Thứ Tư, 12 tháng 12, 2012

The Affordable Care Act (a.k.a. Obamacare) and Women's Health


When it comes to the new Healthcare Act that President Obama signed into law back in 2010, I have to admit that I didn't know much about it.  The actual law itself is well over 900 pages long, so I haven't exactly been excited to read through it myself.  So, most of what I have learned has been from other people or short articles in the news that highlight certain areas of the plan.  However, I try to take all of that with a grain of salt because I know that people and news reports come from one bias or another.  Now that I think about it, I think I mainly just took a "wait and see" attitude because I wasn't sure whether this would be a long-term change.  Mitt Romney asserted that if he was elected, the Affordable Care Act (Obamacare) would be the first thing he eliminated. But now that President Obama has retained his position for the next 4 years, I'm more curious about what the ACA means for me personally and as a woman.

I was able to go to a Breastfeeding Class at UVRMC last week in preparation for the birth of my baby.  The Lactation Consultant said something that really struck my interest, "As of January 1st, all health insurance plans will be required to cover lactation support including consultations and breast pumps."  Since I have thoroughly researched the benefits of breastfeeding and have chosen to make that a priority for myself and my baby, that was an exciting prospect for me.  Oftentimes cost of care can get in the way of me seeking out certain medical services.  For example, if I struggled with breastfeeding and my health insurance didn't cover lactation consultations, I would probably be less likely to seek out those services.  I think a lot of people, especially students who are often living paycheck to paycheck, feel the same way.  But, if my health insurance would help me cover the cost of lactation consultations and renting/buying a breast pump, it would be a big financial relief for me and my family.


So, I decided to do a little research for myself and I want to share what I have found with all of you.  The new requirement for insurance companies to cover lactation support is a part of the Preventative Services for Women section of the ACA.  Basically, there are certain preventative services that have been thoroughly researched that show long-term health benefits for women that will now be made available through health insurance plans without any cost sharing (that means you pay no coinsurance, no deductible, no copayments).  The following services are covered under this provision:

  • Well-woman visits: Annual well-woman visits you make to your doctor and additional visits if your doctor deems them necessary (mammograms, pap smears, etc).
  • Gestational diabetes screening: This is for women 24 to 28 weeks pregnant to screen for diabetes that can develop during pregnancy.
  • HPV DNA testing: Women who are 30 and older will have access to HPV (human papillomavirus) screenings every 3 years in order to prevent or detect early cervical cancer.
  • STI Counseling: Counseling appointments with your care provider to discuss sexually transmitted infections.
  • HIV screening and counseling: Similar to HIV counseling, and also screenings to catch HIV and AIDS early.
  • Contraception and contraceptive counseling: Women will have access to all FDA approved contraceptive methods, procedures, and education.  This does not include abortifacient drugs.
  • Breastfeeding support, supplies, and counseling: Counseling and support from trained providers and access to breastfeeding equipment such as breast pumps.
  • Interpersonal and Domestic Violence screening and counseling: Provided to all adolescent and adult women to protect the safety of abused women.

These additional benefits were set to become activated on August 1, 2012 or on January 1, 2013, depending on when your plan year or policy year begins.  There is an important caveat, however!!!  There are certain plans that are not subject to these changes in coverage.  New private health plans that were started after March 23, 2010 (when the ACA was signed into law) should be subject to this new coverage, but there are some plans that are given "grandfathered status."  From the healthcare.gov website, "If you have health coverage from a plan that existed on March 23, 2010 — and that has covered at least one person continuously from that day forward — your plan may be considered a 'grandfathered' plan.

This is true whether you are covered by an individual health insurance policy that you had on that date, or you are covered by a job-based health plan that your employer established before March 23, 2010. This is true even if you enrolled in that job-based plan sometime later."  For example, DMBA, the health insurance provider that BYU retains for Student Health Plans and Employees has chosen to retain "grandfathered" status, so this provision does not apply (Link).  

If you want to find out if these new provisions apply to your insurance plan or if your plan is "grandfathered," contact your insurance provider.  Additionally, even if these new benefits apply to you, your insurance company may still require you to seek out these services from in-network providers, so be sure to check with your insurance company to see where you can seek these services.  Because my plan is one of the many that is retaining "grandfathered" status, this means that I won't be able to receive this kind of coverage for myself.  However, I am glad that other women will be able to benefit from these changes in the healthcare plan and have better access to preventative services at little to no cost to themselves.  It is encouraging to see an increased awareness of the importance of preventative care for women's health and well-being.  

What are your thoughts on this change in healthcare accessibility for women? 


For more information on Preventative Services for Women under the ACA, Click Here or Here.
For more information on Grandfathered Health Plans, Click Here.        

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