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Published 03/20/12

What the Left has said:

The Affordable Care Act –

  • Prohibits insurance companies from denying coverage to women due to preexisting conditions.
  • Gives women preventative care such as mammograms and birth control at no out-of-pocket cost.
  • In 2014, prohibits insurers from charging women higher premiums than they charge men.

But here’s the truth:

Ask the Experts:

  • Carrie Lukas, Executive Director of the Independent Women’s Forum
  • Nina Owcharenko, Deputy Director Health Policy Studies, Heritage Foundation
  • Edmund Haislmaier, Senior Research Fellow, Health Policy Studies, Heritage Foundation

The preexisting-condition mandate is antithetical to how insurance works.

The supposed “problem” of preexisting conditions is in large part a complete misnomer. And where it’s not a misnomer, the prohibition against insurance companies denying coverage because of preexisting conditions presents a very dangerous affront to the basic concept of insurance.

First, over 90% of insured Americans are on employer-provided group health insurance plans. These individuals, now and prior to the enactment of ObamaCare, could not be denied new coverage, be subjected to preexisting condition exclusions, or be charged higher premiums because of their health status when switching to different coverage. (1)

Where an issue concerning preexisting conditions does exist, it’s not a very big issue — and certainly not one necessitating a $2-trillion (2), unconstitutional (3) government take-over of the health care industry.

There are different rules that apply to the individual, non-group insurance market. About 9.4% of Americans have their health insurance through these kinds of plans. (1) Instead of addressing the problem presented to only this less-than-10% of people with these kinds of plans simply by, say, applying to them the same, already existing rules governing employer-provider group health care plans, ObamaCare does something much more perverse.

ObamaCare creates an incentive for people to wait until they get sick to purchase any health insurance coverage. Insurance spreads out large, unpredictable catastrophic costs that are incurred by a few people by charging a larger group a much smaller amount in premiums. (4) The insurance business model rests on the idea that all subscribers meet two general criteria: They are able to pay the insurance premium, and they are relatively similar in health. If either of these are not met, there will either not be enough money to cover the exceptional catastrophic health care needs of a small minority of subscribers, or there will be too many claims filed among the group, causing the business to lose money and the capacity to pay for anyone’s treatment.

If you can’t be denied for coverage because of a preexisting condition, then why should you waste your money paying insurance premiums while you are perfectly healthy when you can just enroll in coverage only when you become sick? This very idea of prohibiting coverage exclusions because of preexisting conditions for everyone flies directly in the face of the very concept of health insurance and turns it into nothing more than 3rd party payment of all medical bills.

Without a doubt, the prohibition of denying coverage to those with preexisting conditions will raise the average cost of health insurance. Carrie Lukas, of the Independent Women’s Forum, explains, “This means insurance premiums will become more expensive for the average person, which is why policymakers also must create an individual mandate to force everyone to buy the more expensive insurance and to institute price controls over premiums.”

“Free preventative care” is a variation of the free lunch myth.

The claim that women will be able, under ObamaCare to receive preventative care, such as mammograms, at no out-of-pocket cost is a variation on the free lunch myth — the idea that money can be spent at nobody’s expense. (5) The preventative care procedures that doctors will not be obligated to perform at no out-of-pocket cost to the consumer will still have to be paid for by somebody. In this case, that somebody is the insurance company. The increase in costs to the insurance companies to pay for this “free lunch” will still end up being paid in the form of increased premiums by all the customers of that insurance company — including those not receiving any preventative care at all.

In fact, "free" care ends up being the most expensive kind, because of the additional cost-shifting that occurs when we buy something with "someone else's money."  For example, the real winners when the government decides to dictate "free" birth control is Big Pharma,(6) who can now charge insurance companies higher prices since consumers aren't sharing any of the costs and aren't discriminating from product to product by price.

The "Birth Control Mandate" is unconstitutional and harmful to First Amendment rights.

Since the passage of ObamaCare, the Department of Health and Human Services has issued thousands of pages of regulations to explain how pieces of the law will work.  Within the regulations governing preventative care for women was a mandate that employers provide health insurance that covers contraceptive services including sterilization and the morning-after ("Plan B") and week-after ("Ella") pills. Many employers have objected, because these services conflict with their religious beliefs and they do not want to subsidize these services for their workers. No employer should be forced to violate his or her own conscience to follow a federal mandate.  Already, at least seven seperate lawsuits have been filed in federal court challening this part of the law.(7)

It is sad to think that religious hospitals and schools - whose mission is to provide services to the poor and disadvantaged in society - will face steep fines (amounting to about $100 per worker per day (8)) to comply with this mandate.  This means that, in order to obey this regulation, they will have to reduce their services to the most needy in society.

