Insurance companies will be required to cover eight preventive care services (Women's Preventive Services: Required Health Plan Coverage Guidelines), including HIV screenings and contraception, with no co-pays or deductibles, as part of the next phase of the Affordable Care Act, beginning Wednesday.
For those with employer-paid health insurance plans that have enrollment dates, the coverage takes effect at the start of the next enrollment period.
The services provided are:
• Annual well-woman visits. This covers preventive services that are age and developmentally appropriate, including mammograms, screenings for cervical cancer, preconception and prenatal care.
• Screening for gestational diabetes. This covers pregnant women between 24 and 28 weeks of gestation and at the first prenatal visit for pregnant women identified to be at high risk for diabetes.
• Human papillomavirus (HPV) testing. This covers high-risk human papillomavirus DNA testing in women with normal cytology results. Screening should begin at 30 years of age and should occur no more frequently than every 3 years.
• Annual counseling for sexually transmitted infections. This covers counseling on sexually transmitted infections for all sexually active women.
• Annual counseling and screening for human immune-deficiency virus (HIV). This covers counseling and screening for human immune-deficiency virus infection for all sexually active women.
• Contraceptive methods and counseling as prescribed by a doctor. This covers all Food and Drug Administration approved contraceptive methods, sterilization procedures, and patient education and counseling for all women with reproductive capacity.
• Breastfeeding support, supplies, and counseling. This covers comprehensive lactation support and counseling by a trained provider during pregnancy and/or in the postpartum period, and costs for renting breastfeeding equipment.
• Annual screening and counseling for interpersonal and domestic violence.
Among the exemptions in coverage are group health plans sponsored by certain religious employers, and group health insurance coverage in connection with such plans, that will not be required to cover contraceptive services, under the law.
Federal officials, including the secretary of Health & Human Services and the U.S. Surgeon General, will participate in a whole series of conversations around the country to get the word out about this phase of health care reform.
But there are still challenges.
There is still a great need for coverage for people who are not yet covered by health insurance to get access to health care. The Affordable Care Act is being implemented in stages and all elements are not scheduled to be in effect until 2014 and some populations will not be covered by the law because of compromises in getting the law passed.
Some large employers have opted to "grandfather" their plans and there will be a co-pay for services under those plans, although the expectation is the number of firms that opt for the grandfather clause is expected to dwindle as the remainder of the law is rolled out.
Additionally, in some states there are no systems in place to enroll people qualified for the new programs, some of that is a deliberate decision by Republican governors and GOP-controlled legislatures to not enact certain elements of the law in a bid to render what is popularly known as “Obamacare” ineffective.
“The majority of people don’t know what’s in the health reform law unless it has touched someone in their family already,” Cynthia Pearson, executive director of the National Women’s Health Network, said Tuesday in an interview on the Kojo Nnamdi show on NPR.
“How do we keep advocating for people who don’t yet have that good job that offers them insurance or don’t yet have that, you know, really well-paid freelancing business that allows them to pay the cost of the insurance?” Pearson said. “We have to keep working. We’re advocates as well as educators and we are determined not to leave anyone out any longer than we have to…we lost covering everyone so we have to keep working and that’s a job for all of us.”