Women’s Health is Essential Health

In 2014, all health insurance plans in the individual or small group market will have to cover a core set of Essential Health Benefits. This means that when a woman becomes pregnant, she won’t have to worry that her insurance doesn’t cover maternity care. Whether she gets coverage through a small business employer, on the individual market, or the new health insurance marketplaces called exchange – she will know that maternity care and other important health services for women are considered essential.

The components of the Essential Health Benefit package are one of the most important parts of the health care law because they are intended to correct longstanding discriminatory practices that women face in the vast majority of states. The National Women’s Law Center submitted comments on the Essential Health Benefits requirements of the Affordable Care Act to make sure these discriminatory practices are put to an end and the health needs of women are met.

• Nondiscrimination Standard: Women have long faced unfair and discriminatory health insurance practices, including charging women more than men for the same coverage. Congress adopted important non-discrimination protections in the health care law to ensure that these types of discriminatory health insurance practices would cease. HHS should make sure states and insurance plans understand these non-discrimination plans and that past practices that result in discriminatory plan designs are put to an end.

• Maternity Coverage: Only 13% of plans sold in the individual market in 2009 included comprehensive maternity coverage. Thanks to the Affordable Care Act, that will change. But HHS needs to make sure that coverage is comprehensive and that federal standards require a robust package of benefits including preconception, prenatal, labor and delivery, post-partum care.

• Mental Health Services: HHS has proposed that the Essential Health Benefits will cover mental health services on parity with medical services. This is an important expansion of mental health services to insurance in the individual and small group market and will have a huge impact on the 1 in 8 women who will be diagnosed with depression in their lifetime. We recommended that HHS also make sure the Essential Health Benefits package covers services for eating disorders. Did you know that the number one cause of death of young women ages 15-24? And yet many insurance plans don’t cover treatment for eating disorders.

• Prescription Drug Coverage: We know that most women will have access to contraception without cost sharing. But what about other medications, such as those used to treat chronic conditions? The Essential Health Benefits package should make sure women have access to drugs they need to treat chronic conditions such as multiple sclerosis and other autoimmune disorders, chronic pain, heart disease and diabetes. Insurance plans shouldn’t be able to take medical decisions away from doctors and other providers by covering just a handful of drugs.