48 million women might not be able to afford birth control.
THE DETAILS: The ACA covers 18 forms of contraception, saving women a combined $1.4 billion per year. If it was repealed, many insurance companies would likely elect not to cover some of the most effective types of birth control, such as IUDs, because of the cost. This would lead to more unintended pregnancies.
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Prenatal care and delivery might not be covered by insurers. Ditto breastfeeding supplies, such as pumps, and lactation support programs.
THE DETAILS: Before the ACA, just 12 percent of individual market plans included maternity benefits. When women don’t have prenatal care, maternal mortality goes up between threefold and fourfold, so more mothers would die. They would also have a 31 percent higher risk for adverse outcomes, including preterm birth and low-birth-weight babies. Fewer women would breastfeed because of the costs ($50 a month to rent a breast pump and a one-time charge of $50 to buy supplies), and research suggests breastfeeding can help protect moms against diabetes, heart attack, and breast cancer (and lower a baby’s risk for asthma, ear infections, and diabetes)
More women could develop cervical cancer.
THE DETAILS: An estimated 55 million women would lose no-cost access to Pap smears. Uninsured women are three times less likely than insured women to have had a Pap test in the past three years—and have a 60 percent greater risk of being diagnosed with late-stage cervical cancer. Millions would also be on the hook for $450 if they wanted to get the HPV vaccine, which prevents cervical cancer and is free under the ACA. And since the ACA allows young adults to stay on their parents’ plans until age 26, research shows that more young women have been diagnosed with the disease at an earlier and more treatable stage.
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24 million people, including 15 million low-income women, would no longer receive health-care coverage.
THE DETAILS: Our sources agree that repealing the ACA would be devastating for all women’s health, but especially for those who can’t otherwise afford insurance. Rolling back the ACA’s Medicaid expansion would swiftly uninsure millions (since 2013, African Americans have seen a 9.2 percent drop in uninsurance rates, and Latinos a 12.3 percent drop). Because uninsured people skip checkups, they are more susceptible to illness.
All told, getting rid of the ACA would cost as much as $353 billion through 2025.
THE DETAILS: Repealing the law is more expensive than keeping it.
Reported by Jill Filipovic, an attorney, journalist, and author of the forthcoming book The H-Spot: The Feminist Pursuit of Happiness. Her work on law, politics, gender, and foreign affairs has appeared in The New York Times, The Washington Post, Time, Al Jazeera America, and The Nation.
This article was originally published in the September 2016 issue of Women’s Health, on newsstands now.