How new 'women's health' rules in health care law could affect you ; Anne Arundel county women could save hundreds annually with new health insurance mandate, officials say
Once a month, Dr. Henry Sobel or one of his colleagues from the Anne Arundel Medical Center's gynecology department drives to a downtown Annapolis medical clinic.
Located at the Stanton Community Center, the outreach clinic offers free specialty care from AAMC physicians. Thursday was Sobel's day.
To him, there isn't a better picture about how some area women need better health coverage, he said.
"This is a safety net for these women who might otherwise not be able for afford it," said Sobel, chairman of Women's and Children's Services at AAMC.
But in the next year and a half, he and other health experts say women should have better access to health care. Last week, a key provision of the federal health care law known as the Affordable Care Act took effect requiring new insurance plans to include certain coverage for women's health.
The most publicized -- and controversial -- piece of that provision requires insurers to cover contraceptive services. But the law also requires eight different categories of health services, like the "Well Woman" physical examination and breast-feeding consultation services and supplies, to be covered.
In Anne Arundel County, it's estimated about 10 percent of the population -- or more than 40,000 people -- are uninsured. But with national estimates of about 20 percent those with insurance are actually considered "under insured," this provision could impact thousands more.
Most women won't see the changes right away.
"This only applies to new plans that haven't been created or released until now," said Dr. Karoline Mortensen, an assistant professor in the University of Maryland School of Public Health'sDepartment of Health Services Administration.
"Over time, it will affect everyone," she said. "If an employer makes a big enough change to their health plan, it will be impacted. If an employer simply allows employees to re-enroll and doesn't make substantial changes, changes won't take place until 2014 when the rest of the bill takes effect."
This will open up access for mammograms, pap tests and other annual tests affiliated with women's reproductive health who didn't have those screening tests covered before, said Kathy Jo Keever, an Anne Arundel Community College nursing professor.
'Well Woman coverage
It also opens full coverage on the annual "Well Woman" visit, which includes a pelvic exam that is recommended for women's reproductive health, Mortensen said.
"Women who delay these types of services often say they delay those services because of cost," Mortensen said.
For women who have insurance that doesn't cover preventative care, it could save hundreds of dollars a year, local experts said.
For example, at Anne Arundel Medical Center, an annual "Well Woman" exam, which includes a pelvic exams and other health screenings, costs about $170 without insurance compared to a typical physical which costs about $135. Co-pays typically cost between $10 and $20. These costs are typical of many physician's groups, Keever and Mortensen said.
Key part of bill
The contraceptive piece of the provision is the most significant part of the bill in Keever's opinion.
Paying more up front for birth control can save ultimately more money.
"If you look at statistics across the nation, 40 percent of pregnancies were unplanned," Keever said.
Birth control pills that aren't covered can cost between $25 and $50 a month, she said. "Birth control is definitely out of reach for women who are low income and women who have high cost-sharing (in the form of co-pays.)" Keever said.
"This puts birth control in the same categories as other preventative medications like high blood pressure or cholesterol," Keever said. "This provision will keep this at an affordable range for all women, not just those with good insurance plans."
The law could open up the availability of longer-term birth control methods such as sterilization, intrauterine devices, or IUD's, and implants which contain hormones, said Bonnie Birkel, acting director of the state's Maternal & Child Health Bureau.
IUD's can cost anywhere from $300 to $700 and implants can cost between $500 and $800, she said. Many insurers require a co-pay or don't cover these sort of birth control devices, Birkel said. They are less popular than other less-reliable options, such as birth control pills, because of the upfront costs.
More health services
When it comes to other consultation services, like for women who are breast feeding, Sobel said he believes it will help women once they are out of the hospital and trying to breast feed on their own. While women who are still in the hospital after having a baby have access to lactation consultants, those services may feel out of reach for new moms later on.
It's an example of how women do require more health services related to reproduction than men -- but why it's also necessary to ensure they have full coverage, Keever said.
"This is a major stride in the right direction for women's health care and for health care in general," Keever said. "Being able to keep women healthy has a positive impact on health of the entire family."
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