Skip to main content

It’s hard to know what to pay attention to in the flood of health reform policy jargon and acronyms, but here’s one new term that we think it’s important for women to understand: health insurance exchange.  What is an “exchange”? It will be a new way for those of us who don’t have health insurance to find more affordable coverage than we can get now.

When the Affordable Care Act goes into full effect, state health insurance exchanges will begin to play a huge role in shaping health care coverage for millions of people.  An estimated 14 million women will qualify for free or very low-cost coverage under the expanded Medicaid program and another 14 million of us will be eligible for federal subsidies to help us buy private health coverage through state exchanges, according to the Kaiser Family Foundation

How can we make sure these state insurance exchanges operate by rules that work for women and our families? Raising Women’s Voices and our regional coordinators across the country have been holding conversations about this important topic over the last two months. We started with some key questions:


  • Who will decide what kind of coverage a woman will be able to get from the insurance exchange in her state?
  • Will it be difficult for her to enroll?
  • Will there be somebody who can help her sort through her coverage options and make a good choice?
  • Will she be able to use this coverage to see trusted personal physicians or go to family planning clinics in her neighborhood?
  • Will there be providers who speak her native language, if it isn’t English?


Informed by those questions and our discussions, we came up with a few conclusions about what a woman-friendly health insurance exchange would look like that we can share with you here.

Creating A Woman-Friendly Health Insurance Exchange

1.  Exchange governing boards must be independent and representative. A majority of the people serving on the boards of state insurance exchanges should be consumers and consumer advocates, including people knowledgeable about women’s health, public health and addressing health disparities. Nobody connected to an insurance company should be making decisions for us about what kinds of health coverage we will be offered.

2.  Insurance plans in the exchanges must include trusted women’s health care providers. Plans must include sufficient numbers of family planning clinics and other essential community providers of health care. There must be health providers available who speak the languages of the people they are serving.

3.  People must be able to get clear information about their coverage choices and help enrolling in a health plan. The exchange website must be easy to use, and provide the information we need about cost, services covered and whether our trusted health providers are in an insurance plan’s network.  There must be a call center to answer our questions, including late at night and on weekends. Some of us are going to need in-person help from community-based organizations and women’s health providers designated to serve as consumer “navigators.”

4.  HHS must set rules for abortion coverage that ease administrative burdens for insurers and ensure women can get the coverage we need without confusion and delay. Such rules are needed to ensure that the ACA’s abortion requirements will be implemented in a way that is consistent with the law, the goals of the ACA, Congressional intent and current industry practices.  HHS should prevent the imposition of complex and unnecessary burdens on people who are trying to get health insurance.

We’ll be sending these ideas to the policymakers who are setting up ground rules for the state exchanges, but we still want to hear from more women.  Do you have an idea about what a woman-friendly health insurance exchange would look like?  Send it to us at!

Lois Uttley is co-founder of Raising Women’s Voices

This blog is part of the #HERvotes blog carnival.

The views and opinions expressed in this post are those of the author(s) and do not necessarily reflect those of strongly encourages our readers to post comments in response to blog posts. We value diversity of opinions and perspectives. Our goals for this space are to be educational, thought-provoking, and respectful. So we actively moderate comments and we reserve the right to edit or remove comments that undermine these goals. Thanks!