Health Policy and Managed Care
Dr. David J. Miller
November 30, 2013
The Affordable Care Act and its Impact on the Prevention of Chronic Illness in Women's Health
Women have greater health care needs, especially during their reproductive years, than that of men ("Why the ACA Matters," 2012). In many families women coordinate the health care needs of their children, spouses, and aging parents while shouldering the burdens of affordability ("Why the ACA Matters," 2012). The Affordable Care Act may be the highest progression for women’s health in more than a generation ("Why the ACA Matters," 2012). The act will serve to remove cost sharing burdens for major health promotion and preventive services thus offering women an opportunity for better quality healthcare and a healthier life.
Barriers to Healthcare
The rising cost of healthcare in the United States results in many women not having access to affordable health care. The Henry Kaiser Family Foundation reports that 58% of insured women are insured as a dependent or an employee through employee sponsored insurance programs and are susceptible to losing this insurance in the event they are widowed, divorced or their spouse loses their job ("Health Reform: Implications," 2013, p. 2). 53% of uninsured women are poor or have very low incomes usually less than 138% of the federal poverty level ("Health Reform: Implications," 2013). These women would qualify for Medicaid if their state has participated in the Medicaid expansion plan however, since not all states have participated it is unknown if this group will be able to obtain insurance plans that are affordable to gain insurance ("Health Reform: Implications," 2013). Affordability is a cost related barrier that low income women and their families must contend with. Historically women are more likely than men to report that out of pocket expenses has stopped them from receiving needed care or prescriptions ("Health Reform: Implications," 2013).
The Affordable Care Act seeks to remove such barriers from healthcare. Section 4103, Medicare Coverage of Annual Wellness Visit Providing a Personalized Prevention Program, has eliminated copayments for Medicare enrollees for annual wellness exams which includes a health risk assessment and personalized prevention plan (Koh & Sebelius, 2010). Section 4104, Removal of Barriers to Preventive Services in Medicare, eliminated copayments for preventive services that are rated A or B by the U.S. Preventive Services Task Force (USPSTF) (Koh & Sebelius, 2010). Section 2713, Coverage of Preventive Health Services, requires group healthcare plans and private health plans to provide coverage of preventive services that are rated A or B by the USPSTF without cost sharing to the insured (Koh & Sebelius, 2010).
The cost of health care is increasingly rising in the United States. Before the ACA women were likely to pay more for their health insurance than men due to gender discrimination ("Why the ACA Matters," 2012). Beginning in 2014, the Affordable Care Act will prevent this from happening in individual, small group markets and all federally funded healthcare ("Why the ACA Matters," 2012). With the removal of many barriers the ACA will help to ensure that more uninsured women have greater access to quality health care.
Advancements in Women’s Health
Over the past 30 years advancements in medical technologies have led to successes in women’s health. In the 1970s routine pap smears were introduced for cervical cancer screenings (Bettigole, 2013). Cervical cancer was the leading cause of deaths among American women prior to the introduction of this test (Bettigole, 2013). These cancer screenings were typically a cheap and affordable way to detect disease early however, recent findings have shown that laboratory charges for a routine pap smears