Aug. 13--TAHLEQUAH -- Women across the U.S. no longer have to pay for certain health care services, including birth control, which are now covered under the Patient Protection and Affordable Care Act.
Effective Aug. 1, PPACA requires most health insurance plans to cover eight preventive care measures without charging a co-payment or deductible: well-woman visits; gestational diabetes screening; domestic and interpersonal violence screening and counseling; FDA-approved contraceptive methods and education; breastfeeding support, supplies and counseling; HPV DNA testing for women 30 and older; and STD counseling, and HIV screening and counseling.
In May, more than 40 Catholic institutions filed 12 lawsuits in federal jurisdictions, asserting the contraception rule violated religious tenets. But according to the U.S. Department of Health and Human Services, the law allows some nonprofit religious employers to choose whether to cover contraceptive services.
Kathleen Sebelius, secretary of HHS, said an additional element has been added: Nonprofit employers "who, based on religious beliefs, do not currently provide contraceptive coverage in their insurance plan, will be provided an additional year, until Aug. 1, 2013, to comply." Employers who want the extra time must certify they qualify for it.
According to a recent report by Bloomberg, organizations such as churches, which may not provide insurance coverage for contraception, are still exempt from the requirement, as are primary and secondary schools affiliated with religious organizations. But universities, charities, hospitals and other religiously-connected entities must comply.
Despite the recent Supreme Court ruling that PPACA is constitutional, Becky Bernhardt, assistant press secretary for Sen. Tom Coburn, R-Okla., said he believes the rule is unconstitutional. Coburn says it "dangerously expands the federal government's role in health care, and takes away even more of our individual and religious freedoms."
Coburn is a physician who specializes in obstetrics and gynecology. He is also opposed to PPACA.
"Forcing Americans to finance contraceptives and abortifacients is an assault on religious freedom and individual liberty," said Coburn. "This mandate is also completely unnecessary, as these products are already widely available at extremely low prices at clinics across the country. This mandate has nothing to do with serving women, and everything to do with expanding government's control over health care."
Dr. Jena Rogers, M.D., who specializes in internal medicine at Tahlequah Medical Group, believes the ruling is beneficial for all women.
"No matter what community you are talking about, preventive health visits for women, and for men, are beneficial," said Rogers. "Technology and education in health care have improved so much over time that it is much easier and safer to get tested. The percentage of women who now have mammograms have almost doubled in the past 15 years. Screening for diabetes is also much easier and cost-effective."
Rogers has seen a fair share of women fall victim to cervical cancer, among other diseases. She believes PPACA's expanded coverage for women removes at least one obstacle to seeking preventive care.
"It's hard to take the time, spend the money, or a list of many excuses why not to seek preventive care," said Rogers. "You owe it to yourself and your family to do it, though. The most disappointing things I see are examples of patients who could have been treated so much more successfully if they had just had the preventive care. Cervical cancer in women can now be detected so much earlier with successful treatment and results, in many cases, by having a PAP test."
Rogers said her opinion of PPACA derives more from a medical perspective than a political one.
"It has to be better for people to have health care, no matter the source," said Rogers. "Preventive health care can save so many lives, and potentially the overall cost of health care, with earlier detection. It's hard for me to not be supportive of this."
Some people, and politicians, believe the cost of PPACA outweighs the benefits, and that states can't afford to pick up the portion of their tab required under PPACA. Others on both sides of the political spectrum -- like Oklahoma Sen. Jim Wilson, D-Tahlequah, and Rep. Doug Cox, R-Grove -- say the measure is fiscally feasible and will create jobs.
"From what I see, the health care industry seems to be one of the better employment opportunities out there," said Rogers. "We need more doctors, we need more nurses, and the list goes on. Just look at the growth that Tahlequah City Hospital and the medical community right here in Tahlequah has seen."
Patti Gulager, a local resident, has been a nurse for over 36 years. She has a master's degree in nursing from the University of Oklahoma, and has worked in both public health and hospitals in Cherokee County. She has read the entire text of the 1,400-page law, and views the Aug. 1 expansion under PPACA as "exciting for women."
"For many years, some [insurance providers] have offered some women's services at 100 percent, at least for the most part, like PAP smears and mammograms" said Gulager. "That data alone supports the early detection and treatment factors in lowering costs and saving lives."
As a woman, Gulager can relate to this on a personal level.
"My mother was a breast cancer survivor," said Gulager. "When you look at the results of high numbers of women receiving care through these venues, it is very encouraging. Obviously, the expansion of these services -- gestational diabetes, STD screenings -- for everyone should impact some of the higher costs of healthcare."
Gulager pointed out that for women of child-bearing age, lowering the numbers of premature births and decreasing neo-natal needs is critical.
"These are astronomical in the initial cost, with long-term financial ramifications for the children and their families," said Gulager. "Some of the tests paid for through PPACA will give even the poorest of women the opportunity to prevent some of these diseases."
Gulager believes other services provided, including counseling and well-woman visits, will help everyone in the long run.
"It is obvious that getting ahead of bad outcomes is the goal," said Gulager.
"This section is an attempt at being pro-active, instead of [shouldering] the high costs of taking care of the results of having little or no care. When women know they can get these services at no cost, it will be routine, and we should see the bad outcomes begin to shift. I think, from a social perspective, everyone wants to try to change the lifestyles that lead to some of these diseases, but we know ... that is not going to happen. Women who are wives or mothers will make sure that husbands and children are taken care of long before they receive care themselves."
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