Tag Archives: ACA

Finally, Women’s Health Gets Its Due

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It is an amazing time for women in the US. The recent passage of the Affordable Care Act (ACA) shows that women’s health has been embraced as a national priority. Implementation of this landmark legislation will improve and expand health care for millions of women. From yearly well-woman visits to cancer screenings and domestic violence screening and counseling, to breastfeeding support and contraceptive coverage, more women’s health services will be accessible and affordable than ever before.

It’s with this backdrop that I take the reins as president of The American Congress of Obstetricians and Gynecologists, and I couldn’t be more excited. As a nation, we’re finally recognizing that health care is about more than solving accute health crises. It’s about promoting wellness to prevent disease. For ob-gyns, providing top-notch health care includes having meaningful interactions with women and providing them tools not only to maintain their physical health, but to improve their physical, mental, and emotional health, too.

Ob-gyns will be greatly affected by the new law, but we’ll also have a chance to make a great impact. We will be gaining new patients and collaborating with colleagues to optimize their health. We should strive to make the most of these patient-doctor visits and encourage women to put their health first—take advantage of the services ACA offers; get preexisting health conditions under control; make time for eating right, exercise, and the stress-relieving activities that they enjoy. These are fundamental health reminders that we must convey to every woman, every time.

As an ob-gyn, I believe that no medical specialty knows women’s health better than we do. We have a duty to speak up in the best interest of women’s health. During my year as ACOG president, I plan to take every opportunity to advocate for women. I challenge ACOG Fellows to let your voices be heard as well. Talk to your legislators and your community about women’s health, but most of all, talk to your patients. Working with them one-on-one to build the foundation for a healthier future is where we can make the biggest difference.

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Guest Blog: Every Reproductive-Age Woman At Risk, Every Time

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Frances Casey, MD

Frances Casey, MD

Full implementation of the Affordable Care Act (ACA) will remove many of the financial barriers women face to obtain effective methods of contraception. While making contraception affordable for every woman is a good first step toward improved prevention of unintended pregnancies, it remains the responsibility of health care providers to counsel women about all methods of contraception and help them find the one that may be the most effective.

The CHOICE project demonstrated that removing financial barriers related to the most effective methods of contraception decreases rates of unintended pregnancy and abortion. But the CHOICE project also did something many of us ob-gyns do not. Every reproductive-age woman eligible for the study was read a script about the effectiveness of long-acting reversible contraceptives (LARC), such as intrauterine devices (IUD) and hormonal implants.Instead of discussing LARC with their patients, many providers continue recommending less effective contraceptive methods based on misconceptions that adolescents, women who have never been pregnant, or women they estimate are at high risk for sexually transmitted infections (STIs) are not good candidates for LARCs. However, according to ACOG, LARC is the most effective form of contraception available and safe for use in all of these groups.

Because LARCs don’t require ongoing effort by the user, continuation and correct usage rates are higher. This could significantly reduce unintended pregnancy among teens and women if widely adopted. Additionally, women at high risk of both STIs and unintended pregnancy can be screened, obtain a LARC method the same day, and receive treatment without removing the device. Women with medical conditions and physical and mental disabilities can also benefit from both the pregnancy prevention and the non-contraceptive benefits of LARC.

Other women may also benefit from a longer-acting option. Without strict breastfeeding, postpartum moms are at risk for ovulation and repeat pregnancies even earlier than six weeks after delivery. LARC methods can be inserted immediately following delivery or at four weeks postpartum. Despite slightly higher expulsion rates, the benefits of immediate postpartum insertion of LARC methods may outweigh risks for women who are unlikely to receive postpartum care.

Minimizing financial barriers will make contraceptive methods more accessible for women at risk of unintended pregnancies, but it is up to us, as their partners in prevention, to counsel them on the most effective methods, including LARCs, at every opportunity.

Frances Casey, MD, is a Family Planning Fellow at Washington Hospital Center in DC.

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Guest Blog: With the ACA, Many Ounces of Prevention

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Barbara S. Levy, MD

Barbara S. Levy, MD

Have you ever heard the phrase “an ounce of prevention = a pound of cure”? It’s an often-used mantra in the medical community and a message we continuously repeat to our patients. That’s because intervention through prevention makes good sense. In many cases, catastrophic illness can be avoided by nipping small problems in the bud or diagnosing and treating disease early. In addition to living a healthy lifestyle, regularly visiting your doctor for routine screenings and counseling is paramount to achieving this goal.

