Obamacare: Wrong for Women

National Review

While the administration woos women, its health-care overhaul will harm them.

By Grace-Marie Turner

The White House is making a special push to win women’s votes in November, among other things by proclaiming that Republicans are waging a “war on women.” But President Obama’s signature health-care overhaul is an assault on women’s freedom. It will drive up their health-care costs, deprive them of choices, and make it harder for them to find doctors for their families.

Here are ten reasons why Obamacare is bad for women.

1. Higher cost of insurance. During the 2008 presidential campaign, Senator Obama promised that average premiums for a family would go down by $2,500 by 2012 as a result of his proposed reforms, but they actually have gone up by nearly that much — from $12,680 in 2008 to $15,073 in 2011, according to Kaiser Family Foundation data. And the Congressional Budget Office found that Obamacare’s new insurance mandates will raise premiums in the individual market by an additional $2,100 per family. That’s just the beginning. There are at least 20 new or higher taxes in Obamacare that will be passed along to consumers in the form of higher premiums, including taxes on medical devices and health-insurance premiums. This is bad news for women trying to keep coverage while managing a tight family budget.

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2. Losing your current insurance. The administration itself estimates that 51 to 80 percent of Americans will lose their current health insurance because their policies won’t qualify as acceptable under Obamacare rules. As many as 20 million people could lose the insurance they get at work as a result of Obamacare, according to the CBO. McKinsey and Co. says as many as 80 million people could be forced to change policies to comply with the law’s requirements. Other studies have shown that at least a third of businesses are considering dropping coverage because of the costly Obamacare mandates. This is bad news for women who want stability and control over their health insurance.

3. Dependents losing coverage. One of the perverse risks of Obamacare is that it could cause families who are relying on employer insurance to lose their coverage. Under the law, employers must offer affordable insurance to their employees; Washington will deem a policy unaffordable if an employee’s premium is more than 9.5 percent of his or her household income. This means that for a household income of $30,000, if the premium is more than $2,850, the coverage is considered unaffordable. Then the worker is eligible to go to the Exchanges for taxpayer-subsidized insurance. The only problem is that the subsidized insurance will be only for the worker and not for dependents. Families could lose coverage at work and be ineligible for subsidies in the Exchanges.

4. Unintended consequences. One of the first provisions of Obamacare to be implemented requires employers that offer dependent coverage to allow children to stay on their parents’ policies up to age 26. But some families are finding that this has a dark side: Firms and other organizations are finding they can’t afford the added cost and are dropping dependent coverage altogether. Soon after the law passed, the 1199SEIU local of the Service Employees International Union announced that it was dropping dependent coverage: “. . . new federal health-care reform legislation requires plans with dependent coverage to expand that coverage up to age 26,” Mitra Behroozi, executive director of benefits and pension funds, wrote in a letter to members. “Our limited resources are already stretched as far as possible, and meeting this new requirement would be financially impossible.”

5. Conscience and the mandate. The administration has forced a debate over reproductive issues by mandating that most employers must provide insurance coverage that gives free access to sterilization, contraception, and drugs that cause abortion. All women will have access to the mandated services at no extra charge, even if they work for a religious organization such as a Catholic hospital, university, or charity whose religious beliefs are violated by the mandate. Private employers, including women business owners, will be unable to exercise their own right of conscience with regard to services they consider to be morally offensive.

6. Vulnerable Americans hit hardest. The new health law could shred the Medicaid safety net because it does not increase capacity or make desperately needed structural reforms to Medicaid but simply drives more people into the program. Current Medicaid recipients, most of whom have few if any other options for coverage, will soon be forced to compete for care with the 16 to 25 million people being added to the program. Dr. Edward Miller, the dean of Johns Hopkins Medicine, argued in a 2009 Wall Street Journal article entitled “Health Reform Could Harm Medicaid Patients” that our system simply doesn’t have the capacity to absorb so many more patients so quickly. It will become that much harder for a mother on Medicaid to find a doctor for an ill child.

7. Loss of control. One of the things that women want most is more control over decisions involving health care for their families. Under Obamacare, those decisions will be made, not by parents, but by bureaucrats at the 159 new agencies and boards in Washington that will control our health-care system. Already a government agency has recommended restricting access to mammograms. That is only the beginning of government rationing of care as boards such as the Independent Payment Advisory Board decide to cut payments for providers and procedures.

8. The doctor shortage. We need at least 160,000 more physicians just to meet the demands of a growing and aging population. A 2010 survey by athenahealth and Sermo found that 66 percent of doctors are seriously considering dropping out of Medicare and Medicaid, and 53 percent are considering opting out of all third-party insurance. A more recent survey said that as many as 46 percent of doctors are planning to leave medical practice when Obamacare fully kicks in. Meanwhile, there will be 30 million more people in the health-insurance market. Waiting times will grow, as they have in Massachusetts, where a forerunner of Obamacare is in effect; some patients there wait up to 100 days to get an appointment with a primary-care doctor. With many fewer physicians, women and their families will find it harder and harder to find a doctor to see them.

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9. Losing full-time jobs. Many mothers must juggle a full-time job with full-time family responsibilities. But Obamacare’s employer mandate means they could face an even bigger challenge: holding onto that full-time job. Here’s why: The law forces employers with more than 50 employees to provide expensive health insurance to full-time workers or pay a big fine. Many employers are seriously considering cutting their full-time employees to 25 hours a week so they can avoid the costly mandate.

10. Child-only policies vanishing. Children are most commonly insured along with their parents, but child-only policies have been available for families where the parents’ insurance doesn’t cover dependents. Under a provision of Obamacare that went into effect in 2010, insurers can no longer refuse to sell such a policy because of a preexisting condition. This means that parents or guardians could wait to purchase policies until their children got sick. In at least 17 states, insurers have pulled out of the child-only market, saying they would face “adverse selection” because the new rule destroys the basis for shared insurance against risk.

A BETTER IDEA
Women would be better served by having a variety of policies available, so that they can choose one that offers the benefits they want and need. “Defined-contribution” health plans — in which the employer gives each employee a fixed amount of money with which to buy insurance, as opposed to providing the “defined benefit” of a group health plan — would allow working spouses to combine funds to buy the plan of their choice. Cross-state purchasing of health insurance would give them more options. And targeted tax credits would provide extra help with premiums for those with modest incomes.

Opinion polls show that Americans have made up their minds about Obamacare: 68 percent want the Supreme Court to strike down the whole law or at least the law’s central pillar — the individual mandate. The best outcome would be for the Court to send Congress back to work drafting new legislation that gives women and families real control over their health care.

— Grace-Marie Turner is president of the Galen Institute and a co-author of Why ObamaCare Is Wrong for America,

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