1 Patient Protection and Affordable Care Act (Public Law 111-148) and Health Care and Education Reconciliation Act of 2010 (Public Law 111-152).
2 “Essential Health Benefits: Individual Market Coverage.” Office of the Assistant Secretary for Planning and Evaluation, Department of Health and Human Services, December 16, 2011 accessed at URL: http://aspe.hhs.gov/health/reports/2011/IndividualMarket/ib.shtml.
3 Section 1001. Information on the preventive services that are covered is available at http://www.healthcare.gov/news/factsheets/2010/07/preventive-services-list.html. Certain plans designated as “grandfathered” are not subject to this provision.
4 B.D. Sommers, L. Wilson. “Fifty-four million additional Americans are receiving preventive services without cost-sharing.” Office of the Assistant Secretary for Planning and Evaluation, Department of Health and Human Services, 2011. Accessed at URL: http://aspe.hhs.gov/health/reports/2012/PreventiveServices/ib.shtml.
5 Covered benefits are summarized in http://www.healthcare.gov/law/resources/regulations/womensprevention.html. Grandfathered plans are not subject to these requirements.
6 Helen Levy and David Meltzer, 2008. “The Impact of Health Insurance on Health.” Annual Review of Public HealthVol. 29: 399-409; Kaiser Family Foundation, December 2010. Impact of Health Reform on Women’s Access to Coverage and Care. Focus on Health Reform. Washington, D.C.: Henry J. Kaiser Family Foundation. http://www.kff.org/womenshealth/upload/7987.pdf (accessed 03/13/2012)].
7 Institute of Medicine, July 2011. Clinical Preventive Services for Women: Closing the Gaps. Washington, D.C.: The National Academies Press
8 U.S. Census Bureau, 2010 Summary File 1, Tables P12, P13, and PCT12.
9 The Medicare preventive services provisions are in Section 4104. Medicare enrollment data are from the 2011 Medicare and Medicaid Statistical Supplement, Table 2.2 (accessed at URL https://www.cms.gov/MedicareMedicaidStatSupp/08_2011.asp#TopOfPage). The complete list of benefits covered with no cost-sharing is available in “The Affordable Care Act: Strengthening Medicare in 2011,” U.S. Department of Health and Human Services (accessed at http://www.cms.gov/apps/files/MedicareReport2011.pdf).
10 When the Medicare prescription drug program, called Part D, was created, it included a gap in coverage. Beneficiaries pay 100 percent of their drug costs until they reach the $320 deductible amount. After reaching the deductible, they pay 25 percent of the drug cost until total expenditures by the plan and the beneficiary reach $2,930. The “donut hole” occurs after the $2,930 limit where beneficiaries are responsible for the full cost of drugs until total annual out-of-pocket spending on drugs reaches $4,700. To close the donut hole seniors in 2011 began receiving discounts on brand name drugs and generic drugs that will increase yearly until 2020, when the maximum cost-sharing for all prescription drugs above the deductible and below the annual out-of-pocket limit is reached, at 25 percent. The donut hole will be completely phased out by 2020.
11 “The Affordable Care Act: Strengthening Medicare in 2011” U.S. Department of Health and Human Services (accessed at http://www.cms.gov/apps/files/MedicareReport2011.pdf)
12 These numbers were calculated by applying the growth rates shown for all beneficiaries in “Medicare Beneficiary Savings and the Affordable Care Act,” Office of the Assistant Secretary for Planning and Evaluation, Department of Health and Human Services, 2012 (accessed at http://www.aspe.hhs.gov/health/reports/2012/MedicareBeneficiarySavings/ib.shtml) to the 2011 estimates for women in “The Affordable Care Act: Strengthening Medicare in 2011,” cited above.
