Ladies, if you happen to be fortunate enough to have health insurance and can hold on to it until 2014, I have great news for you! On the other hand, if you don’t have insurance, as so many women in Texas, you may be s--t out of luck.

The Supreme Court’s ruling that healthcare reform is constitutional means that ladies who have insurance will get the affordable care they need. Beginning in 2014, insurance companies will no longer be able to charge you more money for policies just because you’re a woman (so-called gender rating).

This is a big deal especially for women who reside in Texas where the individual market is highly unregulated (like most things in Texas) and insurers charge more for women and older Americans. All told, this practice costs American women about $1 billion a year.

On top of all of this, much of women’s preventive care, including contraception, Pap tests, mammograms and domestic violence screenings, will be covered without copay. So instead of shelling out about $12,000 bucks over an 18-year-olds lifetime in copays for birth control pills and doctor’s office visits, she can add that amount to what was saved from preventing gender rating.

Women also have a long history of being denied care because of preexisting conditions. Did you know that many insurance companies consider pregnancy a preexisting condition? That’s right! What about a course of treatment for a yeast infection? You got it, a preexisting condition.

Now that the healthcare law is free to stand, these practices will no longer be tolerated.

Other significant gains for women include, maternity care that currently isn’t covered by many plans and employers must provide a private area and time for nursing mothers to express milk.

Now for those of you in Texas who don’t have health insurance, either because your employer doesn’t provide it or because you cannot qualify for Medicaid because our Governor decided not to expand it, you may have a difficult road ahead.

Under the new law, Medicaid expansion would have provided about 1.8 million more Texans with access to affordable healthcare in 2014. However, in its ruling the Supreme Court gave the states the right to opt out of Medicaid expansion without suffering any financial penalties from the feds.

It came as no surprise to me that Governor Perry jumped on this and decided to opt out of expanding Medicaid thereby throwing 1.8 million Texas men and women under the bus.

I don’t believe the Governor has the final say on this. If you believe, as I do, that all Texans should have access to affordable healthcare, call your state representatives in Austin and tell them so.

Perry’s declaration is beyond belief considering that the feds will pick up 100 percent of the costs of expansion during the first two years of the program, reducing its share to 90 percent five years hence.

We’re only shooting ourselves in the foot by refusing to accept the tax dollars all of us pay (including those employed without health insurance) that will finance Medicaid expansion.