No more struggling to find co-pay dollars for Contraception!

Written by Keely Monroe, Raising Women's Voices

Today is a day for millions of women like me to celebrate!

For the first time, our country is requiring all new health insurance plans to cover contraception – and do it without charging us co-pays and deductibles. It’s all because of the women’s preventive services provision of the new health care law (the Affordable Care Act).

This is a big deal for me as a young woman who uses birth control because it hasn’t been the right time for me to become a mom. As a young professional living in Washington, DC, where the cost of living is high, I have found that the monthly co-pays for my contraceptives take a real bite out of my budget.

I am relieved and thankful that starting today, the health care law is going to begin to change all that for me and for all those women struggling to find co-pay dollars for care we can’t do without!

This new requirement will apply to coverage for a wide range of contraceptive methods – including birth control pills, IUDs and even tubal ligations that are popular with women in their 30s and 40s. It also covers the contraceptive counseling visit with your doctor to figure out which is the best method for you.

When will this great new coverage requirement go into effect for you? It applies to all new health insurance plans beginning today, but will go into effect with the beginning of your new “plan year.” So, student health plans, which generally start with the new school year in late August or early September, are likely to be the first to include this benefit. Other new plans may not incorporate the change until January, which is typically the start of health plan coverage years.

What about existing health insurance plans? They will have to comply with this requirement as soon as they make enough routine policy changes to be considered “new” under the health care law. It’s estimated that could take until 2014 for some existing plans. Call your health insurer or your employer’s human resources office to find out what you will get this great new coverage. 

So this is what’s in it for women: Affordable contraception, well woman visits, important screenings and counseling for intimate partner violence, counseling for sexually transmitted diseases (including HIV), breastfeeding equipment and counseling and diabetes screening when you’re pregnant.

So thanks, health care law, for helping me and millions of women to stay healthy!

Affordable Birth Control Becomes a Reality for Millions More Women

Written by Clare Coleman, guest blogger, National Family Planning & Reproductive Health Association (NFPRHA)

Today, the Affordable Care Act (ACA) gives women across the country a reason to celebrate. August 1 marks the beginning of a new health benefit: all women with new insurance plans will be able to access all FDA-approved contraceptive methods and other preventive health services with no co-pay, a long-standing barrier to care for millions of women.

The coverage requirement is welcome news for many women who are struggling to make ends meet. The policy change means that women will be able to pick up their birth control method of choice from their family planning health center, pharmacy, or other health care provider without having to balance expenses like groceries or rent to meet their basic health needs. Not only will more women now be able to afford routine preventive health services, they will also receive the necessary information and counseling they need to make the best health choices for themselves, their partners, and their families at every stage of their lives.

Today, our country takes monumental steps towards affordable health coverage for women and recognition of contraceptive care as basic care. Don’t let this moment pass! Do your part to educate yourself and others about the women’s health preventive services benefit, so that you can benefit from the coverage and be an advocate with everyone you know. Talk to your employer or human resources office, and insurance provider to find out the details of the new coverage for your specific insurance plan. Talk to your family and friends, and other important women in your life to ensure they know what a huge leap forward we are taking towards reducing unplanned pregnancy, improving health outcomes, and removing barriers to basic care for so many.

The protection of contraceptive coverage is affirmation that women shouldn’t pay more for basic preventive health care – and that is a reason to celebrate! 

The National Family Planning & Reproductive Health Association (NFPRHA), founded in 1971, is a non-profit membership organization established to assure access to voluntary, comprehensive, and culturally sensitive family planning and reproductive health care services and to support reproductive freedom for all.

MamaCare for Women of Color!

Written by Rebecca Spence, American Pacific Islander American Health Forum
and Marissa Spalding, Black Women’s Health Imperative

We love MamaCare! Thanks to the health care law, on August 1 all new health insurance plans will have to provide pregnant women with coverage for gestational diabetes screening without charging us expensive co-pays and deductibles. Women of color and their babies stand to gain the most from this enormous benefit.

