FACT SHEET
The Affordable Care Act: Five Years of
Progress
MARCH 2015
The fifth anniversary of the Affordable Care Act
(ACA) – the greatest advance for women’s health
in a generation – is March 23, 2015. Five years
after the law was enacted, the ACA has already
helped millions of women and families and it is
poised to help millions more. The ACA has made
comprehensive health insurance more affordable
and accessible. It has prohibited insurers from
denying individuals coverage based on their
health status and it has given families the peace
of mind that comes with knowing that they are
not an accident or illness away from bankruptcy.
In addition to guaranteeing access to coverage,
the ACA is helping women access the health
services they need by requiring marketplace
plans to cover essential health care services and
by prohibiting out-of-pocket cost sharing for
preventive care. The law has also started to
transform how we provide and pay for care,
which will improve health outcomes and lower
costs for patients and families.
Why the ACA Matters for Women
Fact Sheets
Summary of Key Provisions (pdf)
Requirement to Have Health Insurance (pdf)
Health Insurance Marketplaces (pdf)
Affordability and Choice in the Insurance Marketplace
(pdf)
Expanding Access to Health Insurance (pdf)
 Premium and Cost Sharing Assistance (pdf)
Improving Health Care for Older Women (pdf)
Improving Health Care for Women of Color (pdf)
Improving Health Coverage for Lower-Income
Women (pdf)
Better Care for Pregnant Women and Mothers (pdf)
Coverage for Lower and Moderate Income Pregnant
Women (pdf)
Expanding Medicaid Family Planning Services (pdf)
Preserving Access to Women’s Health Clinics (pdf)
Comprehensive Sex Education for Teens (pdf)
Restrictions on Abortion Coverage (pdf)
Health IT: The Foundation for Health Reform (pdf)
Also available at www.nationalpartnership.org
Millions See Improved Coverage and Care Thanks to the
Affordable Care Act
 Millions of Women Now Have Access to More Affordable Health Coverage. The
ACA has made it possible for millions of women to enroll in affordable,
comprehensive health coverage through the health insurance marketplace and
Medicaid. During the 2015 open enrollment period, nearly 11.7 million consumers
chose or were automatically re-enrolled in a marketplace plan. Fifty-four percent of
these marketplace enrollees were women.1
In the marketplace, financial assistance is available to millions of eligible enrollees
to help make coverage more affordable. Premium tax credits reduce the cost of
monthly premium payments.2 Cost-sharing reductions lower out-of-pocket expenses
for covered, in-network care.
1875 Connecticut Avenue, NW | Suite 650 | Washington, DC 20009
202.986.2600 | www.NationalPartnership.org
In addition, the ACA has dramatically improved access to health insurance for
lower-income women by allowing states to expand eligibility for their Medicaid
programs to include all adults earning up to 138 percent of the federal poverty level
(FPL).3
 Women Cannot Be Denied Coverage Because of a Pre-Existing Condition or Chronic
Illness. Under the ACA, insurance companies may not discriminate against people
with pre-existing conditions, nor can they take away coverage from people who get
sick while enrolled in health plans.4 Insurance companies can no longer turn women
away because of certain experiences, such as pregnancy5 or being a victim of
domestic violence,6 that have previously been categorized as “pre-existing
conditions.”
 Women Are No Longer Charged More Than Men for Health Insurance. The ACA
prohibits plans in the individual and small group market from charging women
higher premiums simply because of their gender. Furthermore, for the first time in
history, gender discrimination is prohibited in health programs or activities that
receive federal financial assistance, are administered by an executive agency, or
were established by Title I of the ACA.7
 Coverage of Preventive Services is Guaranteed. Most private insurance plans –
including most employer-sponsored plans8 – are required to cover a wide range of
recommended preventive services without cost-sharing, including well women visits;
screenings for gestational diabetes, osteoporosis, and colon cancer; pap smears and
pelvic exams; HPV DNA co-testing; sexually transmitted infection and HIV
screenings and counseling; all Food and Drug Administration-approved
contraceptive methods; breastfeeding support, counseling, and supplies; and
screenings and counseling related to interpersonal violence.