13 National Women’s Law Center. “Turning to Fairness.” 2012. Accessed at http://www.nwlc.org/system/files/pdfs/nwlc_2012_turningtofairness_report.pdf
14 Twenty-four percent of women are covered as dependents, compared with 14 percent of men. Kaiser Family Foundation, Women’s Health Insurance Coverage Factsheet, December 2011. (Accessed at http://www.kff.org/womenshealth/upload/6000-091.pdf).
15 Section 1001, adding Section 2713 to the Public Health Service Act.
16 B.D. Sommers, K. Schwartz. “2.5 million young adults gain health insurance due to the Affordable Care Act.” Office of the Assistant Secretary for Planning and Evaluation, Department of Health and Human Services, 2011. (Accessed at http://aspe.hhs.gov/health/reports/2011/YoungAdultsACA/ib.shtml). The estimate is based on data from the June 2011 National Health Interview Survey (NHIS).
17 This number was estimated by multiplying the NHIS estimate of 2.5 million young adults that gained insurance through Affordable Care Act by the percentage of uninsured adults ages 19-25 who were women, prior to implementation of the dependent coverage provision (44.2 percent, estimate for Calendar Year 2009 from the March 2010 Current Population Survey Annual Social and Economic Supplement).
18 Estimates provided to the Office of the Assistant Secretary for Planning and Evaluation under contract no. HHSP23320095649WC. Information on the RAND COMPARE model is available at http://www.rand.org/health/projects/compare.html.
19 Section 1401.
20 Section 2001. Section 2002 provides for an income disregard of 5 percent of Federal Poverty Guidelines, raising the effective income limit to 138 percent ($31,809 for a family of four).
21 Centers for Medicare and Medicaid Services, Covering People with Pre-Existing Conditions: Report On The Implementation And Operation Of The Pre-Existing Condition Insurance Plan Program, February 23, 2012 (Accessed at http://www.cciio.cms.gov/resources/files/Files2/02242012/pcip-annual-report.pdf)
22 CDC/National Center for Health Statistics: National Health Interview Survey. http://www.cdc.gov/nchs/health_policy/adult_chronic_conditions.htm
23 Kristen Robinson, “Trends in Health Status and Health Care Use Among Older Women” U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Health Statistics, March 2007 (Accessed at http://www.cdc.gov/nchs/data/ahcd/agingtrends/07olderwomen.pdf)
24 Section 4201.
25 The White House, Office of the Press Secretary, “Fact Sheet: President Obama’s Budget Expands, Simplifies Small Business Health Care Tax Credits” (Accessed at http://www.whitehouse.gov/the-press-office/2012/02/16/fact-sheet-president-obama-s-budget-expands-simplifies-small-business-he)
26 Estimates from the 2007 Survey of Business Owners derived from total female-owned and equally female-male owned firms in all sectors. (Data accessed at http://www.census.gov/econ/sbo/)
27 Section 1421. For more information see U.S. Department of Treasury, Internal Revenue Service, “What You Need to Know about the Small Business Health Care Tax Credit” (Accessed at http://www.irs.gov/newsroom/article/0,,id=223666,00.html)
28 U.S. Census Bureau, 2010 Summary File 1, Tables P12, P13, and PCT12.
29 Kristen Robinson, “Trends in Health Status and Health Care Use Among Older Women” U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Health Statistics, March 2007 (Accessed at http://www.cdc.gov/nchs/data/ahcd/agingtrends/07olderwomen.pdf). In 2004, there were almost 1 million women aged 65 years and over living in nursing homes. Furthermore, 19 percent of women aged 65 years and over had a health problem that required special equipment such as a cane, a wheelchair, a special bed, or a special telephone.
30 Section 2401 (Community First Choice Option) and Section 10202 (Balancing Incentive Program).
31 Sections 2404 (protection for recipients of home and community-based services against
spousal impoverishment), 6102 (accountability requirements for skilled nursing facilities and nursing facilities), and 6103 (nursing home compare Medicare website).
32 Section 3509 of the Affordable Care Act, adding Section 229 to the Public Health Service Act.