So, why do we see screening and treatment for this condition as an essential benefit for women of color?

Women of color with gestational diabetes are at high risk of preterm birth, cesarean sections, extra large babies, and high blood pressure (preeclampsia). Also, children born to mothers with gestational diabetes are at increased risk of obesity and developing type 2 diabetes themselves.

While very little is understood about the significant differences between ethnic groups and subgroups, we do know that Asian American, Native Hawaiian, and Pacific Islander (AA and NHPI) women are more likely to suffer from gestational diabetes than are  women of other racial and ethnic groups.  In fact, Asian and Pacific Islander women in one county in California had the highest rate of gestational diabetes among all racial and ethnic groups, nearly twice the rate of White women.  Among all AA and NHPI women who develop gestational diabetes, Native Hawaiian and Filipino women are more likely to suffer the poorest outcomes.

Gestational diabetes also has a serious impact on Black women. Although gestational diabetes resolves after pregnancy, Black women who develop diabetes during pregnancy are nearly  10 times more likely to develop type 2 diabetes than women of other racial and ethnic groups. Women of color and their babies are also at increased risk of developing complications during pregnancy.

Given these differences in incidence of gestational diabetes among our communities, we are glad that this is one of many provisions that will be in effect in all new health insurance plans starting on August 1.   Pregnant women between 24 and 28 weeks of gestation—or at the first prenatal visit for pregnant women identified to be at high risk for diabetes— should have coverage for gestational diabetes without expensive co-pays. Because of the new health care law, this coverage will be in all new health plans, and will be phased into existing health plans as they make enough routine policy changes to qualify as “new” plans under the law.

We believe the health care law will close the gap in care and treatment by providing women of color access to a broad range of preventive services. MamaCare also ensures that women with gestational diabetes can continue to get screening after giving birth in order to monitor their health.

MamaCare will help women of color have healthy pregnancies and healthy babies. That’s what MamaCare is all about!

For more information on the importance of gestational diabetes screening, please visit the Asian Pacific Islander American Health Forum website.

New coverage for tests to protect your fertility and health!

Written by Stephanie S. Arnold Pang, guest blogger, National Coalition of STD Directors

Sexually transmitted infections (STIs) and resulting diseases (STDs) such as chlamydia remain a major epidemic in the United States. Each year, there are approximately 19 million new cases, approximately half of which go undiagnosed and untreatedi, giving the United States the highest STD rate in the industrialized world.ii STDs cost the U.S. health care system $17 billion every year—and cost individuals even more in immediate and life-long health consequences, including infertility, higher risk of acquiring HIV and certain cancers.iii

This is why my organization, the National Coalition of STD Directors (NCSD), is particularly excited about the August 1^st implementation of the provision in the health care law that requires new health insurance plans to cover certain women’s preventive services with no co-pay. Included in this provision is insurance coverage of STD screening and counseling. This is a perfect tie-in to  our  mission--- NCSD is a partnership of public health professionals dedicated to promoting sexual health through the prevention of STDs. 

As we know, anyone who is sexually active can get an STD. However, certain groups are at particular risk, such as women, youth and young adults, people of color, incarcerated persons, and men who have sex with men (MSM). A disproportionate burden of STD-associated complications are born by women and infants and a number of women’s health problems --  including infertility, ectopic pregnancy, and chronic pelvic pain – are linked to unrecognized or untreated STDs.iv Regular screening is critical and now, as a result of health care reform, will be made easier with increased insurance coverage of STD screenings for women.

Screenings for the most common bacterial STDs (Chlamydia, gonorrhea, and syphilis) are already covered without co-pays but now screenings for the most prevalent STD-- the human papillomavirus (HPV) are included. HPV is the virus that causes almost all cases of cervical cancer, a cancer that is almost entirely preventable through prevention, screening and early detection. Because of the new health care law, women over 30 will now have insurance coverage without copays of high-risk HPV DNA testing to determine if she has a strain of HPV that increases her chance of developing cervical cancer.   

