Menopause Mondays: The Facts About The Affordable Care Act And Women’s Health (Politics Aside)

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Sure, you’ve heard everyone talking about how the Affordable Care Act (ACA) is supposed to curb healthcare spending and improve transparency within insurance companies. While that’s all well and good, far too few people are discussing what matters right here, right now, when our policy options are staring us in the face: how the ACA impacts women’s healthcare. So let’s leave the yelling and shouting to the politicians and talk show hosts—and get down to the facts that impact us.

“It’s apparent that something has been seriously amiss with women’s healthcare in America,” says Vista Health Solutions editor Michael Cahill, who notes that women consistently are subject to higher health insurance premiums than are men, according to the National Women’s Law Center. Plus, according to the Office on Women’s Health, in the United States, nearly one in five women ages 18 to 64 are currently uninsured, and women are twice as likely as men to be insured through a spouse’s plan. These millions of “dependents” risk losing coverage if their spouses are laid off, they get divorced, or their husbands die. Meanwhile, even women who are insured often go without the care they need due to exclusions in coverage. “The Affordable Care Act has the potential to reshape the landscape of women’s healthcare starting in 2014,” Cahill says.

Check out these landmark ways in which the Affordable Care Act will change your healthcare—and your health:

You Won’t Pay More Because You’re a Woman

For years, you have been paying higher premiums for one simple reason: You’re a woman. In most states, insurers have traditionally been allowed to consider gender when setting policy rates. In 2009, 95 percent of the best-selling plans in state capitals practiced gender rating, according to one report, Still Nowhere to Turn: Insurance Companies Treat Women Like a Pre-Existing Condition. As a result, women are often charged more than men for the exact same coverage. For example, the report found that, in 2009, a 25-year-old woman could be charged up to 84 percent more than a 25-year-old man for the exact same individual policy (that means no maternity coverage). Fortunately, gender rating on individual policies as well on small group plans (50-100 employees) is banned under the ACA, according to Cahill. “While this is not a complete stop to this practice, it is certainly a start,” he says.

 

You’ll Receive a Wider Range of Coverage

“The ACA’s essential health benefits serve to bring all health insurance plans up to a new standard of coverage. The idea is this: There are ten different categories of medical benefits that every new health plan has to cover in some capacity,” Cahill says. These include outpatient care, emergency-room visits, inpatient care, pre- and post-natal care, mental health treatment, prescription drugs, recovery services, lab tests, pediatric services, and preventative services. “While specific healthcare benefits may vary by state and even within the same state, one category that does have some specific services mandated is preventative care,” he says. For women this includes annual well-woman visits, routine mammograms, cervical cancer screenings, contraceptive methods, breastfeeding equipment, and more. It seems logical to include all of these areas, right? But before the ACA was enacted into law, insurance companies were able to exclude any and all of these from coverage. In fact, according to one 2009 report, that year, only 13 percent of health plans available to 30-year-old women provided maternity coverage. Check out HRSA.gov for a full list of women’s preventative services.

Your Past Won’t Prohibit Future Care
Who hasn’t been sick or injured in the past? Come on, that’s why we get health insurance, right? While insurers have traditionally been able to refuse to cover any costs associated with care for a pre-existing condition permanently or over a period of time, that ends with the ACA, Cahill says. For women this means that past cases of breast cancer, uterine fibroids, cesarean sections, domestic abuse, as well as current pregnancies won’t stand between you and getting the continuing care you need. That’s right, until now, health insurance companies could refuse to sell healthcare insurance to pregnant women, and in a recent CNN article, one woman shared how an insurance company said that, due to her previous cesarean section, the company would not cover her unless she was first sterilized. It’s astonishing these sorts of practices were allowed for so long.

“All of these things coalesce into a notably better healthcare situation for women,” Cahill says. “Many women won’t have to worry about being charged a higher premium than a man, and every woman can benefit from the services provided by the essential health benefits.” So, ladies, when you are filling out your healthcare forms this year, focus on your health needs and the new opportunities to have them covered. This year women nationwide are able to secure the healthcare, equality, and happiness they deserve!

 

Reaching out is IN! Suffering in silence is OUT!

After struggling with her own severe menopause symptoms and doing years of research, Ellen resolved to share what she learned from experts and her own trial and error. Her goal was to replace the confusion, embarrassment, and symptoms millions of women go through–before, during, and after menopause–with the medically sound solutions she discovered. Her passion to become a “sister” and confidant to all women fueled Ellen’s first book, Shmirshky: the pursuit of hormone happiness. As a result of the overwhelming response from her burgeoning audiences and followers’ requests for empowering information they could trust, Ellen’s weekly blog, Menopause MondaysTM, was born.

  • Julie

    I saw your blog about menopause and the ACA. I just had my annual well-woman exam, which is supposed to be covered with no co-pay, but I received a bill for a co-pay. When I enquired, I was told that because of the ACA, if my doctor discusses my menopausal issues and HRT with me (even though I’ve been on it for several years), they have to charge it as an additional office visit, where that wasn’t the case prior to ACA. Could it be true that ACA is taking away benefits for older women?

    • Ellen Dolgen

      Julie, I am so sorry to hear that. Are you on a healthcare exchange, private insurance or medicaid?

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