HHS Guidelines For Women’s Healthcare

HHS today announced new PPACA guidelines pertaining to women’s health, listing several services that must be covered by health insurance plans with no cost sharing by the insured.  In scrolling through healthcare news this morning, I saw numerous headlines stating that birth control and breast pumps must be covered by health insurance with no copays.  This is true, but the requirements don’t take effect for another year (August 1, 2012) and will apply to new policies that begin on or after that date.  

The list of women’s health services that will be covered in full by new plans starting next August includes HPV testing for women age 30 and older, well woman exams, breastfeeding support and supplies, domestic violence screening and counseling, testing for gestational diabetes, HIV and other STI testing and counseling, and FDA-approved contraception (there is a wide range of FDA-approved contraception for women, including sterilization.  I haven’t yet been able to determine whether something as expensive as sterilization would be included in the list of things that new policies would have to cover without cost sharing).

As with any other mandate, this will result in increased health insurance premiums. What’s the risk?  The services won’t be “free”… we’ll still have to pay for them, but we’ll do so via our health insurance premiums and the cost will be spread to the insured population rather than being placed primarily on the women using the services.  Numerous studies have found that even small copays tend to reduce the number of people seeking medical services, and HHS has determined that the women’s healthcare services included in this mandate are important enough that no woman should have to skip them for financial reasons.  Of course, this assumes that she has the money to purchase health insurance or is eligible for an employer-sponsored or public health insurance program.

We don’t yet know how these new guidelines will impact premiums.  They are scheduled to take effect 17 months before the major changes that the PPACA will bring starting in 2014 (guaranteed issue individual plans and a mandate requiring that everyone have health insurance – assuming that the mandate survives the courts).  Once the mandate requiring everyone to have health insurance goes into effect, it would seem that the impact of the women’s healthcare mandate would be lessened, since more people will be paying into the health insurance pool (and not every woman will be using all of mandated services).  Regardless, I think that the HHS guidelines signify a step forward for women, and will no doubt be helpful in terms of increasing access to vital healthcare services.

About Louise Norris

Louise Norris has been writing about health insurance and healthcare reform since 2006. In addition to the Colorado Health Insurance Insider, she also writes for healthinsurance.org, medicareresources.org, Verywell, Spark by ADP, and Boost by ADP, and Gusto. Follow on twitter and facebook.

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