I will say that again— women with new insurance plans will now have coverage without copays to determine if  we are at high risk for cervical cancer before that cancer develops. (The coverage requirement will be phased into existing insurance plans.) This testing, coupled with fact that the new health care law also expands health insurance coverage of the HPV vaccine, will drastically reduce a woman’s likelihood of  being one of the 4,000 U.S. women who currently die each year of this preventable and treatable disease.

This provision also includes insurance coverage without co-pays of high intensity behavioral counseling to prevent STDs for all sexually active adolescents and for adults at increased risk. This provision is a deep change to our health care system-- for the first time, insurance companies will now cover not only the treatment of a disease, but education and training to keep that disease from occurring in the first place. We have additional steps ahead to ensure this is correctly implemented, but this is an enormous step in the direction of sexual health. 

With this part of the health care law going into effect August 1, we are on our way to developing not just a sick-care system but a real health care system.  While this is an amazing start to focus on the prevention of disease, and not just treating it, there is still work to be done for STD screening in certain populations who are especially at-risk, such as men who have sex with men. We look forward to continuing to work with partners to expand access to vital preventive service without expensive copays for more Americans and are proud to support this expansion of preventive care in the Affordable Care Act.

Stephanie S. Arnold Pang is the Manager, Policy and Communications at the National Coalition of STD Directors (NCSD), where she manages all policy and advocacy matters with a specific focus on policymaker education efforts at the federal level with the legislative and executive branches of government.  Prior to joining NCSD, she was a senior Legislative Aide for U.S. Senator Patty Murray (WA), working on issues of sexual and reproductive health and health care reform and also worked at the National Family Planning and Reproductive Health Association (NFPRHA).  Stephanie holds a Bachelor of Arts in Political Science from Beloit College.  She can be reached at sarnold [at] ncsddc.org.

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[i] Centers for Disease Control and Prevention. 2008 Sexually Transmitted Disease Surveillance. Nov. 16, 2009. 

[ii] Public Health Agency of Canada. Report on Sexually Transmitted Diseases in Canada: 2008. Mar. 9, 2011. Retrieved from http://www.phac-aspc.gc.ca/std-mts/report/sti-its2008/06-eng.php.

[iii] Centers for Disease Control and Prevention. Sexually Transmitted Disease Surveillance 2010. Atlanta: U.S. Department of Health and Human Services; 2011.

[iv] Eng t, Butler W. The Hidden Epidemic: Confronting Sexually Transmitted Diseases, Executive Summary. Committee on Prevention and Control of Sexually Transmitted Diseases, Institute of Medicine. 1997. 

No More Duck and Cover: Preventing Domestic Violence in the New Health Law

Written by Sally Schaeffer, Futures Without Violence

While the Violence Against Women Act (VAWA) reauthorization has been stalled in Congress this year, how about a bit of good news for women who care about stopping this kind of violence?

Starting next week on August 1st, a new women’s health provision that was part of the new health care law,  the Affordable Care Act , will take effect. It ensures that women and adolescent girls receive annual preventive health services with no co-pays. Among the services that will be covered by new insurance plans (and eventually, existing plans), are screening and counseling for domestic and interpersonal violence. This means that women and girls who have been hurt by violence and abuse will be far more likely to get help and also receive better health care because providers will know more about how to help them get healthy and be safe.

Importantly, screening and counseling by a health provider has been shown to make a difference in health outcomes for women. One study found that when screening is coupled with education, harm reduction and referrals to domestic and sexual assault services, violence can be reduced and the health status of women improved. Research has also shown that there are no harmful effects of screening and that women usually appreciate being asked and given the chance to get help as long as it’s done in a supportive way.

