What’s next in women’s preventive coverage?
Since August 2012, roughly 55 million American women have been eligible for no-cost coverage for preventive health care including mammograms, screenings for cervical cancer, prenatal care and contraceptive methods.
The contraceptive mandate of the Affordable Care Act has saved birth-control users $1.4 billion according to the Huffington Post. And it’s helped to prevent unintended pregnancies, which costs American taxpayers $21 billion a year, based on a report in the Washington Post.
This issue has been controversial from the start, as exemplified by the Hobby Lobby lawsuit, and the controversy is likely to continue into the future as the topic makes headlines again.
There’s a process underway – the Women’s Preventive Services Initiative (WPSI) – to update the services provided under the Women’s Health Amendment. A panel led by the American College of Obstetricians and Gynecologists released draft updates on September 1, with a public comment period underway throughout the month.
The following changes have been recommended:
- Formalize federal guidance. There’s been a significant amount of guidance and clarification offered over the past few years, which could be formalized through this process. Examples include details like device removal, follow-up care and services including anesthesia and ultrasounds when used for certain birth control methods.
- Cover over-the-counter methods. Currently only prescribed contraceptive methods are covered by insurance, so women pay out-of-pocket for over-the-counter contraceptive supplies like emergency contraception, female condoms and spermicides. This shift will be especially important if oral contraceptive products are approved for over-the-counter sales, which is already a reality in Oregon and California.
- Cover a full-year supply of contraceptives at one time. Research shows that many women can’t (or don’t) obtain monthly refills in a timely manner. Experts say providing an entire year’s supply is cost-effective and improves adherence.
- Correct the “double standard.” Today 18 contraceptive methods used by women are covered, but no-cost coverage is not available for vasectomies and male condoms. This may change. Already, Illinois, Maryland and Vermont have enacted laws to cover vasectomies without patient cost-sharing.
The panel is also accepting new recommendations, and experts are weighing in with their opinions. After the draft recommendation is removed from the public comment page, WPSI will consider comments and finalize the document.
November’s election is sure to lead to additional changes depending on who wins the presidency and which party controls Congress.
Recently Republican nominee Donald Trump caused a stir during his appearance on “The Dr. Oz Show” by stating that birth control should be available to women without a prescription. Although the statement was intended to gain favor with women voters, there was a quick backlash. Women’s advocates note that this switch would raise out-of-pocket costs because insurance doesn’t cover over-the-counter products.
Democratic Party nominee Hillary Clinton has been a long-time advocate of women’s birth control, and has generally garnered more confidence among those who support the Affordable Care Act and want to see it continue.
Although change occurs slowly in Washington D.C., payers and employers can expect shifts in the Women’s Health Amendment in the year ahead.