The Department of Health and Human Services (HHS) have issued a “final rule” on the debate over the discrimination in healthcare and health insurance to charge women more for healthcare, further clarifying a policy already laid out in the Affordable Care Act (ACA), reports Healthline.

The ruling prohibiting discrimination in healthcare and health insurance will have a major impact on women buying health insurance. Before the ACA, women who purchased insurance on the individual market were routinely charged as much as 81 percent more for monthly premiums. Known as “gender rating,” this is the practice of charging women more because they may be considered a higher risk than men because they tend to visit the doctor more frequently, live longer and have children.

Under the ACA, insurance companies are prohibited from charging women more than men and are required to cover the total cost of certain key preventative services specific to women’s health, such as contraception. Companies must also offer maternity coverage, although a loophole leaves some insured women without maternity coverage.

The National Women’s Law Center (NWLC) and the American Civil Liberties Union (ACLU) have praised the policy change, but some still believe insurance companies should be able charge woman more as they are more “high risk."

Hadley Heath Manning, director of health policy at the Independent Women’s Forum, states “if fairness were really the guiding principle, it would be quite simple: women would pay more for health insurance because women consume more healthcare.”

Even with the policy change access to healthcare for woman is not always guaranteed. Women are less likely to be insured due to receiving less of an income says Dania Palanker, J.D., a senior counsel at NWLC, told Healthline.

A 2013 Kaiser Family Foundation study found that one in four women have delayed receiving care for financial reasons and still face greater financial hardship than men

“A lot of what we’re working on now is making sure that insurance companies are providing the services that are required to be covered according to the ACA,” Palanker said.

The NWLC has been fighting for a clear guide so woman purchasing insurance know exactly what to expect from insurance companies. This ruling is a major step to this clarification.

“There are also insurers working very closely with the administration to offer really good coverage through marketplaces and find ways to improve coverage, improve products and reduce costs at the same time,” Palanker said.