By Ashley Mayo
With all of the politics surrounding the passage and implementation of the Affordable Care Act, its easy to lose sight of the ways the law is fundamentally improving health care in Colorado and across America. In our state alone, 291,000 children with pre-existing conditions can no longer be denied coverage, 50,000 young adults have gained insurance by staying on their parents plans, and over 200,000 residents will receive rebate checks from insurers who failed to meet the 80/20 rule.
On Aug. 1, Obamacare brings yet another historic reform: insurance companies must cover preventive services for women without cost-sharing.
This provision is great news for both health and gender equity. Women make up just over half the population of the United States, yet they are 29 percent more likely to live in poverty than men, and their salaries are an average of 23 percent lower. These disparities are rooted in complex social problems, but the ACAs new preventive health provisions will provide some relief for the more than 45 million American women, including 20 million with private insurance and 25 million with Medicaid, who will soon gain access to copay-free preventive care.
The seven newly covered services span a wide range of health issues. Effective Aug. 1, women will have access to the following services without co-pays:
- Well-woman visits: At these visits, women receive all necessary preventiveservices, like Pap smears and breast exams, so that health issues can be prevented or identified and treated in early stages. They also get the chance to actually talk with their providers, helping them make informed and empowered decisions about their own health. Well-woman visits save lives; the introduction of the Pap smear as routine care has reduced the cervical cancer death rate among American women by over 60 percent.
- Breastfeeding supplies and support: Pregnant and post-partum women will have access to comprehensive lactation support and counseling, as well as breastfeeding equipment. Breastfeeding is beneficial to both maternal and infant health. In fact, research suggests that if 90 percent of women breastfed exclusively for 6 months, 1,000 infant deaths could be prevented. However, nursing supplies and breast pumps can cost up to $1,000. These costs will no longer prevent women from breastfeeding their children.
- HPV DNA Testing: HPV is a sexually transmitted virus that causes genital warts and cervical cancer. While the Pap Smear, a test given at annual well-woman visits, identifies the virus, women over age 30 will have access to the more advanced HPV DNA test once every three years. The HPV DNA test screens for high cancer-risk HPV strains, and is often conducted after an ambiguous Pap result. However, women will have access to this (free) test even if their Pap results are normal. This screening is an especially important preventive measure, as an estimated 20 million Americans are infected with HPV, with 5.5 million new cases reported annually.
- STI counseling and HIV testing and counseling: Sexually active women will gain access to annual counseling on HIV and sexually transmitted infections (STIs). These sessions have been shown to reduce risky behaviors, yet only 28 percent of women aged 18 to 44 years reported having discussed STIs with their doctor. With copay-free access to testing and counseling, women will be informed and empowered to take control of their own health.
- Contraception and contraceptive counseling: Women will be eligible to receive all Food and Drug Administration approved contraceptive methods, sterilization procedures and contraceptive counseling. Contraception is basic preventive health care for women. Of women ages 15-44, 99 percent who have ever had sexual intercourse have used at least one form of contraception in their lives. Further, contraception use is critical to appropriate birth spacing and intended pregnancy, which result in improved maternal health and better birth outcomes.
- Domestic violence screening: All women will qualify for screening and counseling for domestic and interpersonal violence. Approximately 25 percent of women will be affected by domestic violence during their lives, and these screenings help detect abuse earlier, improving safety and health for women and children.
- Gestational diabetes testing: All women who are 24 to 28 weeks pregnant, as well as those at high risk for this complication, will have access to gestational diabetes testing. About 18 percent of pregnant women will be affected by the disease, which can result in serious complications for both baby and mother if left untreated.
These preventive services are an investment in not only the health of women, but that of their children and partners as well. There are still many barriers for women to break down, but the ACAs new provision brings us one step closer to health and gender equality. For the millions of Coloradans who will benefit from this law, that means that being a women just got a little easier.
Ashley Mayo is the strategic engagement fellow at Colorado Consumer Health Initiative.