Affordable Care Act: The Power of Policy
The Minerva Project • October 24, 2025
The Affordable Care Act is a monumental healthcare reform law that has had a significant impact on female and LGBTQ healthcare access and protections. Enacted in 2010, the law made affordable healthcare insurance more widely available to people, expanded the Medicaid program, and supported new medical care delivery methods designed to lower the cost of healthcare. This allowed many people to access preventative services, reproductive care, and gender-affirming treatments that were previously inaccessible or unaffordable.
The ACA implemented policies protecting patients from sex discrimination, outlined in the civil rights provision Section 1557. This ensured that health care and coverage could not be denied based on sex or pregnancy and childbirth-related conditions, and that women and men would be treated equally. This provision also prohibited gender rating, in which women were charged more than men for the same coverage in insurance.
The policy is not without limitations, however. Loopholes and inconsistent enforcement has left gaps in coverage for transgender patients and reproductive health services, especially at the state level. Additionally, recent events and cuts to funding and Medicaid threaten the tremendous benefits the ACA brings. Women make up the majority of patients that rely on Medicaid, and LGBTQ+ folks are twice as likely to use it as their primary insurance. These groups will be disproportionately impacted by reduced access, coverage, and nondiscrimination protections.
It is crucial to preserve and strengthen these provisions through actions like policy advocacy to ensure that healthcare remains equitable and reflective of the diverse needs of the community it serves.
