The lead up to the US Supreme Court’s decision on the Affordable Care Act (ACA) has been a bumpy road at best. But beneath all the rhetoric and partisanship surrounding the ACA lies a solemn and unfortunate truth: Too many Americans are uninsured, and lives are being lost because of it. An estimated 18,000 Americans between the ages of 25 and 64 die prematurely each year because they lack health insurance. The uninsured receive less preventive care, disease diagnoses at more advanced stages, and fewer medical interventions post-diagnoses than people with insurance.
The ACA is important and necessary legislation. It helps ensure insurance reforms that guarantee availability and renewability, prohibit preexisting condition exclusions, and prohibit gender rating—insurance reforms that will work best under an individual mandate. Beginning in 2014, the ACA prohibits new insurance plans from denying women coverage on the basis of pregnancy, previous cesarean delivery, history of domestic violence, or other preexisting medical conditions. These protections are landmark improvements in women’s health. The ACA also guarantees women direct access to obstetric and gynecologic care. My own state of Nevada and 42 other states already allow direct access—now, with this new national ob-gyn direct-access standard, all women in every state will no longer face costly and burdensome delays and denials.
Today’s Supreme Court ruling affirming the constitutionality of the ACA is a victory for women indeed. It gives the US Congress the opportunity to act now to improve the legislation to ensure that America’s practicing physicians are able to provide quality health care for all. ACOG supports the many elements of the ACA that have enormous potential to improve women’s health, and we urge all states to act swiftly to implement these important access and coverage guarantees.