​​​​​​​Kaiser Family Foundation report: 10 healthcare policy changes that could affect women

The policy changes proposed in the American Health Care Act (AHCA) and future healthcare reform approaches could have a significant impact on women, especially for those who rely on Medicaid, according to a new analysis from the Kaiser Family Foundation.

KFF analysts looked at elements of the Affordable Care Act that would be fully repealed and those that would be changed or adapted under the GOP’s proposed bill. They also considered changes that could occur in future healthcare reform plans, as the AHCA is the first "prong" of the GOP's planned three-prong healthcare reform plan. Through those lenses, they identified 10 areas where the repeal-and-replace effort could significantly impact women:

  1. Work requirements for Medicaid enrollment
  2. Capped federal funding for Medicaid
  3. Reduced, or eliminated, Medicaid funding for Planned Parenthood
  4. Further restrictions on abortion coverage or access
  5. The proposed change in tax credits from an income-based to an age-based system
  6. Insurance reforms that could end the ACA’s ban on “long-standing discriminatory practices” in the individual market
  7. Rescinded essential health benefits requirements
  8. Reduced coverage for preventive care, like cancer screenings
  9. Reduced coverage of contraception
  10. Decreased protection for pregnancy-related care

“What you would really lose is a lot of the … important preventive services,” Alina Salganicoff, Ph.D., vice president and director for women’s health policy at KFF, said during a press briefing (PDF).

RELATED: Women’s March: Protesters fight for healthcare access, reproductive health

The AHCA’s proposed changes to Medicaid would likely have the strongest impact on women, especially poor women, according to the report. Medicaid is an important option for women nationwide to gain healthcare coverage; Kaiser estimates suggest that in some states, particularly expansion states, as many as 20% to 30% of women are enrolled in Medicaid. Medicaid expansion also offered a coverage option to low-income women who don’t have children, according to the report.

Applying a cap to federal Medicaid spending, as is written in the AHCA, would especially impact family planning services, according to KFF’s analysis. Higher federal payouts incentivize states to cover a complete range of contraceptives, including more expensive options like intrauterine devices, which are extremely effective at preventing unwanted pregnancy.

Another key area to watch will be how Congress ultimately handles calls to defund Planned Parenthood. Despite Congress’s push toward a repeal-and-replace plan that includes funding cuts to Planned Parenthood, a recent KFF tracking poll found that 75% of Americans, including 56% of Republicans, think Medicaid funding for the organization should continue.

Salganicoff said during the briefing that cuts to Planned Parenthood would disproportionately affect poor women, for whom a Planned Parenthood clinic may be the only facility offering women’s health services.

Women in general have benefited in a number of areas under the ACA, according to the brief. The uninsured rate for women between the ages of 19 and 64 fell from 17% to 11% between 2013 and 2015, and other elements, like the essential health benefits provisions, which include maternity and preventive care, led fewer women to delay care because of cost.