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6 Devastating Ways The Senate Health Care Bill Will Affect Black Women

A room of White men just pulled the reins of health care tighter without input from women, minorities, sick or disabled Americans. Here's why these changes are disastrous. 


Senate Republicans released their proposed “health care” plan, the Better Care Reconciliation Act (BCRA), to replace the Affordable Care Act (Obamacare) and it has disastrous implications for Black women. 

Thirteen White male senators huddled behind closed doors for weeks to mark up the bill with no input from women, minorities, sick or disabled Americans.  The result is a law that will cause great harm to Black women if passed.

Black women are 25 times more likely than White women to be infected with HIV/AIDS, twice as likely to be overweight, have heart attacks, develop diabetes, lupus, and hepatitis C.  They also have a higher risk of asthma, arthritis, and cancer.  The health care industry has never served Black women with distinction because of a combination of factors, including, but not limited to, socio-economic status, a culture of distrust of the health care industry, limited access to quality health care, environmental factors, and direct and indirect discrimination.

The BCRA makes it harder for women to access critical health benefits such as birth control, maternity coverage, and abortion.  Obamacare improved women’s access to health care in that it expanded contraceptive access, required private small-group insurers to cover maternity care, and expanded the number of people who could access Medicaid.  This new law seeks to undo the advances made by the ACA and is a step backwards in women’s health care.

BCRA Defunds Planned Parenthood

BCRA strips funding for Planned Parenthood for one year.  Planned Parenthood does not receive federal funding for abortions because of a federal law called the Hyde Amendment, which prevents any federal funding for abortions.  Despite this, these men saw fit to cut funding for family planning services and reproductive health.  Planned Parenthood has long provided health care services such as contraceptives and cancer screenings to women in underserved communities.  Without federal funding, Planned Parenthood will not be able to provide these crucial services that so many Black women rely upon.

BCRA Makes Cuts To Medicaid

Obamacare provided funding for states to expand Medicaid by making more people eligible for the program.  Medicaid is a jointly funded federal-state health insurance program for low-income people that cover children, adults, the elderly and the disabled.  Medicaid pays for half of all births, including two-thirds of unplanned births.  Three-quarters of public dollars spent on family planning are Medicaid dollars, and in 17 states, Medicaid programs also cover abortion with state dollars.  BCRA phases out this Medicaid expansion by 2021.  Given that Black women are disproportionately poor, a Medicaid expansion phase out will have a significant impact on their access to quality health care.

Under BCRA, Essential Benefits Appear to Be Optional

Before Obamacare, only 11 states required maternity coverage on the individual and small group markets.  In other words, a whopping 88 percent of plans on the individual market did not provide maternity coverage.  Obamacare required insurance plans sold on the individual market and through Medicaid expansion to cover a list of 10 “essential health benefits,” which included what we have come to know as basic medical care for women such as pregnancy and maternity care, prescriptions, mental health and lab tests.   BCRA seems to allow states to opt out of Obamacare’s essential health benefits requirement because it will be easier to do so.  Obamacare included a waiver provision, but states could only take advantage of it if they could show an insurance plan would cover as many people but would not cost more.  BCRA would allow states to get a waiver whether or not they make this showing.

BCRA Reduces Access to Abortions and Health Care

Effective January 2018, BCRA would ban individuals and small employers from using their tax credits to buy health plans that cover abortion, with the exception of rape, incest or in the interest of saving the life of the mother.  In other words, employers cannot get tax credits if their plans include abortion coverage.  This will have a chilling effect on smaller employers and discourage them from offering coverage that includes abortion.  BCRA also includes a provision that bans insurance issuers from accessing funds in the State Stability and Innovation Program – a $115 billion pool of money states could use to keep insurance plans from leaving the market or to lower premiums if they offer abortion coverage.  Basically, insurers can only pull funds from the program if they do not include abortion coverage beyond Hyde restrictions.

BCRA Circumvents Coverage for Pre-Existing Conditions

Before Obamacare, insurers could deny sick people coverage.  Obamacare required insurers to charge people with pre-existing conditions and serious illnesses the same amount of coverage.  It also prohibited lifetime caps on coverage for essential health benefits such as cancer drugs or hospitalizations.  BCRA would still require insurers to charge people with pre-existing conditions the same amount, but because the essential benefits requirements would be eliminated, insurers could impose lifetime caps on non-essential services.

BCRA Harms Seniors But Benefits Young People

Like Obamacare, young people can remain on their parent’s health insurance until age 26 under BCRA.  As for seniors, Obamacare barred insurance companies from charging seniors more than three times as they charge their youngest customers.  BCRA allows insurers to charge seniors up to five times as much, which will result in higher premiums for the elderly and arguably, lower premiums for the young.

As former president Barack Obama said: BCRA is “not a health care bill:”

“It’s a massive transfer of wealth from middle-class and poor families to the richest people in America.” 

BCRA’s cuts to health care will result in $1 trillion in tax cuts with 40 percent of that going to the top one percent earners in America.  The only people who benefit from this proposed law are the wealthy and insurance companies.  The irony here is that the vast majority of Americans believe that everyone should have access to affordable, quality health care.  The 13 male senators who put together this draft have shown little to no regard for the health and well being of Americans, let alone Black women, as they will suffer greater harm from the changes in the law. 

These men made sure, of course, to provide coverage for Viagra.  If you balk at the idea of 13 men deciding what constitutes essential health care for you, call your Senator and urge them to vote no on this bill.

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