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Obamacare cuts costs of sexual healthcare with co-pay elimination

Low-cost preventive services and more insurance coverage could translate to significant improvements in Americans’ sexual health

With yesterday’s opening of the Health Insurance Marketplace, millions more Americans now have access to comprehensive sexual healthcare. Thanks to the Affordable Care Act (ACA), also known as Obamacare, vital sexual health services for men and women are now covered by insurance plans at no extra cost.

That means we no longer have co-pays for a long list of services that anchor our public’s health, including: 

  • All FDA-approved birth control.
  • Annual exams for men and women.
  • Sexually transmitted infection (STI) testing and counseling.
  • HIV screening and counseling.
  • Maternity services, such as prenatal care and breastfeeding support.
  • Interpersonal and domestic violence screening and counseling for women.

Consumer Protections

The ACA not only secures preventive services at no extra cost, but it mandates key consumer protections that support sexual health across the lifespan. Insurance companies can no longer deny coverage to men and women with such pre-existing conditions as a human papilloma virus (HPV) diagnosis, or HIV/AIDS. The law also ends annual and lifetime dollar limits on care for essential health benefits, including basic sexual health exams, testing, and counseling.

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Since August 2012, over 47 million women with insurance have gained all of these preventive services and said goodbye to the related co-pays. And today, over 40 million uninsured men and women have new access to sexual health services through high-quality, affordable private plans available in the Federal- and State-run marketplaces, or via expanded Medicaid programs.

Improving Sexual Health

Low-cost preventive services and more insurance coverage could translate to significant improvements in Americans’ sexual health. HIV prevention and care, and family planning offer two examples. For 20 percent of the 1.1 million Americans who are infected with HIV but unaware of their status, health reform means HIV testing and counseling at no extra cost. For HIV-positive friends and family, it means a much better chance of getting linked to and retained in care to suppress their viral load (currently, only 66 percent of those diagnosed are linked to care, and a mere 37 percent are retained in care).

Unintended pregnancy rates, which are closely tied to the proportion of women who are uninsured in any given State, should fall as more women get coverage in private plans, or through expanded Medicaid programs. It follows that expansion in coverage should also reduce adverse outcomes associated with unintended pregnancies, such as premature births and delays in prenatal care. 

Making It Easy to Get Covered

New benefits and options don’t mean much if they aren’t easy to find, or sign up for. That’s why the ACA created the Health Insurance Marketplace. In Federal and State marketplaces, consumers can compare plans and sign up with just one application. Help is available 24/7 online through live chat, via a toll-free phone hotline, and in-person from thousands of navigators and community organizations across the country.

The ACA is truly making it easier to expand sexual health benefits to millions more Americans by creating this user-friendly Marketplace and by guaranteeing essential services and consumer protections.

Republished with permission of the Altarum Institute.