WebMD Medical News
Daniel J. DeNoon
Laura J. Martin, MD
Aug. 1, 2011 -- Health care reform requires new insurance plans to fully cover women's preventive care, which now will include free birth control, yearly wellness visits, breastfeeding counseling and equipment, and screening for gestational diabetes, domestic abuse, HPV, sexually transmitted infections (STIs), and HIV.
Health and Human Services Secretary Kathleen Sebelius today announced the expanded definition of women's preventive care. The ruling closely follows the advice of an Institute of Medicine expert panel, released July 20.
"Today, as part of the Affordable Care Act, we are announcing historic new guidelines that will help women get the care they need to stay healthy," Sebelius said at a news teleconference. "Today we are accepting the recommendations of the Institute of Medicine, so no woman in America needs to choose between paying a grocery bill and paying for the key care that can save her life."
The new requirement does not affect health plans in effect before March 23, 2010. These "grandfathered" health plans include most employer-sponsored plans. However, the majority of employer plans already cover contraception.
Starting August 2012, new health plans will have to offer the expanded wellness coverage without requiring a co-payment. Insurers may "use reasonable medical management to help define the nature of the covered service," according to the Department of Health and Human Services (HHS).
Howard Koh, MD, HHS assistant secretary for health, estimated that by 2013, 34 million U.S. women ages 18 to 64 will receive the benefits spelled out in the new ruling. While preventive care saves money by avoiding or delaying more costly chronic disease care, Koh said the new benefits would mean a "small" increase in premium costs.
The new definition of women's wellness includes access to all FDA approved forms of birth control. The so-called abortion pill RU-486 and similar drugs are not covered.
Religious institutions that offer health insurance to their employees may choose not to offer birth control, according to an amendment to the prevention regulation proposed by the Obama administration. The HHS says it "welcomes comment on this policy."
Preventive services that will be covered without co-pay include:
Mammograms and cervical cancer screening already are covered, without co-pay, under the Affordable Care Act. The law also makes preventive services free for women on Medicare.
SOURCES:News teleconference with HHS Secretary Kathleen Sebelius and HHS Assistant Secretary for Health Howard Koh, MD.News release, Department of Health and Human Services.HHS web site.FDA web site.
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