As women, we are often the primary (or sole) caregiver for our families—not to mention the cook, head nurse, and chief financial officer among many other roles. Without a second thought, we may put the needs of others before our own. This is especially true if money is tight and it’s a decision between getting an annual well-woman exam, paying $50 for a birth control prescription, or meeting the needs of a child, spouse, parent, or friend. But this philosophy doesn’t serve women well—if you’re sick, who will look after the people you care about?

The Affordable Care Act (ACA)—the new US law that expands health care coverage by making health care more affordable and accessible—focuses on expanded access to preventive services. Making preventive services available for little or no out-of-pocket cost makes it easier for women to do the right thing for their health and put themselves first. As I discussed in my last post, a growing number of women are now eligible to receive contraception and other preventive health services without a co-pay.

Preventive services that are now covered include:

  • Annual well-woman visit
  • Human papillomavirus (HPV) testing
  • Preventive vaccinations including HPV, flu, hepatitis A & B, shingles, and chicken pox
  • Sexually transmitted disease prevention counseling
  • Obesity screening and counseling
  • Smoking cessation
  • Depression screening

The ACA chips away at many of the barriers to access and care that women have faced for years. Here at ACOG, we’re closely monitoring the implementation of the law and will continue to advocate for comprehensive care for the women we serve. I believe this legislation is a major step in the right direction to improving women’s health and improving health outcomes for all Americans.

Check out these links to learn more about ACA and how it will affect you:

Prevention, Wellness, and Comparing Providers (HealthCare.gov)

Benefits for Women and Children of New Affordable Care Act Rules on Expanding Prevention Coverage (HealthCare.gov)

Effective Date: Women’s Preventive Health Coverage Requirements (ACOG)

Barbara S. Levy, MD, is vice president of health policy at ACOG.

Guest Blog: The Co-Pay Question—Contraceptive Access Under the ACA

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Barbara S. Levy, MD

Barbara S. Levy, MD

If you’ve been to the pharmacy or doctor’s office lately, there’s a good chance that you noticed something different about your bill—there may not have been one. Depending on what type of insurance you have, you may now be eligible to receive all FDA-approved contraception and other preventive health services without a co-pay. This is due to the Affordable Care Act (ACA), a law with a lofty goal: overhauling our current health care system to provide the majority of Americans with affordable access to health care. While the intricacies of the ACA—and health insurance policies—are complex, it’s important for women to understand these most recent changes because they so specifically apply to us.

Whether or not you still have a co-pay for contraceptives depends on where you get your health insurance. More than half of people in the US get their insurance either through their job or by purchasing an individual insurance plan. Currently, the contraceptive coverage provision applies to most of these private plans. Insurance companies that adopted ACA policy changes early on may have already updated their plans to offer free contraception beginning in August 2012. As time passes, more plans will comply. However, there are some exceptions—some plans have grandfathered status that gives them more time to meet the terms of the new requirements, and some religiously affiliated organizations are currently exempt from providing this coverage.

State Medicaid programs already provide no-cost contraception to enrollees. The ACA expands Medicaid’s reach, potentially decreasing the number of uninsured women ages 19–64 from 20% to 8%. Many states are still hammering out exactly how Medicaid provisions will be implemented. ACOG is following this issue closely and supports the adoption of the ACA’s Medicaid expansion in all states.

So how can you find out whether your plan has changed and what new services are covered? You’ll need to ask a few questions and then update your records to be sure your health care team (you, your insurer, pharmacy, and your doctor) is on the same page:

  • Ask your employer or your health insurer whether the ACA has caused any significant changes to your plan. If so, what are they, and specifically, is contraception now covered without a co-pay?
  • If there are updates to your plan, be sure to notify your pharmacy and your doctor’s office and report any problems to your plan administrator or insurance company. It’s up to you to be sure you’re being charged correctly based on what your policy covers.

As an ob-gyn, I am thrilled by the increased availability of no-cost contraception that the ACA provides. Contraception is a basic health necessity for women. More access puts women in the driver’s seat, helping us avoid unintended pregnancy and take control of our reproductive health.

Learn more about contraceptive coverage and the ACA.

Barbara S. Levy, MD, is vice president of health policy at ACOG.