Skipped a recommended medical test or .... TPA must pay for ... in Brief: Restric!
ng Insurance Coverage of Abor!on, January 2014. WA. OR. WY. UT. TX. SD. OK.
Women Were a Cri9cal Part of the ACA Debate The White House Blog Health Insurance Reform as a Women's Issue: The First Lady's Take Comprehensive Health Care Reform: An Essential Prescription for Women A Report by the Joint Economic Committee Representative Carolyn B. Maloney, Chair Senator Charles E. Schumer, Vice Chair
March of Dimes Calls for Health Coverage for Women of Childbearing Age and Children Join YWCA to tell Congress that now is the time to pass comprehensive healthcare reform.
AMA president says pregnant women are barred from buying individual health policies
AARP on What Health Reform Means for Women Health Care: A Basic Right
Healthcare Reform in America You can make a difference!
Costs Are a Barrier to Care for Many Women Percentage of men and women who say they or a family member have done each of the following in the past year because of COST:
27%
Put off or postponed gePng needed health care
40%
Skipped a recommended medical test or treatment
20% 33%
Didn’t fill a prescrip3on
Cut pills or skipped doses of medicine
Had problems gePng mental health care
Men
22% 32% 15% 23% 10% 14%
Source: Kaiser Family Founda3on Health Tracking Poll (conducted September 12-‐18, 2013) hAp://kff.org/health-‐reform/poll-‐finding/kaiser-‐health-‐tracking-‐poll-‐september-‐2013/
Women
Millions of Uninsured Women Could Gain Access to Affordable Coverage, but Many Are in the Gap Insurance Coverage of Women in the U.S., 2011-‐2012
Eligibility for Coverage
2.6 million Employer Based/ Private 65%
6.8 million Uninsured 19%
4.4 million Medicaid 12%
2.4 million 2.5 million
Unsubsidized Marketplace -‐ 14% (income ≥ 400% FPL)
Tax Credit Eligible -‐ 37%
Medicaid Eligible -‐ 24% Coverage Gap -‐ 13%
(income below 100% FPL in a state not expanding Medicaid)
Undocumented -‐ 13%
Other Government 4% 96.3 Million Women 18.7 Million Uninsured Women Ages 19 -‐ 64 are not legally authorized in the U.S. Medicaid Eligible includes women eligible for Medicaid NOTE: Undocumented refers to those who in all states. Percentage may not add up to 100% due to rounding. SOURCE: Kaiser Family Founda3on analysis based on 2014 Medicaid eligibility levels and 2012-‐2013 Current Popula3on Survey, U.S. Bureau of the Census.
Impact of the Supreme Court Ruling: Half of states will be not be expanding Medicaid in 2014 VT
WA MT OR
ID
NV CA
ND
WY
MN WI*
SD
CO
UT
AZ
NM
PA* IL
KS OK
MO
TX
OH
IN*
WV KY
AR*
AL
VA
NH
MA CT RI NJ DE MD DC
NC
TN MS
AK
MI*
IA*
NE
NY
ME
SC GA
LA FL
HI
Implemen9ng Expansion in 2014 (26 States including DC) Seeking to Move Forward with Expansion post-‐2014 (2 States) Not Moving Forward at this Time (23 States) . SOURCES: State decisions on the Medicaid expansion as of December 11, 2013. Based on data from CMS, available at: hAp://medicaid.gov/AffordableCareAct/Medicaid-‐Moving-‐Forward-‐2014/Medicaid-‐and-‐CHIP-‐Eligibility-‐Levels/medicaid-‐chip-‐eligibility-‐ levels.html. Data have been updated to reflect more recent ac3vity.
The ACA Makes Many Insurance Reforms Affec9ng Women Before ACA • No uniform na3onal policy regarding dependent coverage age limits
Aier ACA • Dependent coverage extended to age 26, Uninsured rate for women 19-‐25 fell from 30% in 2009 to 25% in 2012
• Pregnancy and history of domes3c • No pre-‐exis3ng condi3on exclusions violence could be considered pre-‐exis3ng condi3ons • Individual insurance plans could charge higher premiums to women. Many did.
• Plans are no longer permiAed to use gender to determine premiums: gender-‐ ra3ng banned
• Individual insurance plans typically • Individually purchased plans and excluded maternity care, considered employer-‐based plans include maternity pregnancy a “pre-‐ex”, or required costly care riders for coverage. Only employer plans required to cover maternity care. • Plans were not required to cover • ALL new plans must cover recommended preven3ve services without cost sharing. preven3ve services without cost-‐sharing. Source: Kaiser Family Founda3on, Health Reform: Implica9ons for Women’s Access to Coverage and Care, 2013.
Adult Preven9ve Services to be Covered by Private Plans Without Cost Sharing Cancer
Chronic Condi9ons
Vaccines
Healthy Behaviors Pregnancy
Reproduc9ve and Sexual Health
ü Breast Cancer
ü Cardiovascular health ⁻ Hypertension screening ⁻ Lipid disorders screenings ⁻ Aspirin
ü Td booster, Tdap
ü Alcohol misuse
ü STI and HIV counseling (adults at
ü Type 2 Diabetes
ü Hepa99s A, B
– Mammography for women 40+* – Gene3c (BRCA) screening and counseling – Preven3ve medica3on
ü Cervical Cancer ‒ Pap tes3ng (women 21+ )
‒ High-‐risk HPV DNA tes9ng ♀
ü Colorectal Cancer ⁻
screening (adults w/ elevated blood pressure)
ü Depression screening (adults, when follow up supports available)
ü Osteoporosis One of following: screening (all women fecal occult blood 65+, women 60+ at tes3ng, colonoscopy, high risk) sigmoidoscopy ü Obesity Screening (all adults) Counseling and behavioral interven3ons (obese adults)
ü MMR ü Meningococcal
ü Pneumococcal ü Zoster ü Influenza, ü Varicella ü HPV (women and men 19-‐26)
screening and counseling (all adults)
ü Diet counseling (adults w/high cholesterol, CVD risk factors, diet-‐related chronic disease)
ü Tobacco counseling and cessa3on interven3ons (all adults)
ü Interpersonal and domes9c violence screening and counseling (women 18-‐64)♀
ü Well-‐woman visits (women 18-‐64) ♀
ü Tobacco and cessa9on interven3ons
ü Alcohol misuse screening/counseling
ü Rh incompa9bility screening
ü Gesta9onal diabetes screenings♀ ⁻ 24-‐28 weeks gesta9on ⁻ First prenatal visit (women at high risk for diabetes)
ü Screenings ⁻ ⁻ ⁻ ⁻ ⁻
Hepa33s B Chlamydia (