Health Care Reform: New Coverage for Women

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As of this month, an estimated 47 million women covered under a variety of health plans gain access to eight more preventive health-care services. We previewed this aspect of the Affordable Care Act (ACA) last year.

Of course, it’s not just women who are benefiting from the ACA—in the last couple of years, everyone has been able to receive free preventive services including flu shots and other immunizations, and screenings for cancers high blood pressure, cholesterol and depression.

Before the most recent mandate kicked in, some insurance companies did not cover certain preventive services for women, and others required them to pay deductibles or co-pays for what, in many cases, is essential care. Now, these preventive services are free of charge:

  • well-woman visits;
  • gestational diabetes screening that helps protect pregnant women from one of the most serious pregnancy-related diseases;
  • domestic and interpersonal violence screening and counseling;
  • FDA-approved contraceptive methods, and contraceptive education and counseling;
  • breastfeeding support, supplies and counseling;
  • HPV DNA testing for women 30 or older;
  • sexually transmitted infections counseling for sexually-active women;
  • HIV screening and counseling for sexually active women.

Since its inception, the ACA has improved access to care for many women covered by insurance plans and Medicare. Since last year, mammograms, folic acid supplements for women who may become pregnant, hepatitis B and anemia screening for pregnant women, for example, have been offered without having to meet a deductible or pay coinsurance. Such preventive services offered without cost sharing are based on recommendations by the Institute of Medicine, a body of independent medical and scientific experts who use evidence-based research to reach conclusions about care.

But be aware that people covered by plans with grandfathered status—that is, plans that were in effect prior to enactment of the legislation on March 23, 2010—are not required to cover these services. Grandfathering is complicated, however, so contact your insurance company to determine if your plan qualifies; even if it existed before 2010, if certain changes have been made to it, it might have lost grandfathered status.

Also, some nonprofit religious organizations, such as churches and schools, are not required to cover the services; most of the issues surrounding those decisions concern opposition to contraceptives and counseling.

It’s a heated issue in many quarters; the Obama administration recently addressed it with this limp explanation: “The Obama administration will continue to work with all employers to give them the flexibility and resources they need to implement the health care law in a way that protects women’s health while making common-sense accommodations for values like religious liberty.”

Preventive services currently offered for women covered by Medicare include annual wellness visits, mammograms, diabetes screening and bone mass measurement for people at risk of osteoporosis. Nearly 25 million women with Medicare used at least one free preventive service in 2011.

To learn all 22 preventive services for women that are covered for free, link here. To find out about the health-care services for which anyone might be eligible at no extra charge, link here.

 

DISCLAIMER: Because of the generality of this update, the information provided herein may not be applicable in all situations and should not be acted upon without specific legal advice based on particular situations.

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