The brouhaha has died down and much of the affordable care act, also known as Obama-care will indeed go through. ( I’m not going to discuss all the details and certainly none of those dealing with Medicaid.)
It’s important to know that all new health plans starting on or after August 1, 2012 must include important services that affect women, and it’s about time! Believe it or not until the affordable care act was put in place there was no definitive set of recommendations for preventive services for women. To address this woeful omission,the US Department of Health and Human services asked the Institute of Medicine (IOM) to develop a comprehensive list of services for women.
Here are the recommendations of the IOM for girls and women between the ages of 10 and 65. (Those older than 65 will be covered by Medicare and should, we hope, get age appropriate services; obviously contraception will not be among them.)
- Gestational diabetes screening between 24 and 28 weeks of gestation or at the first prenatal visit for pregnant women identified to be at high risk for diabetes
- Testing for high risk human papilloma virus (HPV) for women undergoing cervical cancer screening (PAP smears) and HPV testing beginning at age 30 and every three years thereafter for women with normal PAP results
- Annual counseling on sexually transmitted infections for sexually active women and girls.
- HIV infection counseling and screening on an annual basis for sexually active women and girls.
- Coverage of the full range of FDA – approved contraceptive methods, sterilization procedures and patient education and counseling for women and girls with reproductive capacity.
- Comprehensive lactation support and counseling and coverage of the cost of renting breast-feeding equipment.
- Interpersonal and domestic violence screening and counseling.
- At least one well- woman preventive care visit annually, including preconception and prenatal care for those interested in having children.
Women have always had more out-of-pocket costs for healthcare expenses than men. This will begin to even out once we have affordable health care options. I am especially excited about the contraceptive portion of these options. (OK this does make it sound as if my life is dependent on the IOM, which I admit would be sad!) Because contraceptives approved by the FDA include barrier methods, hormonal methods, emergency contraception and implanted devices; women may now be more likely to select long-acting reversible contraceptive such as the IUD which up to now has been expensive.
The insurance companies may not be happy but we should be; these options will save lives. A study published in the journal Health Affairs estimates that an increase in the use of clinical preventive services in United States could result in saving more than 2,000,000 life years (that’s 1 year for 2 million people or 2 years for one million…you get it) each year that it is in force. The government and yes, the Supreme Court got it right!