Moral and fiscal reasons are creating question over some of the provisions of the Affordable Care Act
The New Year is bringing with it new medical coverage for women’s reproductive health with the Affordable Care Act—coverage that has left some groups upset with the proposed fiscal and moral consequences.
The Patient Protection and Affordable Care Act, a bill that expands medical coverage for all previously ineligible persons over a period of years and reforming health care coverage, includes specific coverage for women that was previously unavailable through many insurance providers and business policies.
Advocates for the new women’s provisions under the act say that the changes will be beneficial for women in many ways.
Amy Allina, program director for the National Women’s Health Network—an organization that promotes and analyzes issues that are affecting women—says that the provisions that will take effect in 2012 will help women immensely.
“These provisions have an enormous amount to offer women in lifting some of the barriers to health care from the past.,” she said. “This is a historical accomplishment for women’s health.”
One of the primary aspects of coverage that will take effect next year is the free access to birth control and contraceptives that will be on insurance plans beginning in January.
“We have done research on the benefits of covering contraceptive effectiveness as well as the adverse effects, and the result is that it will save women in being able to prevent unwanted pregnancies,” said Christine Stencel, media relations officer for The Institute of Medicine, a division of the National Academies.
The IOM has conducted “evidence reviews” of the coverage that was recommended to the Department of Health and Human Services’ suggestions for additions to the act.
Among those reviews and suggestions, several previously uncovered benefits were suggested to optimize the health coverage for women including, breast cancer screening, HIV screening and counseling and regular well-women care visits.
“The committee reviewed the suggestions and decided this coverage should be added because, based on the science, these would be beneficial to women’s health,” Stencel said.
The most contentious issue, for some, is the access and coverage of contraceptives in basic health insurance plans.
Sister Claire Hunter, F.S.E. and director of the Diocesan Respect Life Office, says the coverage goes against the Catholic Church and that the coverage makes her uncomfortable.
“As a Catholic, I don’t feel comfortable with this coverage,” she said. “I think as Americans, we have the right to freedom of religion and my conscious just doesn’t agree with this coverage.”
In addition to her concerns with the morality of covering birth control, Sister Claire also believes that Americans don’t have a clear understanding of the responsibilities and consequences involved with taking contraceptives.
“The greater concern is the regard to human life. New life is not able to implant is the woman is taking birth control,” she said. “Women who need this for medical reasons should look into other alternatives rather than a chemical substance. We need to have a deeper understanding of the body and of sexuality.”
Allina says the moral argument doesn’t make sense to her since the actual contraception is available on a voluntary level.
“I find this argument a bit confusing,” she said. “No one is forcing women to take birth control. It is a provision that is there for the women who need and want to have access to it.”
The morality of such legislation is not the only concern that has been raised about this provision and others like it within the act.
Kate Nix, policy analyst at The Heritage Foundation—a conservative organization—says that the fiscal responsibilities are being ignored, as well.
“The U.S. spends more, as a percentage of our GDP, than any other nation on health care,” she said. “To the American people it seems very obvious that we should be able to expand coverage, bring costs down, without spending almost a trillion dollars over a decade on new federal programs.”
Listen to Nix describe some of the moral objections to the act:
Others, say that the coverage will raise the premiums only a fraction of a percent while enabling millions of uninsured Americans access to health care for themselves and for their families.
Sara Collins, vice president for Affordable Health Insurance—a division of The Commonwealth Fund—says that the increase would be marginal compared to the coverage that will be afforded to so many Americans.
“These new provisions will be beneficial because they will save costs over time,” she said. “The increase in premiums will only be about 0.4 percent while guaranteeing millions of people much better coverage.”
Nix says that there is no question that the health care system that was in place was fractured, but that there should have been a different type of reform.
“I think no one would disagree that before the affordable care act passed, we were in desperate need of health care reform,” she said. “There really are two ways to go about it. A market driven action or empower the government. Rather than empowering the consumer of the health care coverage, we are going in the opposite direction and expanding medical programs which are already unaffordable.”
According to a blog post by Ruth Robertson with The Commonwealth Fund, “Women spend more out-of-pocket on health care than men do and are more likely to forgo needed care each year because of cost. And millions of women both with and without insurance are missing out on essential preventive care each year.”
Allina agrees that the new health care system is not perfect, but says ignoring the problem of health care coverage would be worse for Americans.
“Take a look at the system,” she said. “Doing nothing would have been harmful to Americans and harmful to women.”
Though some of the provisions have been a contentious issue since the beginning of the health care reform revisions were made, most agree that health care will be crucial in the upcoming elections and important for Americans as the new year approaches.
“I think you’ve seen in the polls that opposition to the law has remained steady for the American people since its passage,” Nix said. “You’ve actually seen support for full repeal increase. So I think it’s definitely something that is not going to go away soon.”
Others, like Allina say that the election will be a turning point for health care decisions.
“Health care will be very important in the elections because people will have started to see the impact of these new benefits and will see their health care improve with the laws,” she said. “I also recognize that this is such a politically fraught issue and that health care reform turns into a proxy for supporting democratic politicians, which takes away some of the real importance.”
The upcoming election and the moral and fiscal debate are still strong over the act and over women’s health.
“It is rife with harmful unintended consequences that will impact the health care system and the economy,” Nix said. “The law also fails to address several of the most important goals for health care reform, such as the rising cost of insurance. It is imperative that the law be repealed so that this route can be avoided and the right reforms can be put in place.”