In the run up to the passage of the Affordable Care Act (ACA), many of the law’s proponents were actively engaged in advocacy that promoted the law’s benefits for women. In particular, there was much attention to the numerous provisions that addressed the long-standing inequities and discriminatory practices adopted by many private insurance plans that disproportionately disadvantaged women. These included charging women higher rates than men, while also excluding benefits important to women, such as maternity care and contraception. As we approach the end of the ACA’s third open enrollment period, it is a good time to step back and reflect what we are learning about how the private insurance reforms and expansions have affected access to coverage for women and to identify where gaps remain. uninsured through a combination of Medicaid expansions, private insurance reforms, and tax credits. Although the ACA’s Medicaid expansions have broadened coverage for many, but not all, of the nation’s poorest women (Ranji & Salganicoff, 2015), the law also has done much to improve access to affordable private insurance coverage for millions with modest and middle incomes by offering subsidized premium assistance. In addition, coverage rates for young adults have also greatly improved owing to the law’s requirement that employer plans offer workers the option of keeping adult children up to age 26 enrolled as dependents. But, as will be discussed, this option has also presented some unanticipated challenges for young women. The ACA also instituted a series of private insurance reforms to alleviate some of the long-standing barriers to coverage, many disproportionately affecting women. Historically, insurance carriers selling plans on the individual insurance market adopted policies that specifically placed women at a disadvantage, either by charging them higher premiums than men for the same level of coverage (a practice called gender rating), limiting their scope of benefits, such as excluding maternity care or contraception, or in some cases, excluding coverage for certain preexisting conditions, including pregnancy. The ACA bans plans from instituting these policies. In the first 2 years of insurance expansions, women represented 54% of enrollees in Marketplaces using the healthcare.gov platform (Office of the Assistant Secretary for Planning and Evaluation, 2015), despite the fact that they were less likely to be uninsured. This may not be surprising given that women are more likely than men to manage family health, have contact with the health system, and have higher rates of chronic health problems as well as experience cost-related barriers to care. For these reasons, the elimination of many of the structural barriers to insurance along with offer of subsidies could have made enrollment in insurance coverage a higher priority for women than men.