Giant Step Forward for Health Care

  • By:  Erin Zabel

There are few things more important to women and families than access to high-quality, affordable health care. On March 23, 2010 the Affordable Care Act (ACA) was passed by Congress and signed into law by President Obama. The new law provides the mechanisms for increasing insurance coverage to more than 50 million Americans who currently have no access to health care.

Families USA, a national health care consumer advocacy group, has found that more than 26,000 people die prematurely each year due to lack of health insurance. This law should begin to change that dismal statistic and improve access for many more of our fellow citizens. The ACA also includes new requirements of insurance plans to make coverage and costs more equitable. Some key components of the law include:

• People will no longer be denied health care coverage for a pre-existing conditions.
Starting in 2014, the ACA stops health insurers from denying people coverage due to pre-existing conditions, such as cancer, high blood pressure, or diabetes. In the past, some insurance companies have denied coverage to women due to being pregnant or even being a survivor of domestic violence, categorizing both situations as pre-existing conditions. Thanks to the health care law, these types of unjust practices will no longer be allowed.

• Preventive services without co-pays.
Starting in August 2012, new health plans are required to cover preventive services without any co-pay for enrollees. For women, this also includes birth control, breast and cervical cancer screenings and annual well-woman exams. For children, this includes their regular well-visits. For men, this includes their annual check-up, blood work, and anything associated with routine preventive care. Encouraging all people to access preventive care should greatly decrease health care costs associated with illness when people wait too long for treatment because of lack of access to health insurance.

• Young adults can now stay on their parents’ health insurance until age 26.
Many insurance companies used to discontinue coverage of young adults once they graduated from either high school or college. Now all insurance companies are required to allow young adults to remain on their parents’ plans until they reach the age of 26. This is particularly crucial in difficult economic times when it’s harder for new grads to find jobs or jobs that offer health care coverage.

• Women will no longer be discriminated against in health insurance.
Today, women are often charged much higher rates for health insurance coverage, simply because they are women. For example, a healthy 22-year-old woman can be charged premiums 150 percent higher than a 22-year-old man. Starting in 2014, insurance companies will no longer be allowed to discriminate against women in this manner.

And most importantly…
• The ACA creates affordable health insurance options for everyone.
Currently, close to 50 million people do not have health insurance coverage and in turn have limited or no access to health care. Thanks to the ACA, millions of people will no longer have to worry about what will happen if they get sick, get into an accident, or break a limb.

There are two ways people will become eligible for new health insurance coverage under the law:
• Medicaid - Some people will get their new insurance coverage through the Medicaid program. Medicaid is actually one of the largest public health insurance programs in the world and will be covering additional people who cannot afford private insurance.
• Exchanges - Some people will buy private health insurance through an exchange, which will be a new marketplace for people to pick the plan that works best for them. Many people will qualify for credits that will reduce the cost of their health insurance plan.

Here’s a rundown of the changes that have already taken effect and those that will take effect:
As of September 23, 2010:
• Affordable health insurance coverage for dependents under age 26—3.1 million people have already benefited!
• Children and teenagers 0-18 with pre-existing conditions cannot be denied health insurance coverage
• Women have direct access to OB/GYN providers, without referrals
• Caps on coverage and restrictions are placed on insurers’ limits
• Prevention coverage without co-pays for those with private health insurance and those on Medicare.

As of August 1, 2012:
• No co-pay for wellness check-ups
• No co-pay for prenatal screening or breastfeeding support, supplies, and counseling
• No co-pay for birth control and contraceptive counseling
• No co-pay for screening and counseling for interpersonal and domestic violence
• No co-pay for STI testing and counseling.

As of January 1, 2014:
• Approximately 12.8 million women of reproductive age will gain new access to insurance coverage under Medicaid and state insurance exchanges
• New insurance companies will be required to offer maternity coverage
• Insurers will be prohibited from denying people insurance coverage or limiting their benefits because of pre-existing conditions
• Insurers will be prohibited from charging women more for health insurance coverage than they charge men
• New insurance plans will have to include a standard minimum package of benefits,
knows as Essential Health Benefits (EHB), including: ambulatory patient services, emergency services, hospitalization, maternity and newborn care, mental health and substance use disorder services, prescription drugs, rehabilitative services and devices, laboratory services, preventive and wellness services and chronic disease management, and pediatric services including oral and vision care.

For more information on the ACA, visit www.healthcare.gov/law/index.html.

Erin Zabel is the vice president of external affairs for Planned Parenthood of Southeastern Virginia. She can be reached at This email address is being protected from spambots. You need JavaScript enabled to view it. or 757-309-4834. For more information on PPSEV, visit www.ppsev.org, find us on Facebook, or text ppsev to 97063.

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