By Jennifer Mezey, National Women’s Law Center
In a significant victory for women and girls, the US Department of Health and Human Services announced this week that all new insurance plans would be required to cover a wide range of preventive services aimed at women’s health – without cost sharing — starting in the first plan year after August 1, 2012 (for many plans, January 1, 2013). This recently announced list of preventive services will be added to an existing list of services that all new plans were required to cover starting the first plan year after September 23, 2010 (for many plans, January 1, 2011). This expanded coverage is brought to you courtesy of the Affordable Care Act.
Included among the preventive services that many plans started providing with no cost sharing for women and girls as of January 1, 2011 are:
(1) Mammograms for every 1-2 years for women over 40;
(2) Cervical cancer screening;
(3) Smoking and alcohol cessation programs for adults;
(4) A wide range of prenatal screenings and tests;
(5) Diabetes and blood pressure screening and counseling; and
(6) Depression screening for adolescents and adults.
Added to this list are the newly announced preventive services for women which will be covered at no cost by many plans starting on January 1, 2013, including:
(1) Lactation consultation and supplies;
(2) Screening and counseling for interpersonal and domestic violence;
(3) Screening for gestational diabetes;
(4) DNA co-testing for HPV;
(5) Counseling regarding sexually transmitted infections including HIV;
(6) Screening for HIV;
(7) Contraceptive methods and counseling; and
(8) Well woman visits.
For a complete list of all of the covered services and vaccinations, please see http://www.uspreventiveservicestaskforce.org/uspstf/uspsabrecs.htm, http://brightfutures.aap.org/3rd_Edition_Guidelines_and_Pocket_Guide.html, http://www.immunize.org/catg.d/p2010.pdf and http://www.hrsa.gov/womensguidelines/.
That these services will be covered with no cost sharing is an acknowledgment of the importance of preventive services and the barriers faced by many in accessing these services. Through screening and counseling, obesity and diabetes can be identified and treated before the conditions worsen. Cervical and colorectal cancer screenings as well as mammograms can identify cancers before they spread. Prenatal screening and services can identify and address problems before they become dangerous for pregnant women and their children. But with all the good preventive services can do, cost can be a barrier, particularly for low and moderate income individuals and families. A study by the Commonwealth Fund found that nearly half (45%) of women and more than one-third (36%) of men report delaying or not receiving a cancer screening or dental exam because of its cost.
HHS will be defining an additional package of benefits in future regulations defining the “essential health benefits package.” This package will have to be covered by all insurance plans in the Exchange, all plans in the individual and small group markets and Medicaid benchmark plans. The ACA requires that the essential health benefits package include coverage of maternity care, mental health treatment, prevention and wellness and other categories of services to be defined by HHS.
The bottom line is this – thanks to the ACA, in 2014, millions of women, girls and their families will have access to a broad range of affordable preventive and treatment services that can improve their health in the short and long term.
(The views expressed by guest bloggers do not necessarily
reflect the views of Georgetown University Health Policy Institute’s Center for
Children and Families.)