As President-elect Donald Trump and the Republican-led Congress weigh changes to the Affordable Care Act, two women's health practitioners have some advice for how Washington should proceed as they consider reshaping the landmark public health program.
President Barack Obama's signature legislation has been coming apart at the seams as health insurers bolt public exchanges and insurance costs surge for many of Obamacare's 20 million users. Yet Molly Maloof, a physician, technologist and a wellness expert, told CNBC something that the GOP appears to be figuring out on its own: Repealing and replacing Obamacare may be easier said than done.
"I'm really concerned that reversing it will make the problem worse. I don't know if Trump totally understands the weight of this problem," Maloof told CNBC recently. As Congress and the president-elect move to reshape the legislation, the physician said she'd like to see more discussion around family planning and women's health care, which could take a hit under reform.
Still, even House Speaker Paul Ryan acknowledged the challenges Obamacare reform presents. He told CNBC this week that a "reasonable" transition period was necessary, as to ensure the government was "not pulling the rug out from under people midstream."
Maloof told CNBC that the U.S. health-care system was "very paternalistic" — a reflection of data showing that women's health costs are often higher than men's. A 2014 study by Mercer showed that women pay more than their male counterparts for health benefits — primarily because they tend to utilize those services more.
"Before the ACA, women paid $1 billion more than men each year for identical health plans in the individual market. This is not right," Maloof said.
Maloof and Katherine Ryder, the founder of Maven, a digital app targeted toward women that connects them with health-care providers, said they would like to see broader changes in the health-care industry under Trump. "Women make the disproportionate number of health-care decisions in the U.S.," Ryder told CNBC. "So we wanted to design a product with the female patient in mind."
A similar philosophy motivated Ryder in 2014 when she created Maven, a digital clinic that seeks to provide women with affordable and readily available health care. The idea occurred to Ryder after she turned 30 and she witnessed her friends having children.
"I realized that there wasn't as much support as there could, or should, be around this moment in a woman's life," Ryder said. "Right now our health-care system is really inconvenient, and there are gaps in women's care" — which could be exacerbated if Obamacare reform isn't executed properly.
The playing field is even more uncertain, with Trump planning to nominate Georgia GOP Representative Tom Price as Health and Human Services secretary. Price, himself a physician, has previously argued in favor of reducing the government's role in health care, something that makes both Maloof and Ryder somewhat uneasy.
"Health care is a heavily regulated industry, which has contributed to the slow pace of change, but it's also been a sector historically dominated by men," Ryder added. "Most key stakeholders at the helm of insurance companies, hospitals, government — even digital health companies — are men."
Maloof's advice to Trump would be to find a good solution to fixing the health-care system before repealing Obamacare, acknowledging Republican opposition but arguing that the U.S. can't go backward.
"A lot of women voted for Trump because they thought [former Secretary of State Hillary Clinton] wasn't a better choice," says Maloof. In light of Trump's focus on the economy, women would like to see how Trump plans to help women play a bigger role in the economy and achieve parity, Maloof argued.
Back in September, then-candidate Trump announced his plan to provide six weeks of paid maternity leave. Ryder told CNBC she's optimistic about the future of paid maternity leave, but doesn't believe Trump's proposal goes far enough.
"Business leaders are finally recognizing the importance of supporting women in the workplace because it makes for better companies," she added.
Maloof agreed. "We need far more women leaders in government … and to recognize that the economics of caring for children are better. It's better to have children that are happier and more nourished and well loved," she said.