Two key milestones achieved in the past week had nothing to do with politics and elections, yet their impact on health care will be of greater significance that any of the week’s elections. As of last Wednesday, Aug. 1:
• Health insurance companies had to mail rebates to customers by that date if their policy premiums did not meet new Affordable Care Act standards requiring insurers to spend at least 80 percent of their revenues from customers’ premiums on actual medical care. The 80 percent minimum applies to individual and small-group policies. For large-group policies, the minimum expenditure on provision of medical care was 85 percent of premium dollars. So check your mail: Blue Cross Blue Shield of Tennessee, for example, has mailed a total of $8.6 million to 73,000 policy holders. Checks from other insurers are in the mail, too.
• New health insurance policies are henceforth required to provide eight new additional preventive-care services to women without cost-sharing or co-pay requirements. These new preventive-care benefits may not be available to all women right away: Some may have to wait until their current annual health insurance policies are renewed. In any case, all insured women will get these benefits as January 1, 2014.
The new benefits for women cover: Well-woman visits, including an annual well-woman preventive-care visit to provide or help schedule the recommended preventive-care services; Gestational diabetes screening for pregnant women; Contraception and contraceptive counseling (abortifacient drugs are not included ); HIV screening and counseling; Breastfeeding support, supplies and counseling; Interpersonal and domestic violence screening and counseling; STI counseling relating to sexually transmitted infections; HPV DNA testing to help prevent cervical cancer relating to human papilloma virus.
These gender specific services covering 47 million American women often have been unavailable or unaffordable to a large percentage of women who need them. They are being covered under the ACA without cost-sharing requirements to help address serious national health-care threats that apply specifically to women. They’re especially necessary because women’s health-care policies before the ACA often were more expensive and less comprehensive than those for men.