Health care just got cheaper for at least some women, and that’s no tragedy
Ladies, we could be saving some big bucks soon.
Another provision of the much-maligned Affordable Care Act, or Obamacare as it’s commonly called, kicked in this week.
It requires insurers to provide eight prevention-related health care services that specifically affect women at no extra cost to us.
No co-pays. No deductibles. The insurer must cover the entire cost as part of your policy.
Unfortunately, there are a few big loopholes that could exempt your insurance plan.
And shame on Congressman Mike Kelly for denigrating the fact that yeah, we’re women, and we need a little more from our insurance than men.
I’ll get to all that later.
Let’s start by looking at the eight services that insurers have fequently scrimped on, but that are now supposed to be included:
- Well-woman visits. This is what most of us call an annual exam, which includes a pap smear, breast screening and pelvic exam. Normally, you'd pay your regular co-pay for an annual visit. No more. It's now considered a "preventative service," like annual wellness visits, mammograms and cholesterol screening, which under ACA are also co-pay-free.
- All FDA-approved contraceptives and patient education about all aspects of reproduction. This is a biggie. No more co-pays on birth control, which can save over $200 a year. However, this does not cover Plan B, also known as the morning-after pill.
- Gestational diabetes screening, which identifies a common yet serious pregnancy-related disease in women and unborn babies.
- Domestic and interpersonal violence education and counseling.
- Breast-feeding support, supplies and counseling. This includes renting breast pumps, which cost about $50 a month.
- HPV DNA testing for women 30 and older. These are in addition to annual pap smears and can be done once every three years. These tests have been shown to reduce the instances of cervical cancer.
- Sexually transmitted disease counseling.
- HIV screening and counseling.
If you already have private health insurance, these rules will kick in whenever your plan renews.
If you buy your own insurance, this is when you start another year of coverage.
For most women who get their insurance through an employer or a spouse’s employer, it will be after the next open enrollment period when you’re allowed to make changes in your coverage.
Now let’s talk about all of the loopholes that will allow way too many insurance plans to duck these requirements.
If you’re on Medicaid, check your state's policies. Each state gets to decide which of these measures it will adopt and which it won't (the federal government gives extra money to state plans that adopt them).
If you get insurance through a religious-affiliated employer, you could be out of luck.
Because some employers affiliated with religious groups kicked and screamed that providing contraceptives is against their beliefs (even though many women, like myself, take them because they stop the growth of ovarian cysts that could, unchecked, render us infertile -- oh, the irony), they’ve been given an extra year to comply.
Then there are the “grandfathered” plans.
If your plan has not changed since March 2010, which is when ACA was born, your plan may be grandfathered, which means it is not required to meet any of these mandates.
According to the federal government, about half of large-employer plans and a third of small-employer plans will be considered grandfathered in 2013.
Now, they might include them in order to remain competitive, but they don't have to.
Even with the loopholes, this is good news.
This kind of medical care for women is expensive, and some forgo testing and checkups because of the cost.
Providing it as a part of everyone’s insurance plan should make it possible to prevent or diagnose many life-threatening illnesses earlier, when they’re easier and cheaper to treat.
We’re not only going to alleviate a lot of pain and suffering, we’re going to save a lot of money as well.
One thing this is not: a tragedy.
Kelly, a Pennsylvania Republican, compared the day these requirements took effect to 9/11 and Pearl Harbor.
“I want you to remember August the 1st, 2012, the attack on our religious freedom,” Kelly said at a Washington press conference. “That is a day that will live in infamy, along with those other dates.”
No, women getting access to medical care as part of their self- or employer-funded health insurance is not anywhere near an act of of war or terrorism.
Suggesting such is not only offensive to women but also to the families of loved ones who died in both tragedies.