As the 115th Congress begins its work, it's clear that Republican leaders are wasting no time - and leaving no procedural stone unturned - in their rush to repeal the Affordable Care Act (ACA). They are moving at a breakneck pace to end a law that has helped 20 million more Americans gain health coverage, many for the first time. It has brought the country's uninsured rate to its lowest level in history. And it has been, without question, the greatest advance for women's health in a generation.
The ACA's benefits are myriad and very clear. To mention just a few:
- Most health plans now cover women's health services like maternity care and contraception.
- Most plans now cover, without cost-sharing, women's preventive services, including birth control and breastfeeding support, counseling and equipment.
- Women - and men - with preexisting conditions can no longer be denied coverage because they have been sick. That means breast cancer and domestic violence survivors, women who have had cesarean sections and people with chronic conditions like high blood pressure or diabetes cannot be denied health coverage.
- The law prohibits lifetime and annual caps on benefits, and other predatory practices, so that insurers can no longer take away your coverage when you get sick and need it most.
- Women can no longer be charged more than men for the same insurance policies. Before the ACA took effect, more than nine in 10 of the best-selling plans on the individual market practiced gender rating, which cost women approximately $1 billion per year.
- Discrimination in federally funded health care - including sex discrimination - is finally against the law.
Women stand to lose all this, and much more, if Republicans repeal the ACA. Indeed, doing so would jeopardize the health of millions of women and undermine the economic security of countless families.
Yet Republican congressional leaders seem undeterred. In the days or weeks ahead, they seem absolutely determined to take coverage away from tens of millions of people.
The big question facing the country is: What comes next?
And answers are just about impossible to come by.
That's because Republican leaders in Congress are refusing to provide real answers to hard questions about what happens to women - to those of us with preexisting conditions - to those who cannot afford coverage without the financial supports the ACA provides - if the ACA is repealed. The answers they give are designed to sound reassuring but, in fact, they are grossly inadequate.
When it comes to our health care, as with so much else, the details matter - a lot. We deserve transparency. With so much at stake, "trust us" simply isn't good enough.
In fact, reasonable people have no cause to trust opponents of the ACA. Republicans have been attacking the law since it was first introduced in Congress. But for more than six years, they have failed to coalesce around an alternative. They have failed to make clear their priorities for health care reform. They have failed to offer a better way.
Instead, they have spent precious time attacking and working to undermine a law that has helped millions of women, men and children in this country.
What do ACA opponents in Congress support as an alternative and what, if any, protections will continue under their ACA replacement law? The fact is: We don't know. But it's a question that urgently needs answers.
When we talk about international treaties, lawmakers like to say that trust without verification is a dangerous thing. It is indeed. And this is certainly true when it comes to something as critical as our health coverage. Offering no details - no verification - about a replacement package, Republican congressional leaders are asking us to trust them as they strip millions of their health coverage and economic security.
That's simply not acceptable. Our health is too important to fly blind. Women and families have too much to lose. We should all reach out to our senators and representatives - this week - to demand clear answers ... before it's too late.