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

Current Scope: Where Do Women Get Their Health Coverage? 2 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

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

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 4

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 5

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

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

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 8

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

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 10

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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 12

For Profit Challenge Burwell v. Hobby Lobby and Conestoga 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? 13

Non-Profit Challenge Notre 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? 14

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

Quality Improvement Medical Homes Accountable Care Organizations Comparative Effectiveness 17

Women’s Preventive Health Services Let us know! (contraception + other services) Toolkit: Assistance calling your plan Template letters to appeal common coverage issues 18

Thank You! 19