Health Reform: No-Cost Contraception Starts Today

Health Reform Law to Extend 8 Free Preventive Health Services –- From Birth Control to Breastfeeding Support -– to 47 Million Women

By Lisa Zamosky
WebMD Health News

Reviewed by Louise Chang, MD

Aug. 1, 2012 -- Today ushers in a new provision of the health reform law that makes additional preventive health services -- from contraception to HPV testing -- available for free to an estimated 47 million women.

Women with health plans that start on or after Aug. 1, 2012, must now be allowed access to eight new preventive health services with no co-pays or deductibles. The eight new services available starting today are:

  1. Well-woman visits
  2. Gestational diabetes screening
  3. Domestic and interpersonal violence screening and counseling
  4. FDA-approved contraception, including contraceptive education and counseling
  5. Breastfeeding support, supplies, and counseling
  6. HPV DNA testing for women aged 30 or older
  7. Counseling for sexually active women about sexually transmitted infections
  8. HIV screening and counseling for sexually active women

These services build upon a roster of existing preventive care that the health reform law, officially called the Affordable Care Act (ACA), already makes available, free of cost, to people with private insurance and Medicare, including annual wellness visits, cholesterol, and other cardiovascular screenings, and cancer screenings including mammography, colonoscopy, and screening for cervical cancer.

The eight services were recommended to the Department of Health and Human Services by the independent Institute of Medicine after an extensive scientific review.

Support for the Services

The American Congress of Obstetricians and Gynecologists (ACOG) hailed the ACA's inclusion of additional women's preventive health services as an important step toward making necessary health care available to more women.

"Today, our nation affirms the importance of a woman's ability to access needed preventive care," ACOG President James T. Breeden, MD, says in a news release. "An annual well-woman visit is a fundamental part of medical care and promotes prevention practices, recognizes risk factors for disease, identifies medical problems, and establishes the often life-long patient-physician relationship. This annual visit provides an excellent opportunity for ob-gyns to counsel patients about maintaining a healthy lifestyle and minimizing health risks."

Breeden adds that contraception, which is already covered by most employer-sponsored plans, plays an important role in optimizing women's health before pregnancy and childbirth, ultimately leading to healthier pregnancies and babies.

Contraception Controversy

The law has always allowed churches and other religious organizations the choice of either buying or sponsoring group health insurance that does not pay for contraception if doing so is counter to their beliefs.

But religious-affiliated groups such as universities and hospitals were not included in this exemption.

This caused an uproar among many religious groups, most notably the Catholic church. The Obama administration says it has a compromise. The insurance companies providing health plans to employers with religious affiliations will be required to cover the cost of contraceptives, not the employer. The Obama administration extended the time until August 2013 for religious institutions to comply with the law.

Removing a Barrier to Prevention

Eliminating costs associated with women's preventive health services has been identified as an important factor in removing a major barrier to needed care.

A 2009 report by the Commonwealth Fund found that more than half of women -- up by more than 25% from 2007 -- delayed or avoided preventive care because of cost. In addition, the government cites a study that found women's use of mammograms went up by as much as 9% when costs for the screening were removed.

Although the provision takes effect today, most women won't gain access to free preventive services until the start of their plan year. For most Americans, that's likely to be in January 2013, when most health insurance policies renew.

Grandfathered health plans -- those already in place when the Affordable Care Act became law in March 2010 and that haven't made significant changes to their benefits -- are exempt from the new requirement.


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SOURCES: News release, U.S. Department of Health & Human Services. Newsroom: "Affordable care act rules on expanding access to preventive services for women." News release, The American Congress of Obstetricians and Gynecologists. WebMD Health News: "Health Care Reform: Questions and Answers."

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