FACT SHEET
Why the Affordable Care Act Matters for
Women: Improving Health Care for
Older Women
OCTOBER 2015
Access to affordable, quality health care is central to older women’s quality of life and
economic security. The Affordable Care Act (ACA) expands access to important preventive
health care, gradually closes the costly “donut hole” in Medicare Part D prescription drug
coverage and improves coordination of health care services.
Expanding Coverage and Reducing Medicare Costs
The ACA expands access to important preventive services.
 Medicare beneficiaries and enrollees in marketplace health insurance plans are able to
access important preventive health care services, such as an annual comprehensive
wellness visit, without any cost-sharing (i.e., no copays or deductibles).
 Medicare beneficiaries are now eligible for an annual wellness check-up without any
copays. These wellness check-ups include time for health care providers to review a
wide variety of health information with patients and create personalized prevention
plans.1
The ACA closes the Medicare “donut hole,” saving
women money. The Medicare “donut hole” is a gap in
prescription drug coverage in some plans. Once a
beneficiary’s spending for prescription drugs reaches a
certain amount, the “donut hole” requires the beneficiary
to pay an increased portion of drug costs until his or her
spending reaches a total spending cap, at which point
Medicare coverage kicks in again.2 The ACA is gradually
reducing the amount beneficiaries must pay in the “donut
hole,” and will close the gap completely in 2020.3
The ACA is gradually
reducing the amount
beneficiaries must pay in
the Medicare Part D “donut
hole,” and will close the
gap completely in 2020.
Improving Care Coordination
Women have improved access to coordinated care. By investing in primary care, patient
safety, patient experience of care and the Center for Medicare & Medicaid Innovation, the
ACA lays the groundwork to improve quality and coordination of care. This means patients
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will be less likely to experience dangerous drug interactions, duplicative tests and
procedures, conflicting diagnoses, and preventable readmissions – and their family
caregivers will get the support they need.
The ACA creates new ways to deliver health care services.
 The ACA created the Center for Medicare & Medicaid Innovation to test, evaluate and
expand new payment and care delivery models that improve quality and care
coordination. For example, new models currently being tested include Accountable Care
Organizations, primary care transformation initiatives such as the Comprehensive
Primary Care Initiative, and best practice initiatives such as the Partnership for
Patients.
 The ACA encourages the use of health information technology in these models to help
improve care coordination and reduce medical errors.
 More attention and resources have been dedicated to ensuring that older women are
safe when they transition from a hospital to their home or to another facility. The ACA
created the Community-Based Care Transitions Program, which tries new models to
provide transitional care services to high-risk Medicare beneficiaries to help make these
transitions smoother and safer.
1 Families USA. (2012 February). Medicare’s Annual Wellness Visit: What It Means for You. Retrieved 21 August 2015, from
http://familiesusa.org/sites/default/files/product_documents/Consumer-Guide-Medicare-Wellness-Visit.pdf
2 U.S. Dept. of Health and Human Services, Centers for Medicare & Medicaid Services. (2015 January). Closing the Coverage Gap – Medicare Prescription Drugs Are Becoming
More Affordable. Retrieved 21 August 2015, from https://www.medicare.gov/Pubs/pdf/11493.pdf
3 Ibid.
The National Partnership for Women & Families is a nonprofit, nonpartisan advocacy group dedicated to promoting fairness in the workplace, access to quality health care and
policies that help women and men meet the dual demands of work and family. More information is available at www.NationalPartnership.org.
© 2015 National Partnership for Women & Families. All rights reserved.
NATIONAL PARTNERSHIP FOR WOMEN & FAMILIES | FACT SHEET | IMPROVING HEALTH CARE FOR OLDER WOMEN
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