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was a watershed, bringing the country closerto universal health coverage after decades offailed attempts. 164 Prior to the ACA, almost 16 percent of US citizens had no health insurance, andsince private insurers had significant authority toexclude applicants, set different rates or excludecertain medical treatments, even those withinsurance could find themselves without cover forneeded medical services. Once the ACA is fullyimplemented, health insurance will be mandatoryfor all citizens and insurance plans will berequired to include basic health services.The Act is expected to vastly improve accessto health services, including for women. It isexpected, for example, that 47 million women willgain access to free preventative health care. 165The ACA outlaws discriminatory pricing policies ofprivate insurers that charge higher premiums towomen and people with pre-existing conditions.It establishes mandatory, full-cost coverage ofreproductive and family planning services as wellas preventative medical services for women suchas mammograms and cervical cancer screenings.And it foresees more comprehensive services forpregnant women and mothers on Medicaid andall women on Medicare. 166Yet, while the ACA expands access to basic healthcareservices, especially for women, it falls short ofuniversal coverage for all without discrimination.Two main avenues for extending coverage—theexpansion of employer-based insurance andof Medicaid—have in the past disadvantagedwomen, especially unmarried, poor and ethnicminority women, and are likely to do so in thefuture.First, employer-based insurance coverage allowscompanies to make decisions about the type ofhealth plans they provide to workers, leadingto variability in what is covered and how muchemployers contribute. This discretionary powerwas further bolstered by a 2014 Supreme Courtruling that allows certain employers to opt out ofthe newly introduced birth control benefits basedon their religious beliefs. 167 Higher-paid workersare more likely to have insurance through theiremployers and also to have better coveragethan those in lower paid jobs. This has importantgender implications given that women—especially women of colour and immigrantwomen—are over-represented in low-wageoccupations.Second, the eligibility rules and benefit levels ofMedicaid vary and tend to be more restrictivein states that have a high proportion of womenof colour in their population. 168 Undocumentedimmigrants are excluded altogether frompurchasing insurance coverage. Finally, thereform fails to address a major strategic healthneed of women by precluding any federalfunding for abortion. As a result, the ‘right tochoose’ will remain unaffordable for many,particularly those on low incomes.Expanding health coverage in ThailandIn Thailand, the Government introduced theUniversal Coverage Scheme (UCS) starting in2001. Under this scheme, general revenue is usedto pay the contributions of 80 per cent of thepopulation, i.e., all those who are not alreadycovered by public social insurance for privatesector employees and civil servants. 169 Theintroduction of the UCS followed a number ofunsuccessful attempts to extend social insurancecoverage to informal workers, who representabout 62 per cent of the workforce. 170 The UCSenrols entire households and offers a relativelycomprehensive benefit package, including awide range of sexual and reproductive healthservices such as safe abortion in the case ofrape and health risks. 171 Because the stateassumes almost the total cost of coveragefor the majority of the population, 172 the Thaisystem is comparable to the tax-financed healthsystems of Malaysia, Sri Lanka or the UnitedKingdom, which provide high levels of financialprotection. 173The UCS has achieved impressive results. By2010, total health coverage had reached 98 percent of the population and the share of OPPs