs?
You may. The federal government recently released their final regulations on this issue, and while most women will receive their birth control for no additional costs, some women employed by certain religious-organizations will not. It’s a complicated issue, so check out our article on the “Contraception Compromise” for more clarifications.
Who can help me know my options? Where do I go?
Your best resource for Marketplace-related information is the federal portal for signing up for insurance, which is HealthCare.Gov. Another comprehensive source of information about health care, the ACA, and its effects on individuals and states is the Kaiser Family Foundation. In addition, other resources on women’s health and how it is affected by the ACA can be found at our national partner, Raising Women’s Voices and the National Women’s Law Center.
If you have questions about the Marketplace, you can call the HealthCare.Gov at 1-800-318-2596.
Want more resources? Find them here.