Worse for Women

An Analysis of the Effects Senator McCain's Health Plan Would Have on Women's Access to Health Care

CAPAF and the Planned Parenthood Action Fund analyze how McCain's plan would affect women's health care.

SOURCE: report cover

Read the full report (pdf)

Senator John McCain’s health plan would drastically restructure America’s health care system, with especially devastating effects on women. The health plan of the Arizona senator and Republican presidential nominee would dangerously destabilize the employer-based health insurance system upon which 160 million non-elderly Americans rely for their health care, steering them instead toward the individual market where basic medical needs often are not covered.

Tens of millions of women would be at risk of losing their current insurance coverage even though they use health care services more frequently than men, suffer chronic illness more often than men, and require maternity care and other reproductive health services. Specifically, under the McCain health plan:

  • More than 59 million women who receive their health insurance through their job, ƒƒor their spouse’s job, are at risk of losing that insurance
  • More than 30 million women with employer-sponsored health insurance who suffer ƒƒfrom a chronic condition could lose their coverage, find it harder to obtain coverage, or have to purchase supplemental insurance to cover their chronic condition

In addition, Sen. McCain’s health plan would erode important state requirements aimed specifically at protecting women’s access to some of their most basic health needs. By permitting plans to cherry-pick their state of residence as well as enabling plans to sell policies without regard to state insurance rules through so-called “association health plans,” Sen. McCain’s plan would encourage insurers to eliminate coverage of basic health services. These state requirements include:

  • Twenty-nine statesƒƒ require cervical cancer and Human Papillomavirus screening Sixteen statesƒƒ require coverage of the HPV vaccine
  • Thirty-one statesƒƒ require comprehensive drug benefit plans to include contraception
  • Twenty-one statesƒƒ require coverage of maternity care
  • Forty-nine statesƒƒ require breast reconstruction

Depending on where a woman lives, the state protections at risk include:

  • Direct access to obstetricians/gynecologistsƒƒ
  • Annual breast, ovarian, and cervical cancer screeningƒƒ
  • Sexually transmitted infection screeningƒƒ
  • Prohibitions on gender-based premium rating
  • Limited definitions of pre-existing conditions that prevent surgeries like Caesarean sections from limiting women’s coverage

Rather than giving women more control over their health care decisions, as Sen. McCain promises to do, his health plan would take away women’s ability to access critical health care services.

This is not to say that the current U.S. health insurance system provides the best health coverage to women. Millions of American women are thoroughly familiar with the inadequacies of the current employer-based health care system. Women are more likely to experience interruptions to their employment and to work part-time, often due to increased caregiving duties, and are therefore less likely to have employer-sponsored health insurance.

Women are also more likely to be covered by a spouse or partner’s employer-sponsored health plan, making their health care coverage vulnerable during times of divorce, retirement, death, or other disruptions. And more women than men work for small businesses that do not offer health insurance to their employees.

Indeed, our current health care system is broken and needs immediate attention, as the Center for American Progress detailed in its 2005 proposal, and as Planned Parenthood Federation of America outlines in its forthcoming plan. Both of these progressive plans build upon existing state and federal health care protections to offer affordable health coverage to all Americans. But under the guise of “reform,” the McCain health plan instead erodes existing avenues for accessing affordable coverage and current health care protections. Instead of providing people with the tools they need to manage their health care decisions, the McCain plan would cut off options that currently exist and would leave people—especially women—worse off than before.

Over the years, policymakers on the federal and state level, as well as large employers, have provided significant health insurance protections in the group market that provide health security to millions of Americans. States have also enacted a range of consumer protections in the small group and individual markets, although these protections are typically less comprehensive.

States began enacting these laws as insurance companies looked for ways to avoid paying for care. Consumer coverage protections vary by state and may include requirements to cover specific services, prohibitions against denial or revocation of coverage based on health status, limits on excluding coverage for pre-existing conditions, and outside review of insurance company disputes.

Under the McCain plan, employer incentives to provide coverage in the group market would erode, while consumer protections in the individual market would be gutted, allowing health insurers to do what they’ve sought to do for decades—pick and choose who they will insure, avoiding high-risk individuals and costly health conditions. In short, Sen. McCain’s plan seeks to maximize the profits of health insurance companies, not maximize health insurance coverage for Americans—especially women. We detail how the McCain plan harms women in the pages that follow.

Read the full report (pdf)


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Jessica Arons

Director, Women\'s Health & Rights Program