While we’re on the topic, however, it’s worth examining the significant harm that Obamacare does to the fairer sex.
In 2008, women accounted for three-fifths of all Americans enrolled in Medicaid, our government-run health insurance program for the poor. Medicaid is under enormous strain because its costs grow faster than state tax revenues do. As a result, state governments are cutting services to women on Medicaid, which already provides the worst health outcomes in the country.
Instead of fixing this problem by improving the existing Medicaid program, Obamacare severely worsens Medicaid’s structure, by shoving an additional 11 to 17 million people—disproportionately men—into Medicaid. This means that state governments will have to divert even more resources away from the women who are already in the program.
Women disproportionately own, and work for, small businesses
There are only 20 female CEOs in the Fortune 500 survey of America’s largest corporations. But women have been starting new businesses at a faster rate than men for the last 20 years, and are expected to create the majority of new small-business jobs in the years to come. According to the U.S. Census, in 2007, women owned 37 percent of all businesses in the United States; from 1987 to 2007, the number of businesses wholly owned by women has nearly doubled, to about 8 million.
Obamacare’s employer mandate applies steep fines—$2,000 per employee—to any company with more than 50 employees that doesn’t offer health coverage to all of its workers. This fine creates a huge disincentive for small businesses to grow, because most small businesses have thin profit margins, and can’t afford extra costs. Business owners know that they can avoid the mandate by staying under 50 employees.
Obamacare includes significant income tax increases. Many of those tax increases fall on the middle class, but some are specifically aimed at those making more than $200,000 a year: in particular, a 3.8 percent surtax on investment income, and a 31 percent increase in Medicare payroll taxes on income above $200,000. The problem is that 54 percent of all private-sector workers—approximately 70 million Americans—are employed by companies that file their taxes as individuals. Indeed, 85 percent of all small businesses in the United States file under the individual tax code.
In addition, it’s small businesses who will be hit hardest by how Obamacare increases the cost of health insurance. Large businesses can self-insure, escaping the law’s web of mandates and regulations. But small businesses can’t. Those firms that already offer health coverage to their workers will face the choice of eating the cost of higher premiums, or dropping coverage for their employees and paying the fine.
Service industries will be hit hardest by Obamacare mandates
Women, relative to men, disproportionately work in service industries; i.e., non-agricultural and non-industrial work. Nine out of ten women in the U.S. work in the service economy. It’s these businesses which have the most ability to switch from full-time to part-time labor in order to avoid Obamacare’s employer mandate, especially in lower-wage areas of the service economy such as retail.
Darden Restaurants, the company that owns the Olive Garden, Red Lobster, and LongHorn Steakhouse chains, has announced that it will be restricting some of its hourly workers to 29-hour work weeks in order to avoid Obamacare’s employer-mandate threshold of 50 full-time employees. “It was 29½ [hours], and they’d kick you out,” former Olive Garden busboy Keaton Hasty told the Orlando Sentinel. “They’d always print off a little slip every day and say who was getting close.”
Some women prefer the flexibility of part-time work. But others need the full-time paycheck, and they will have less ability to achieve it in the areas of the service sector that are most sensitive to higher labor costs.
Pre-Obamacare, the U.S. led the world in breast cancer survival
While there are many things about the American health-care system that need reform, one area where we do well is in offering state-of-the-art health care to those who are the most ill. According to the CONCORD study, if you’re diagnosed with breast cancer in the United States, you have an 84 percent chance of living for another five years. That’s the highest survival rate in the developed world; in Britain, by contrast, only 70 percent of breast cancer patients live for five years or more.
It’s likely that our leadership in this area will not continue under Obamacare. As I noted above, Obamacare puts 11 to 17 million more Americans into Medicaid. A recent study from the American Cancer Society found that women on Medicaid were 2.5 times as likely to get diagnosed with breast cancer late, compared to those on private insurance. Medicaid patients fared slightly worse than those with no insurance at all. And a decent percentage of the newly-enrolled Medicaid patients will come from the ranks of the privately insured.
In addition, Obamacare pays for its coverage expansion by dropping Medicare’s reimbursements for health-care providers. These reimbursement cuts will worsen the emerging shortage of primary-care physicians, making it harder for women to get the regular preventive care they need to diagnose breast cancer early on, when the disease can be adequately treated.
Women use the health-care system more than men
Overall, Obamacare makes the health-care system worse, rather than better. It expands flawed government programs, especially Medicaid, that already serve women poorly. It bludgeons small businesses, where women are disproportionately active. It will drive up the cost of insurance for many Americans of both genders, while making it harder to get a doctor’s appointment. Worsening the quality and cost of American health care will especially impact women, who use the health-care system more frequently than men do.
These are serious problems. But the Obama campaign believes it’s more important to have a debate about whether or not insurers should be forced to pay for $9-a-month oral contraceptives, instead of letting Americans freely choose the insurance plans that best suit their needs. The President highlights this relatively trivial component of his health-care boondoggle, because he knows that a discussion of Obamacare’s real impact on women just might cost him the election.
Follow Avik on Twitter at @aviksaroy.