This brief provides an overview of the important role the Affordable Care Act (ACA) has had on increasing access to comprehensive coverage among women. Over 10 million adult women (19-64) gained coverage between 2010 and 2019, as did over 7 million women of reproductive age (15-44). Despite the ACA’s coverage gains, approximately 7.9 million women of reproductive age remain uninsured. Access to comprehensive and continuous health coverage for women, particularly those of reproductive age, is critical to improving maternal and infant health. This brief examines the population of remaining uninsured women, including demographics and potential pathways to coverage.
• Coverage expansions under the ACA decreased uninsured rates and improved stability of health coverage for women. Over 10 million adult women (19-64) gained coverage between 2010 and 2019, as did over 7 million women of reproductive age (15-44).
• The ACA’s coverage expansions have been associated with improved access to care, increased use of health services, and better self-reported health among women of reproductive age.
• Despite the ACA’s coverage gains, approximately 7.9 million women of reproductive age remain uninsured.
• A disproportionate share of uninsured women are Latino (40 percent), and nearly half reside in the 12 states that have not adopted the ACA Medicaid expansion (47 percent).
• Nearly 1.9 million uninsured adult women (19-64) who live in Medicaid non-expansion states would be newly eligible for Medicaid if the remaining 12 states adopted the Medicaid expansion.
• Among women of reproductive age, an estimated 3.8 million have incomes at or below 138% FPL, the ACA Medicaid expansion income eligibility limit. Over half of them – 1.9 million – live in Medicaid non-expansion states and could fall in the coverage gap.
• An estimated 4.1 million uninsured women of reproductive age are eligible for subsidized Marketplace coverage under the tax credit provisions of the American Rescue Plan.