The Affordable Care Act: Obama's greatest achievement on gender equality?

As we count down the days to the opening of the health-care exchanges, it's worth mentioning that the Affordable Care Act is easily the biggest law promoting gender equality since the Violence Against Women Act of 1994 for the Family Medical Leave Act of 1993.

Barrack Obama has taken his share of flack on women's issues. Most recently, people have challenged his record of high-level executive-branch appointments for women, which has been considerably better than George W. Bush's but weaker than Bill Clinton's. On the other hand,Obama has appointed a record percentage of female judges -- by a country mile. (He's still not appointing women at their prevalence level in the population, but he's getting close)  And the pay gap between men and women is stubbornly constant, with women (still) making roughly 77 cents on average for every man.

But starting January 1, 2014, the ACA will remove several billion dollars in annual gender discrimination.


It's currently legal in 34 states for insurance companies to charge men and women different rates for insurance. The problem is worst on the individual market, where people without access to insurance from their employer or a government program like Medicare or Medicaid have to go. A recent study from the National Women's Law Center (NWLC) estimated that differences in rates charged to females add up to more than $1 billion every year.

At first glance, the reasons for the discrepancy seem obvious (though unfair) -- women get pregnant, and pregnancies carry the potential for a host of medically expensive complications. Of course, having good maternity care is useful for both males and females, as Sen. Debbie Stabenow (D-Mich)  memorably pointed out to her colleague Jon Kyl (R-Ariz.) during a Senate Finance Committee hearing on the ACA held in 2009:

Jon Kyl: "I don’t need maternity care, and so requiring that to be in my insurance policy is something that I don’t need and will make the policy more expensive."

Stabenow: "I think your mom probably did."

(Can we please summarily declare this the best use of the "your mom" put-down line, ever?)

But  as the NWLC's study pointed out, more than 85 percent of individual policies they surveyed exclude maternity care and still charge women anywhere from 7 to 57 percent more for insurance.

The problems extend to the group insurance markets, where 34 states allow insurers to charge employers with a disproportionate share of female employees higher rates.

The ACA ends gender discrimination in all plans, individual and group. The resulting changes will equalize insurance rates and will likely save women several billion dollars a year -- not nearly enough to close the pay gap, but several billion bucks of progress is a reason to celebrate.

As importantly, the ACA mandates that insurance policies offered under the exchanges need to include prenatal and maternity care as part of their standard benefit packages, ending the need for women to purchase expensive riders. Birth control coverage is also mandatory, which is another large win for women, both in cost savings and in personal autonomy. 

Of course, other reproductive health services, notably abortion, won't be covered in exchanges and will require purchasing riders, thanks to the Ben Nelson. So the ACA is not perfect from a women's equality standpoint.

However, it eliminates a large part of the insurance discrimination that both overcharges women for insurance and limits their access to critical health services --it goes a long way, baby, indeed