Women
Download: The Affordable Care Act and Women in New Hampshire
Download: New Comprehensive Coverage for Women’s Preventive Care
The Affordable Care Act means insurance companies can no longer charge a woman more just because of her gender. It also means no longer branding a woman as a pre-existing condition simply because of a Caesarean section or because she was a victim of domestic violence. It means women can no longer be dropped from their insurance because they get sick, their children can no longer be denied care because of a pre-existing condition, and women and their families can receive preventive health care without a co-pay. Here are just a few of the ways the Affordable Care Act is helping women in New Hampshire:
Ending insurance company discriminatory practices against women
The Affordable Care Act ends insurance company practices that discriminate against women. Insurers will no longer be able to charge women higher premiums than men, and they will no longer be able to use Caesarean sections or domestic violence as pre-existing conditions to deny women health care.
Providing security for essential health care, such as maternity care
The Affordable Care Act gives women more security over their health care. Under the law, all new health plans will be required to offer essential benefits for women such as maternity care, newborn care, and prescription drug benefits. According to the National Women’s Law Center, only 13 percent of health plans in the individual market include maternity care.
Covering preventive services – such as mammograms - with no deductible or co-pay
New Hampshire women can now receive recommended preventive services without a co-pay, deductible, or any other out-of-pocket expense. This provision will cover such services as mammograms, new baby care, and well-child visits, and includes contraception without co-pays. (A full list of services is available at www.healthcare.gov.)
Eliminating barriers to ob-gyn services and providing doctor choice
The Affordable Care Act ensures women have more freedom to choose their own health care provider. The law guarantees women the right to choose their primary care doctor from their health provider network and also eliminates barriers for women to see OB-GYNs. Under the law, health plans can no longer require a referral from a primary physician in order to visit an OB-GYN, putting women in the driver’s seat over these important decisions.
Ensuring better access and quality in health coverage
The Affordable Care Act forces insurance companies to play by the rules, prohibiting them from dropping a woman’s coverage if she gets sick, billing you into bankruptcy because of an annual or lifetime limit, or, starting in 2014, discriminating against anyone with a pre-existing condition – children with pre-existing conditions are already covered by this last provision thanks to the Affordable Care Act.
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New Comprehensive Coverage for Women’s Preventive Care
For the first time, the U.S. Department of Health and Human Services is adopting new guidelines for women’s preventive services to fill the gaps in current preventive services guidelines for women’s health, ensuring a comprehensive set of preventive services for women.
Previously, preventive services for women had been recommended one-by-one or as part of guidelines targeted at men as well. The Department of Health and Human Services directed the Institute of Medicine (IOM), for the first time ever, to conduct a scientific review and provide recommendations on specific preventive measures that meet women’s unique health needs and help keep them healthy. HHS used this study to issue new guidelines in August of 2011 that focus on women's wellness and the unique preventive services women need.
The additional women’s preventive services that will now be covered without cost sharing (co-pay) requirements include:
- Well-woman visits: This includes an annual well-woman preventive care visit for adult women to obtain the recommended preventive services, and additional visits if women and their providers determine they are necessary. These visits help women and their doctors determine what preventive services are appropriate, and set up a plan to help women get the care they need to be healthy.
- Gestational diabetes screening: This screening is for women 24 to 28 weeks pregnant, and those at high risk of developing gestational diabetes. It helps improve the health of mothers and babies because women who have gestational diabetes have an increased risk of developing type 2 diabetes in the future. In addition, the children of women with gestational diabetes are at significantly increased risk of being overweight and insulin-resistant throughout childhood.
- HPV DNA testing: Women who are 30 or older now have access to high-risk human papillomavirus (HPV) DNA testing every three years, regardless of pap smear results. Early screening, detection, and treatment have been shown to help reduce the prevalence of cervical cancer.
- STI counseling, and HIV screening and counseling: Sexually-active women will now have access to annual counseling on HIV and sexually transmitted infections (STIs). These sessions have been shown to reduce risky behavior in patients, yet only 28% of women aged 18 to 44 years reported that they had discussed STIs with a doctor or nurse. In addition, women are at increased risk of contracting HIV/AIDS. From 1999 to 2003, the CDC reported a 15% increase in AIDS cases among women, and a 1% increase among men.
- Contraception and contraceptive counseling: Women will have access to all Food and Drug Administration-approved contraceptive methods, sterilization procedures, and patient education and counseling. These recommendations do not include abortifacient drugs. Most workers in employer-sponsored plans are currently covered for contraceptives. Family planning services are an essential preventive service for women and critical to appropriately spacing and ensuring intended pregnancies, which results in improved maternal health and better birth outcomes.
- Breastfeeding support, supplies, and counseling: Pregnant and postpartum women now have access to comprehensive lactation support and counseling from trained providers, as well as breastfeeding equipment. Breastfeeding is one of the most effective preventive measures mothers can take to protect their children’s and their own health. One of the barriers for breastfeeding is the cost of purchasing or renting breast pumps and nursing related supplies.
- Domestic violence screening: Screening and counseling for interpersonal and domestic violence is now provided for all women. An estimated 25% of women in the U.S. report being targets of intimate partner violence during their lifetimes. Screening is effective in the early detection and effectiveness of interventions to increase the safety of abused women.
The coverage of these preventive services gives Americans access to many of the services already offered to Members of Congress. In addition, not only are these services similar to a list of preventive services recommended by the National Business Group on Health, but many private employers already cover these services.
New private health plans must cover the guidelines on women’s preventive services with no cost sharing (co-pays) in plan years starting on or after August 1, 2012. (Tip: If your plan renews on January 1st, that is when these provisions will go into effect for you.) There is an exemption for some of the provisions for approved religious-based organizations or institutions.
This information is directly from the HHS Womens Guidelines page, http://www.hrsa.gov/womensguidelines/.
