The Supreme Court’s decision last June to uphold the Affordable Care Act was an important step toward achieving near-universal health care coverage in the United States. But the ruling undermined the Affordable Care Act’s guarantee of insurance coverage for Americans living near the poverty line by allowing states to opt out of the Medicaid expansion program that would have extended coverage to more than 17 million low-income Americans.
As a result, several states have threatened not to expand their Medicaid programs despite the fact that the federal government would pay for 100 percent of the expansion for the first two years, gradually transitioning to 90 percent in 2020.
Interestingly—and perhaps not surprisingly—most of the states that are threatening to reject Medicaid expansion have the highest rates of uninsured women. It is probably no coincidence that these same states also have the fewest number of women in elected office, while the majority of states with the highest representation of women in elected office have chosen to expand their Medicaid programs.
Louisiana is no exception. If Louisiana were to expand Medicaid 176,000 women would become newly eligible for Medicaid coverage.
Status of Women’s Health in Louisiana:
Total number of uninsured women and girls: 381,200
Total number of women in need of publicly funded contraception: 287,660
Percentage of unintended pregnancies: 55%
Preterm births as percentage of all births: 15%
Percentage of Legislators that are female: 11%
Low-income Louisianans, and women in particular, face significant health disparities relative to more affluent groups in part because of inequitable access to insurance coverage and health care. Medicaid currently only covers certain groups of low-income individuals—mostly working parents with incomes well below the poverty line. Because women are more likely than men to be poor and also more likely to be parenting, more women than men qualify for Medicaid under the pre-Affordable Care Act eligibility criteria. But there is still significant unmet need in access to health care coverage for low-income women living just above the income eligibility threshold for Medicaid, as well as for women who are not pregnant or parenting.