Women’s unique health care needs are addressed by the Affordable Care Act, according to Alina Salganicoff. She is vice president and director of Women’s Health Policy at the Henry J. Kaiser Family Foundation, a nonpartisan health care nonprofit.
“More women than men are low-income, and therefore face more cost-related barriers to care,” she said.
The Affordable Care Act’s (ACA) requirement that preventive services must be covered with no cost-sharing means that more women will get more health care, according to Salganicoff.
“The evidence is clear that cost-sharing is a barrier,” said Salganicoff. She pointed out that women who already have coverage will pay higher rates for preventive care than those who get care through the new plans offered by the ACA.
Grandfathered plans are exempt from the ACA’s new health care standards, which includes preventative care benefits. Over time, fewer and fewer grandfathered plans should exist, Salganicoff said.
“Preventive services are considered an essential benefit,” she added.
Those services include pap smears, mammograms, vaccinations, colonoscopies, contraception, screening, and counseling for domestic violence.
Pregnancy may also no longer be considered by insurers a pre-existing condition, or be excluded from health insurance coverage. Coverage for maternity and newborn care is also mandated under new ACA rules.
There are also “new workplace protections for breast-feeding,” said Salganicoff. New mothers must be provided no-cost support and counseling for nursing, and renting a breast milk pump will be covered with no cost sharing.
In the workplace, nursing mothers will need to be provided adequate breaks and a private room other than a bathroom where they can express milk in a clean environment. That new 2014 rule affects companies with 50 or more employees.
For women beyond childbearing years, the ACA makes some changes, too, according to Salganicoff. “ACA expands the preventive services covered by Medicare Part B; half of women on Medicare have incomes under $20,000 per year,” she said. They will be able to get preventive services they might have avoided before because of out-of-pocket costs.
An upcoming Supreme Court case, in which Hobby Lobby sued over having to provide contraceptive coverage to its employees, could have far-reaching effects, depending on the court’s decision, according to Laurie Sobel.
The ACA requires that “all plans must cover all FDA-approved contraceptives without cost-sharing.”
Sobel is senior policy analyst for Women’s Health Policy at the Kaiser Family Foundation. “All for profit employers must cover contraceptives,” she said. “Nonprofit houses of worship are exempt.” Though Hobby Lobby is a for profit business, its owners sued on religious grounds, over having to provide the coverage.
The Supreme Court will hear Hobby Lobby v Sibelius on March 25, and is expected to reach a decision in June. The case will determine the answer to questions such as: “Is an employer a person? Can a for-profit business exercise religion?”
If the court were to find that a company has religious rights, more issues than health insurance might be affected, according to Sobel. More challenges to health insurance requirements could also follow, such as transfusions, vaccinations, fertility treatments, and so on.
Companies could even ask to opt out of civil rights and nondiscrimination requirements, according to Sobel. The case has attracted scores of friends of the court briefs in support of the administration, and its outcome will matter not just for the ACA, but also for the larger society.