Yesterday, the President released his budget for Fiscal Year (FY) 2016. The budget maintains the President’s commitment to fully implementing the Affordable Care Act and takes other steps to protect women’s access to health care. The budget proposes requiring states to cover preventive services without cost-sharing in traditional Medicaid – a major step towards increasing access to the preventive services that women need to live longer lives and stay healthy.
The proposal to expand preventive services coverage to Medicaid includes eight women’s preventive services. These services were developed by the Institute of Medicine and endorsed by the Health Resources Services Administration (HRSA). They include: (1) Breastfeeding support, supplies, and counseling; (2) Screening and counseling for interpersonal and domestic violence; (3) Screening for gestational diabetes; (4) DNA testing for high-risk strains of HPV; (5) Counseling regarding sexually transmitted infections, including HIV; (6) Screening for HIV; (7) Contraceptive methods and counseling; and (8) Well woman visits. Thanks to the ACA, most women already have access to these services without cost-sharing, including women in private plans and women enrolled in expanded Medicaid coverage.
For women in traditional Medicaid, though, there is a patchwork of coverage for preventive services across the states. States can choose to provide all eight women’s preventive services without cost-sharing but not all states do. For example, a woman enrolled in Medicaid in Virginia doesn’t have coverage for a rental of a breast pump, but if she lived in the neighboring state of Maryland she would have coverage for her breastfeeding equipment. Similarly, there is variation in the coverage of birth control in Medicaid – although states are required to cover family planning services through Medicaid, there is latitude to determine which methods of birth control they cover. The President’s proposal would eliminate these gaps in coverage.
Expanding preventive services without cost-sharing to low-income women in Medicaid is particularly needed because 35 percent of women below 200 percent of poverty report forgoing needed heath care due to cost. The President’s proposal removes cost as an obstacle to preventive care and expands coverage for recommended preventive services to the millions of low-income women who are covered by traditional Medicaid.
Our full analysis of the president’s budget and women’s health is available here.