What Do You Know About August 1st and The Affordable care ACT?

Answer: True!

There are EIGHT preventive benefits that insurance companies must cover without cost, starting when their plan years renew on or after August 1, 2012. They are:

1. Breastfeeding comprehensive support and counseling from trained providers, as well as access to breastfeeding supplies, for pregnant and nursing women

2. Contraception: Food and Drug Administration-approved contraceptive methods, sterilization procedures, and patient education and counseling, not including abortifacient drugs

3. Domestic and interpersonal violence screening and counseling for all women

4. Gestational diabetes screening for women 24 to 28 weeks pregnant and those at high risk of developing gestational diabetes

5. Human Immunodeficiency Virus (HIV) screening and counseling for sexually active women

6. Human Papillomavirus (HPV) DNA Test: high risk HPV DNA testing every three years for women with normal cytology results who are 30 or older

7. Sexually Transmitted Infections (STI) counseling for sexually active women

8. Well-woman visits annually for adult women to obtain the recommended preventive services that are age and developmentally appropriate, including preconception and prenatal care

Answer: True!

Known as a “Well Woman Visit,” plans must cover an annual check-up for adult women to obtain the recommended preventive services that are age and developmentally appropriate, including preconception and prenatal care.

Answer: True!

The birth control coverage DOES include all FDA-approved contraceptive methods, sterilization procedures, and patient education and counseling. This includes the pill, patch, ring, and IUDs. Over-the-counter products such as female condoms, spermicides, sponges, and emergency contraception (available without a prescription to individuals ages 17 and up) are also included.

Note: These benefits are for “all women with reproductive capacity,” which means that “male” condoms and vasectomies are not covered.

Answer: False!

The Affordable Care Act treats the contraception coverage differently in relationship to religious organizations. Group health plans sponsored by certain religious employers (like houses of worship) are exempt from the requirement to cover contraceptive services. Institutions that are religiously-affiliated but do not qualify for the exemption have the option of a one-year grace period, so women insured by those employers might not receive coverage until their plan years renew on or after August 1, 2013.

If you work for a religiously-affiliated institution, check with your human resources staff to see what coverage they will provide.

There is an accommodation for religiously-affiliated institutions that oppose contraceptive coverage whereby the health insurance company, rather than employer, would bear any costs associated with it. A handful of mostly Catholic institutions have filed lawsuits claiming that—even with the accommodation—the requirements of the Affordable Care Act infringe on their religious liberty as an organization. The Religious Coalition for Reproductive Choice (RCRC) advocates for public policies that protect each person's ability to access and use birth control according to their own conscience and religious beliefs. We believe that religiously-affiliated institutions that employ and serve the general public and/or receive taxpayer support should not be allowed to discriminate against contraception for religious reasons. Individuals—not employers—should be making decision about birth control!

Answer: False. August 1 is the day non-grandfathered* insurance plans are required to provide coverage for contraception and other preventive health benefits when their plan year (or policy year, as it’s known in the individual market) renews. As such, the only women who have this coverage immediately are those whose health plan year starts on August 1. Many health plan years are calendar, so most women will have coverage starting January 1, 2013.

*Some health insurance plans that existed on March 23, 2010, have a special “grandfathered” status which means they do not have to comply with certain provisions of the Affordable Care Act, including no-charge coverage for preventive services. To find out if your plan is grandfathered, check the materials which describe your plan’s benefits (companies must disclose their grandfathered status) and/or check with your employer’s health benefits administrator.