 Coverage of Maternity Care Services Is Guaranteed. Women enrolling in coverage
through the marketplace are guaranteed that maternity care services will be covered
as an essential health benefit. Prior to passage of the ACA, most health plans
purchased in the individual market did not cover maternity care.9
 Pregnant Women and New Mothers Can Access Additional Support Services. The
ACA provides financial support for a home visiting program that pairs new and
expectant families with trained professionals who provide parenting information, as
well as resources and support during pregnancy and throughout a child’s first three
years. Preference for visitation is given to at-risk families. In addition, pregnant and
parenting women in Medicaid have gained access to critical new services and
providers, including support services for, and education about, post-partum
depression; free tobacco cessation counseling and therapy; improved access to
certified nurse-midwives; and access to free-standing birth centers.
Building on the Affordable Care Act’s Success
The ACA’s benefits for women are clear. Only five years after the ACA was enacted, access
to health care coverage has increased, coverage of preventive services and essential
women’s health services is guaranteed, additional support for pregnant women and new
NATIONAL PARTNERSHIP FOR WOMEN & FAMILIES | FACT SHEET | THE AFFORDABLE CARE ACT: FIVE YEARS OF PROGRESS
2
mothers is available, and women now enjoy protection against sex discrimination when
accessing health care. The ACA has already helped millions of people and will continue to
improve the health and lives of women and families across the country.
Building on this success is critical and requires complete implementation of the law,
adequate resources for all departments and agencies that administer and enforce the ACA
and oversee enrollment in coverage, and continued investment in improving health care
delivery. Such advances will move us closer to the day when all women and families have
health insurance, prevention is a priority, and care is coordinated, so that each person has
access to the quality, affordable health care she or he deserves.
1 Dept. of Health and Human Services, Office of The Assistant Secretary for Planning and Evaluation. (March 2015). Health Insurance Marketplaces 2015 Open Enrollment Period:
March Enrollment Report. Retrieved from http://aspe.hhs.gov/health/reports/2015/MarketPlaceEnrollment/Mar2015/ib_2015mar_enrollment.pdf
2 See our fact sheet What Women Should Know about Health Insurance Marketplaces for more information.
3 Kaiser Family Foundation. (2014). Status of state action on the Medicaid expansion decision. Retrieved from: http://kff.org/medicaid/state-indicator/state-activity-aroundexpanding-medicaid-under-the-affordable-care-act/
4 The White House. (n.d.). Affordable Care Act: The new health care law at two years. Retrieved from http://www.whitehouse.gov/sites/default/files/uploads/careact.pdf
5 The White House. (n.d.). The Affordable Care Act helps women. Retrieved from http://www.whitehouse.gov/sites/default/files/docs/the_aca_helps_women.pdf
6 Futures Without Violence. (2012, June). How the Affordable Care Act (ACA) affects victims of domestic, sexual, and dating violence. Retrieved from
http://www.futureswithoutviolence.org/userfiles/file/HealthCare/ACA%20and%20DV%20final.pdf
7 Patient Protection and Affordable Care Act, Pub. L. No. 111-148, § 1557 (2010), amended by Health Care and Education Affordability and Reconciliation Act, Pub. L. No. 111152 (2010) (to be codified at 42 U.S.C. § 18116).
8 On June 30, 2014, the Supreme Court of the United States held in Burwell v. Hobby Lobby that certain closely held for-profit corporations with a religious objection to
contraceptive coverage may opt out of the contraceptive coverage requirement. In August 2014, the Department of Health and Human Services promulgated a proposed rule
intended to guarantee that employees of these corporations receive contraceptive coverage directly from their insurer or third party issuer.
9 Courtot, B. & Kaye, J. (2009, October). Still Nowhere to Turn: Insurance Companies Treat Women Like a Pre-Existing Condition. National Women’s Law Center Publication.
Retrieved on January 14, 2011, from http://www.nwlc.org/resource/still-nowhere-turn-insurance-companies-treat-women-pre-existing-condition
NATIONAL PARTNERSHIP FOR WOMEN & FAMILIES | FACT SHEET | THE AFFORDABLE CARE ACT: FIVE YEARS OF PROGRESS
3