You have probably heard about the Affordable Care Act (ACA) and the provision on preventative services, including contraception, that started it’s kick off on August 1st this year. There has been a great deal of media coverage and therefore also a lot of misinformation that is being shared about the provision; what it means, who it covers, when it starts, and what it includes. We will try to address some of the answers here, but many of the specifics will have to be researched on your own. In that case, we will give you links and also tell you where and who you may need to questions.
What It Means:
“All new insurance plans will be required to cover additional services and tests for women, with no out-of-pocket costs,” said HHS Secretary Kathleen Sebelius, “including domestic violence screenings, FDA-approved contraception, breast-feeding counseling and supplies and a well-woman visit, where she can sit down and talk with her health care provider.”
Who It Covers:
Health and Human Services estimates that 47 million women are enrolled in health plans affected by the rules, which take effect as health plans are renewed. To state it more clearly, this regulation only applies to women who have health insurance coverage. Ultimately the ACA goal is to have everyone insured, but that won’t happen for several years, if ever. In the meantime, only women who have health insurance now and will be renewing their policy or women who will be getting insurance are covered by this provision.
When It Starts:
Here is where it gets tricky. This provision only kicks in when your health insurance policy renews. If your renewal date is March 1st 2013, you will not have this benefit until that time. If your renewal date is October 1st 2012, you need to check with your insurance agent or your employer to find out if you will be covered in this year or have to wait until next year. The catch is that if you have to renew your policy prior to September 23rd, you may have missed the window to have this provision included in your new policy.
“Most of the new coverage isn’t very controversial, except that part about FDA-approved contraception. The original version of rules issued by the Obama administration exempted churches and other religious organizations, but still required religious-affiliated universities, hospitals and social-service agencies to abide by the coverage requirement. After a months’ long backlash led by the Catholic Church, the administration decided to give all religiously affiliated organizations an additional year while it seeks a compromise. A Colorado case, (involving a private employer) still must make its way through the judicial process, as will several other cases brought by private employers. Meanwhile, the new rules begin to take effect for everyone else.”
– NPR’s Health Blog “Shots”
What Is Included and How Often:
There are 22 screenings and exams that are considered preventative medicine for women and 27 screenings and exams for children that fall into this category and thus are covered by this new provision. Of course the only one that is getting all the attention are the measures covering contraception. In New Hampshire, we have a law that provided that contraception be covered by insurance plans in our state for the last 12 years. The current legislature tried to repeal that law, unsuccessfully.
”Health plans now must cover all Food and Drug Administration approved contraceptive methods, sterilization procedures, and patient education and counseling for all women of child-bearing age, with an exemption for group health plans sponsored by certain religious employers, according to Health and Human Services fact sheet. Grandfathered plans in effect before March 2010 also are exempt.
– Union Leader
Get the full list of 22 covered preventive services for women and children.
Read the Guidelines for Women’s Preventive Services
This is just the briefest of summaries, but hopefully will clarify some of the information that is being circulated. It is important for you to know your insurance policy renewal date and to check your plan for the exact terms of coverage. Ask your HR person or your insurance agent to clarify if you have any questions. Remember that Medicaid already covers most of the screenings named in the list.
For more information on women’s preventive services, use the resources below:
See the final rule
Read a fact sheet on Women’s Preventive Services and Religious Institutions.