Well-woman visits.
Gestational diabetes screening
• 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.
Mammograms and Colonoscopies (with certain restrictions for age)
Remember, these services are not “free”; you are still paying for them with your premiums and deductibles. It is vital to understand with all these changes there is no proverbial free lunch. Someone is paying, and it is both the employer and employee who is supplementing both their own care as well as the care for those who don’t pay or are subsidized by the government.
A somewhat controversial aspect of Obamacare is the mandate for contraception coverage. The initial law stated that the following services would be mandated for coverage by insurance providers:
Barrier methods, like diaphragms and sponges
Hormonal methods, like birth control pills and vaginal rings
Implanted devices, like intrauterine devices (IUDs)
Emergency contraception, like Plan B® and ella®
Sterilization procedures
Patient education and counseling
This coverage proved controversial among Christian hospitals, Christian charities, Catholic hospitals, and other businesses owned or controlled by religious organizations that oppose contraception on doctrinal grounds. A compromise was reached that allowed religious organizations to opt out of the requirement to include birth control coverage in their employee insurance plans. In those instances, the insurers themselves will offer contraception coverage to enrollees directly, at no additional cost. The controversy rages still with at least 63 lawsuits nationwide challenging the mandate.
In addition to preventative services, women will have access to maternity care through their current insurer or through an expansion of Medicaid. Policies issued by the ubiquitous health exchanges are also required to offer a level of maternity care.
Proponents of Obamacare also state that women will benefit, although not uniquely, from the expansion of coverage, elimination of pre existing conditions, and government subsidies.
Detractors of the Affordable Health Care Act quote generalized objections when asked specifically how Obamacare will impact women. They raise issues of increased cost of premiums, restriction of access to doctors, being forced into Medicare or various health exchange plans, and cumbersome regulations. All of these potentially will negatively effect health care delivered to women.
A much less known but incredibly powerful regulatory agency may have a marked effect on women’s health care under the new law. The US Preventive Services Task Force is a 16 member panel of appointed medical personnel charged with the daunting task of determining what constitutes prevention under the new law. In other words, they decide if services, tests, and procedures are to be paid for. More importantly, however; they also decide what won’t be covered, which can potentially restrict access either economically or pragmatically. The word we all run from is rationing, yet on the surface it seems as if this is what may happen. According to their website the following services are not considered “justified” and will not be covered as preventative:
Chlamydia screening in most women over 25
Cervical-cancer screening in those over 65
Breast-cancer screening using digital mammography or MRI instead of the traditional x-ray.
Screening for ovarian cancer and the genes that raise a women’s risk of breast cancer Clinical breast exams in women older than 40.
Even having a doctor teach women how to do a breast self-exam is unlikely to be covered, since the task force says women are rarely the ones to find their breast cancers.
This is the same panel that said women should not get screening mammograms before the age of 40 and then sparingly between 40-50. They also nixed the idea of routine HPV screening in young, sexually active women.
For women, The Affordable Care Act is a mixed bag. While it creates a positive atmosphere where prevention is stressed , it also may limit certain choices and individualized care. Now more than ever taking control of your own health by making solid healthy lifestyle choices becomes paramount.