Yolanda’s story also reminds us of why this provision is so important. As a young mother of three, Yolanda found herself in an abusive marriage. Her husband was frequently violent, and one night punched her in the face and split her lip, which sent her to the emergency room. As she sat on the examination table, the physician who was stitching her lip asked: “Who did this to you?” Yolanda mustered her courage and quietly said: “My husband.” The physician responded by telling her she needed to learn how to duck better.

Yolanda spent the next several years learning how to duck before finally leaving that abusive relationship. Empowered by her experience, she went to medical school, became a doctor, and now teaches students at a prestigious university the importance of identifying and treating domestic violence and sexual assault.

Thanks to dramatic health care reforms like the new health care law, as well as the hard work of advocates and health care providers over the last 20 years, we’re pretty confident that Yolanda’s ER doctor today would be more attentive to her needs, and would refer her to the appropriate community and health services.

But we need to be sure that’s the case and that is why these new provisions are so important. The new health care lawtakes an important step to pro-actively encourage health care providers to better identify the signs of domestic and interpersonal violence, and it features important provisions for health insurance companies so that they can no longer deny coverage to a woman based simply on a history of domestic violence. This is a part of health care reform we call can be proud of.

For more information on the importance of intimate partner violence screening and counseling, please visit the Futures Without Violence website.  

Breastfeeding Gets Easier with New Health Law

Written by Sheila Sanders, guest blogger, Illinois Maternal and Child Health Coalition

I am a proud breastfeeding mom and it gives me great joy to know that because of my choice to breastfeed, I gave my children the best possible start at life. Breast milk provides disease-fighting antibodies that can help protect infants from several types of illnesses and is easier for babies to digest than formula. Mothers who breastfeed also see health benefits, including a decreased risk of some health problems, such as breast and ovarian cancer. Most importantly, breastfeeding helps to deepen the bond between mother and child. 

That’s why I’m so excited that starting this Wednesday, new private insurance plans will be required to cover breastfeeding support (from a lactation counselor) and supplies (like rental of breast pumps) without a co-pay or deductible.  This requirement is because of the Affordable Care Act health insurance law.

Doing what was best for my children didn't come without sacrifice. As a mother of two, working full time and maintaining a home (with a dog) has made it difficult to continue breastfeeding. I've faced many struggles balancing a new baby with a demanding toddler, finding the right time and place to pump (even in a very supportive workplace), and just getting through the day with a serious case of mommy brain. WOW!  I am learning with my second child that you can never be too prepared when entering this chapter of life.

As many moms do, I internalized a lot of these struggles. I didn't want to seem inadequate or give off the impression that I couldn't do it. Then it clicked that I could talk to other breastfeeding moms. Learning that I wasn't the only one who has experienced these problems has made a tremendous difference. I tell every breastfeeding woman that I meet how important it is to build a network of support. I encourage them to reach out to friends, family members, and coworkers and not to be afraid of leaning on those people when needed. It can make all the difference when you have someone to watch the kids for an hour or two, help cook dinner, or just make a quick phone call to see how you are doing.

Another important resource is my lactation counselor. My counselor provides constant support and empathy, while suggesting solutions that I never could have come up with on my own. She is the one that encouraged me to build my own circle of support and she is the one that kept me going any time I felt like the burden was too great.

I have struggled as a breastfeeding mom, even with so much going for me; and, as someone who works in community outreach, I know that I am one of the lucky ones. So many moms want to do what is right for their child, but lack the financial or social resources to breastfeed successfully. Fortunately, there is a great new provision in the health care law that kicks in on August 1, which provides support for breastfeeding women by eliminating some of the financial barriers. Starting this Wednesday, new private insurance plans will be required to cover breastfeeding support (from a lactation counselor) and supplies (like rental of breast pumps) without a co-pay or deductible.  

The Affordable Care Act is changing the way that women access health care for the better, and the provisions taking effect on August 1 are a stunning example. By eliminating some of the barriers women face when breastfeeding, this law is supporting women and ensuring a healthy future for the next generation.

