FACT SHEET
Why the Affordable Care Act Matters for
Women: Expanding Access to Health
Insurance
OCTOBER 2015
Thanks to the Affordable Care Act (ACA), millions of people now have access to more
affordable health coverage through expanded Medicaid programs and subsidized health
insurance plans sold in the marketplace. As of early 2015, the uninsured rate dropped to 9.2
percent, meaning seven million people obtained health insurance since 2014.1 The ACA’s
protections have helped create this historic decline in the uninsured; they have also made it
easier for women to find and enroll in the health insurance options that best meet their needs
and those of their families.
Historic Expansion of Medicaid
The ACA has helped to close gaping holes in the nation’s safety net. Medicaid provides
essential care over the course of women’s lives, from family planning and maternal health
services to nursing home care. In states that have chosen to expand their Medicaid
programs under the ACA, Medicaid eligibility has been raised to include individuals with
incomes up to 138 percent of the Federal Poverty Level (FPL).2
 In 2015, in states that have expanded their Medicaid programs, an individual earning
up to $16,243 annually qualifies for Medicaid, as does a family of four with an annual
income of up to $33,465.3
 With this change, millions more people now qualify for Medicaid’s comprehensive health
coverage and strong cost-sharing protections.4
Affordable Insurance in the Marketplace
The ACA has established critical protections to make private health insurance options
more affordable for women and families. Ensuring that health insurance remains
affordable and comprehensive is critical to keeping individuals covered and ensuring that
women and families are able to access the care they need.
 Premium tax credits and cost-sharing subsidies are available to help women and
families with lower incomes afford insurance in the marketplace.
 Women are guaranteed coverage for preventive services such as birth control,
mammograms and cervical cancer screenings, with no cost-sharing.
 Women no longer have to pay more than men for the same insurance policies. The ACA
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prohibits plans in the individual and small group markets from charging women higher
premiums simply because of their gender.
 Women can no longer be denied coverage
because they are sick or have pre-existing
conditions. The ACA has ended outrageous,
predatory practices that allowed insurers to
refuse to cover women who had breast cancer
or C-sections, who received medical care due
to domestic violence, or who have chronic
conditions like high blood pressure or
diabetes.
The ACA prohibits insurers from
denying coverage for pre-existing
conditions. Before the ACA, some
health plans considered domestic
violence, breast cancer, or Csections to be pre-existing
conditions.
 Insurers are now prohibited from imposing
lifetime dollar-value caps on coverage and
they are barred from placing annual dollarvalue caps on essential health benefits, like maternity care.
 Children and young adults now have improved access to quality care. The ACA gives
young adults the right to stay on their family’s health insurance until age 26.
Additionally, health plans are now prohibited from denying coverage to children with
pre-existing conditions, such as asthma or diabetes.
Insurance Shopping Made Easy
Thanks to the ACA, women and families can use the marketplace to find a range of
reliable health coverage options; access information about a plan’s covered benefits, costsharing requirements and quality; and make comparisons before choosing a plan. In
millions of American families, women gather information on coverage options, compare
plans and make decisions about which health plan best suits their family’s needs and
budgets. The ACA makes comparing and selecting a health plan easier so women can find
and enroll in plans that cover needed health care services and prescription medications.
 In the marketplace, women and families now have unprecedented access to
standardized, unbiased information about available health insurance plans. This
information allows women to assess plans based on the things that matter most to them
– such as premiums and cost-sharing requirements, quality, provider network, and
prescription drug coverage and scope of benefits.
 Plans must be certified as qualified health plans (QHPs) before they are sold in the
marketplace. This certification signifies that they adhere to required standards for
provider network adequacy, scope of benefits, cost and other factors.
 The marketplace also determines each enrollee’s eligibility for Medicaid and for privateinsurance premium subsidies.
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1 Cohen, R. A., & Martinez, M.E. (2015 August 15). National Health Interview Survey Early Release Program: Health Insurance Coverage: Early Release of Estimates From the
National Health Interview Survey, January-March 2015. U. S. Department of Health and Human Services Centers for Disease Control and Prevention. Retrieved 21 August 2015,
from http://www.cdc.gov/nchs/data/nhis/earlyrelease/insur201508.pdf
2 Note: In 2014, Medicaid eligibility expanded to individuals and families with household family income at or below 133 percent FPL. However, a standard 5 percent income
disregard used when determining eligibility effectively raises the limit to 138 percent of FPL.
3 Values calculated by National Partnership based on data from: U.S. Dept. of Health and Human Services, Centers for Medicare & Medicaid Services. (2015). 2015 Poverty
Guidelines. Retrieved 22 October 2015, from http://www.medicaid.gov/medicaid-chip-program-information/by-topics/eligibility/downloads/2015-federal-poverty-levelcharts.pdf
4 Families USA. (2015 July). A 50-State Look at Medicaid Expansion. Retrieved 21 August 2015, from http://familiesusa.org/product/50-state-look-medicaid-expansion
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.
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