Women pay higher health premiums because of their higher health costs.

The prohibition against charging women higher premiums than insurance companies charge to men of the same age and general health status also flies in the face of the basic concept of insurance. Studies have shown that, in addition to the costs created by women needing maternity care (which, of course, are an entire set of regular and event-related costs that do not apply to males), women are more likely to make more frequent visits to their physicians, thus resulting in increased costs to the insurance companies. (9) For insurance to work properly, premiums paid out need to relatively reflective of an individual’s expected costs. Because women generally incur higher medical costs as compared to men, it only makes sense that they pay higher insurance premiums.

This is the same logic that leads auto insurance companies to charge less to middle-aged women than teenaged boys. Carrie Lukas writes (10), “Instead of using the loaded term “discriminate,” we should recognize that such price differentials are more properly understood as risk adjustment: Insurers recognize that their policies are more valuable for some who likely will incur more costs.”

ObamaCare will put women at a high risk for rationing.

Finally, women have been the first to see what impact the efforts to control costs in ObamaCare can have on the ways of treating their health problems. The FDA has considered revoking their approval of the drug Avastin, which is used to treat patients with advanced-stage breast cancer. The FDA is not considering revocation of approval because the drug has been found to be unsafe, but instead because the drug is costly, to the tune of $8,000 a month. As the Washington Post notes:

The FDA is not supposed to consider costs in its decisions, but if the agency rescinds approval, insurers are likely to stop paying for treatment. (11)

The harm that comes to women through ObamaCare may not just be through the fallacies of what ObamaCare claims it does for women, but also through cost-based prohibitions on certain treatments and drugs, like Avastin, that very well could save lives.

Another example is mammograms. For women between the ages of 40-49, mammograms were rated a C-level (or, unnecessary) preventative service.(12) Decisions for who should get a mammogram should be made by doctors and patients, not by federal bureaucrats who are seeking to contain costs.

Women are also businesspeople and taxpayers.

Women are participating in the work force in increasing numbers. Many women own and manage their own small businesses. The Left too often ignores the fact that women – as businesspeople and as taxpayers – will be hurt as ObamaCare takes its toll on the economy and jobs (13), and will pay higher taxes as a result of this law, taking away from the resources they use to provide for themselves and their families.

There are several taxes that will disproportionately hurt women (14):

  • The individual mandate tax penalty
  • The Cadillac Plan excise tax
  • The Medicine Cabinet tax
  • The cap on Flexible Spending Accounts
  • The tax on tanning salons


(1) http://blog.heritage.org/2011/01/19/hhs-report-on-obamacare’s-preexisting-conditions-impact-say-what/

(2) http://www.investors.com/NewsAndAnalysis/Article.aspx?id=522147

(3) http://www.kaiserhealthnews.org/Stories/2011/January/31/Florida-Judge-Rules-Health-Law-Unconstitutional-Text.aspx

(4) http://health.howstuffworks.com/medicine/healthcare/insurance/health-insurance.htm


(5) http://www.youtube.com/watch?v=YmqoCHR14n8

(6) http://www.theatlantic.com/business/archive/2012/03/the-biggest-beneficiary-of-the-contraception-mandate-drug-companies/254048/

(7) http://healthcarelawsuits.org/blog/detail.php?c=2787210&t=Universities%2C-TV-Network%2C-and-States-File-Lawsuits-Against-HHS-Mandate

(8) http://energycommerce.house.gov/news/PRArticle.aspx?NewsID=9333

(9) http://www.ncbi.nlm.nih.gov/pubmed/10718692

(10) http://www.nationalreview.com/articles/228279/first-ladys-new-tactic/ramesh-ponnuru


(12) http://fixhealthcarepolicy.com/health-care-news/video-how-obamacare-rations-mammograms/

(13) http://iwf.org/news/show/23924.html

(14) http://dailycaller.com/2012/03/19/obamacares-tax-war-on-women/


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