Sheila Sanders lives in Chicago with her two beautiful children, husband, and dog. She works for the Illinois Maternal and Child Health Coalition. Sheila can be reached by email at ssanders [at] ilmaternal.org

Help is on the Way: Breastfeeding Support for Healthier Moms and Babies

Written by Amy Romano, guest blogger, Childbirth Connection

This year, World Breastfeeding Week coincides with a major milestone for mothers: on August 1, the women’s preventive health provisions of the Affordable Care Act (ACA) go into full effect. Every new insurance policy will now begin covering breastfeeding equipment and lactation support services without co-pays.

Leading professional groups recommend exclusive breastfeeding for the first six months of life, with some breastfeeding continuing through at least the first year. That’s because of the tremendous health benefits to both women and children – including lower rates of infections, obesity, sudden infant death syndrome and asthma in children and reduced risk of breast and ovarian cancers in mothers.

But women are not meeting their breastfeeding goals. New Mothers Speak Out, Childbirth Connection’s report of postpartum experiences of the national Listening to Mothers II survey participants, reported:

• while 61% of women intended to exclusively breastfeed as they approached the end of pregnancy, just 51% were exclusively breastfeeding one week after birth
• only 46% of women breastfed as long as they had wanted
• 16% of employed mothers reported that breastfeeding issues were “a major challenge” in the transition to employment.

Eliminating the cost of skilled breastfeeding support means more women can get support and information to prepare for breastfeeding, proper assessment in the early postpartum period, and help troubleshooting any breastfeeding problems that arise. Eliminating the cost of breast pumps can help women exclusively breastfeed even after returning to employment or other duties.

These changes are part of a larger national picture of integrated strategies to increase both the number of women who breastfeed at all and the duration of exclusive breastfeeding. A major federal commitment to increase the number of Baby-Friendly Hospitals through the Best Fed Beginnings Collaborative will help ensure that more women and babies get off to a good start with breastfeeding. Another ACA provision, already enacted, requires most employers to provide private space and reasonable break time for breastfeeding mothers to pump at work. More work is needed to address cultural attitudes, clinician education, family leave policies, and access to affordable, high-quality child care.

Childbirth Connection is pleased to celebrate World Breastfeeding Week and the health reform preventive services milestone with our sister organizations working to improve the health of women and families. Here are some links to more information.

• For more about breastfeeding, check out Childbirth Connection’s brand new Breastfeeding Resources Page.
• For more about the new health law and coverage for preventive services like breastfeeding support, visit Countdown to Coverage, the public awareness campaign by Raising Women’s Voices. You can find out more about when your health plan might begin covering breastfeeding supports and other women’s preventive services. (Some new health plans may not incorporate these provisions until their new plan year begins on January 1, 2013. Existing health plans may not have to comply for another year or so. You may want to call your health insurance plan to ask when these provisions will go into effect. )
• For more about World Breastfeeding Week, visit the global campaign web site: Understanding the Past, Planning the Future.

Amy Romano directs the Transforming Maternity Care Partnership for Childbirth Connection. Childbirth Connection is a 94 year old organization working to improve maternity care through consumer engagement and health system transformation. 

New Coverage of Breastfeeding Support, Supplies, and Counseling

Written by Megan Renner, guest blogger, US Breastfeeding Committee

For breastfeeding mothers and advocates, this August 1 means more than the usual start of World Breastfeeding Week and National Breastfeeding Month. It is also the date after which new health plans will be required to cover breastfeeding support, supplies, and counseling without a co-pay, coinsurance or deductible. (Read an explanation of how this takes effect.)

Every year roughly four million women give birth in the United States, and more than three out of four of them start out breastfeeding.i Study after study has affirmed the value of breastfeeding in protecting both mothers and children from a host of acute and chronic diseases and conditions.ii It saves billions in health care costs.iii Breastfeeding mothers also report feeling more closely bonded with their babies—a factor which may lower the risk of postpartum depression.

