The Health Care Law and What Women Stand to Gain

1. The Health Care Law and What Women Stand to Gain Reproductive Law & Policy 101 June 13th, 2014 Judy Waxman, Vice PresidentHealth & Reproductive Rights National Women’s Law Center

2. Current Scope: Where Do Women Get Their Health Coverage? Source: National Women’s Law Center analysis of 2012 health insurance data from the U.S. Census Bureau Current Population Survey’s (CPS) 2012Annual Social and Economic (ASEC) Supplements

3. Goals of the Affordable Care Act • Facilitate coverage for more people • Improve coverage for all insured • Health workforce expansion • Quality improvement

4. Facilitate Coverage • 26 year olds can stay on parents plan • Medicaid • Up to 138% FPL • 26 states including DC • Exchange • Financial help to 400% FPL • No gender rating • No pre-existing condition limits

5. Improve Coverage: Coverage Must Be Comprehensive • Ambulatory patient services • Emergency services • Hospitalization • Laboratory services • Maternity and newborn care • Mental health and substance use disorder services, including behavioral health treatment • Pediatric services, including oral and vision care • Prescription drugs • Preventive and wellness services and chronic diseases management • Rehabilitative and habilitative services and devices

6. Plans Must Cover Preventive Care (No Cost Sharing) • USPSTF • Immunizations • Children • Women

7. USPSTF • 35 preventive services • Examples: • Blood pressure screening • Mammograms • Cholesterol screening • Depression • Osteoporosis

8. Women’s Preventive Health Services • Contraception methods and counseling • Well-woman visits • Gestational diabetes screening • HPV DNA testing for women > 30 years • STI counseling • HIV screening and counseling • Breastfeeding support, supplies, and counseling • Domestic violence screening and counseling

9. Breastfeeding • Rental or purchase of breast pump • Counseling • Nursing time at work Well Women Visit • At least one annually • Prenatal care visit included

10. Contraception Coverage Rules • All methods must be covered • Brands, if no generic available • Reasonable medical management • Plans must have a “waiver” process to obtain medically appropriate contraceptives • Services related to contraception are covered; insertion, removal, and follow up

12. Accommodations For Certain Employers • Houses of Worship exempted • Non-profit religiously affiliated entities are accommodated • Organization certifies it is religiously affiliated • Insurer provides seamless coverage for women in the plan • For profit entities must comply

13. For Profit ChallengeBurwell v. Hobby LobbyandConestoga Wood • Can a corporation have religious beliefs? • Is the contraceptive coverage requirement a burden on the corporation’s religion? • Does the government have a compelling reason for imposing the contraceptive coverage mandate? • Is there another way to provide the coverage that is easier on the employer?

14. Non-Profit ChallengeNotre Dame v. Burwell • Does the organization have religious beliefs? • Is the accommodation requirement a burden on the organization’s religion? • Does the government have a compelling reason for imposing the contraceptive coverage mandate? • Is there another way to provide the coverage that is easier on the employer?

16. Workforce Expansion • Scholarships • More residency slots • Primary care • General surgery • Low interest loans/tax relief • Community Health Centers

17. Quality Improvement • Medical Homes • Accountable Care Organizations • Comparative Effectiveness

18. Women’s Preventive Health ServicesLet us know! 1-866-745-5487 (contraception + other services) CoverHer@nwlc.org Toolkit: www.nwlc.org/preventiveservices • Assistance calling your plan • Template letters to appeal common coverage issues

19. Thank You!