Prior to the passage of the ACA, insurance companies were allowed to discriminate against women due to our unique health needs. Insurers could deny coverage to women if they had been pregnant, had fought and survived cancer, or even if they had suffered domestic violence. In many cases, health plans didn’t even cover maternity care.
If the ACA is overturned, then women could be denied coverage based on their medical history, their age, and their occupation, among other factors. As a result, women could be charged more, or priced out of the insurance market altogether. Insurance companies could also try to reinstate gender rating, a common pre-ACA practice in which insurance companies charged women higher premiums than they did men, even though other parts of the ACA protect women from discrimination in the health care system.
The gravity of what the loss of coverage for women and girls would look like, should ACA be repealed, makes it paramount that we speak out against our state legislature supporting anything that could lead to reduced coverage. That's why this week, we weighed in on a GOP authored bill - Assembly Bill 1 - that claims to addresses coverage of preexisting medical conditions in our state.
It's important to note that under the direction of former Governor Scott Walker, Wisconsin joined this multi-state lawsuit to overturn the ACA. In December, a Texas District Court judge held that the ACA is unconstitutional in Texas v. Azar. As this case makes its way through the appeals process, the ACA remains the law of the land.
Despite Wisconsin’s voters speaking out loud and clear in November by electing state-wide officials who campaigned on a promise to withdraw Wisconsin from the ACA lawsuit, the Republican-led Legislature rejected the outcome of the November elections and voted to force the state to remain as plaintiffs in Texas v. Azar, threatening coverage for many Wisconsinites.
And with recent actions and actions taken over the past eight years to sabotage the ACA while the GOP has held a super majority in our state, now the Republican controlled legislature is attempting to show interest in protecting coverage for Wisconsinites.
Unfortunately, their proposal, AB1, does not guarantee insurance for people with preexisting conditions in the same capacity as the ACA, nor does it address other very important issues of coverage -- including essential health benefit mandates such as maternal care. AB 1 does not address lifetime coverage limits, preventative care, consumer protections, or bar discrimination based on gender. During the Assembly Committee on Health’s January 15, 2019 hearing, the bill authors testimony made it clear that they were not interested in expanding the scope of AB1 to include expanded coverage. Without the broader protections and subsidies of the ACA, AB1 does not protect enough people—and could actually lead to harmful unintended consequences, including higher costs.
Northern District of Texas Judge Reed O'Connor's December ruling didn't just put protections for preexisting conditions at risk, it attempts to throw out the entire law, including the subsidies that help Wisconsinites afford coverage. AB1 would not close the gap in coverage that will open up should ACA be repealed through the courts.
Our state legislative leaders are in a unique position to work to ensure that Wisconsinites continue to be covered and protected in an affordable and comprehensive manner. Rather than enact this inferior talking-point bill, the Assembly should instead focus on withdrawing Wisconsin from the lawsuit and join the numerous attorney generals seeking to uphold the ACA's framework. Such action would allow the Assembly to proudly take ownership for protecting coverage for Wisconsinites and would have the full support of the Wisconsin Alliance for Women’s Health. AB1 is no substitute for the ACA.
Cecely Castillo, Policy Director