But many women who choose to breastfeed have to stop sooner than they want to (or are discouraged from even starting), due to a number of barriers, including lack of knowledge, social norms, poor family/social support, lactation problems, returning to work or child care, and deficits in health services.

Women who encounter lactation problems early on, who experience concerns about milk supply, or who receive conflicting advice from their health care providers are less likely to continue to breastfeed without professional assistance. Now, thanks to this new coverage, many more families will have access to comprehensive lactation support and counseling by a trained provider during pregnancy and in the postpartum period, regardless of their ability to pay.

We know that 70% of families with children have either a single parent who works or two parents who both work.iv Nearly 4 out of 10 women serve as the primary breadwinner in their familiesv, and returning to work is continually cited as a primary reason for early weaning. When mother and child are separated for more than a few hours, the mother must express milk to maintain her supply and avoid complications. Again, thanks to this new coverage, the cost of breast pump rental and supplies will no longer stand in the way of breastfeeding success when mothers must be separated from their infants.

Surgeon General Regina Benjamin has called on the entire nation to support the removal of barriers that can stand in the way of a mother reaching her personal breastfeeding goals. The Surgeon General’s Call to Action to Support Breastfeeding is an unprecedented document from the nation’s highest medical source, based on the latest evidence about the health, psychosocial, economic, and environmental effects of breastfeeding.vi In it the Surgeon General calls on health care providers, employers, insurers, policymakers, researchers, and the community at large to take 20 concrete action steps to support mothers in reaching their personal breastfeeding goals. The new Women’s Preventive Services coverage contributes toward the implementation of actions in at least three of the six sections of the Call to Action (mothers and families, health care, and employment).

While the barriers to breastfeeding success are very real, the solutions are known and increasingly within reach. The Women’s Preventive Services coverage of breastfeeding support, supplies, and counseling is now an established part of the expanding “landscape of breastfeeding support.” This is a tremendous step forward on our journey to ensure that all mothers have the support they need and deserve to reach their personal breastfeeding goals.

To learn more about actions to support breastfeeding families across the country, join the conversations on Facebook and Twitter August 6-31 for the "Everyone Can Help Make Breastfeeding Easier": 20 Action in 20 Days campaign.

The United States Breastfeeding Committee (USBC) is an independent nonprofit coalition of more than 40 nationally influential professional, educational, and governmental organizations. Representing over one million concerned professionals and the families they serve, USBC and its member organizations share a common mission to improve the Nation’s health by working collaboratively to protect, promote, and support breastfeeding. For more information on the USBC, visit www.usbreastfeeding.org.

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i Breastfeeding: Data and Statistics: Breastfeeding Report Card—United States, 2011. U.S. Department of Health and Human Services, Centers for Disease Control and Prevention Web site.

http://www.cdc.gov/breastfeeding/data/reportcard.htm. Accessed July 27, 2010.

ii Ip S, Chung M, Raman G, Chew P, Magula N, DeVine D, Trikalinos T, Lau J. Breastfeeding and Maternal and Infant Health Outcomes in Developed Countries. Rockville, MD: Agency for Healthcare Research and Quality; 2007. Evidence Report/Technology Assessment No. 153.

iii Bartick M, Reinhold A. The burden of suboptimal breastfeeding in the United States: a pediatric cost analysis. Pediatrics. 2010;125(5):e1048-e1056.

iv Taubman P. Free Riding on Families: Why the American Workplace Needs to Change and How to Do It (issue brief). Washington, DC: American Constitution Society; 2009.

v The Shriver Report: A Study by Maria Shriver and the Alzheimer’s Association. The Shriver Report Web site. http://www.shriverreport.com/index.php. Accessed November 16, 2009.

vi U.S. Department of Health and Human Services. The Surgeon General’s Call to Action to Support Breastfeeding. Washington, DC: U.S. Department of Health and Human Services, Office of the Surgeon General; 2011.