Women Get More Free Preventive Care — Should Men Be Jealous?

Health reform has got women covered. The U.S. Department of Health and Human Services (HHS), in rules implementing the reform law’s mandate, has enumerated a host of preventive services for women that (non-grandfathered) insurers and plans must cover the services consistent with the rules, without cost sharing, in the first plan year that begins on or after Aug. 1, 2012, HHS says in a news release on its website.

Now, certain men might feel like it’s Christmas for the neighbors across the street, but they got no presents under their tree. Hey where are my goodies? Well, Santa will bring free goodies for men (like a colonoscopy if you’re a good boy), but we’ll have to wait for the proper agency to decide what other presents we get. See below.

As an interim final rule, the women’s preventive services rule takes effect now, but there will be a comment period, and changes could be made to the list of services based on the comments.

The new coverage guidelines were developed by the Institute of Medicine (IOM) for the Health Resources and Services Administration (HRSA). They mandate coverage without cost-sharing for a host of services around reproductive health. Here’s a quick list. See the HRSA website for more details.

• well-women visits;
• screening for gestational diabetes;
• human papillomavirus (HPV) DNA testing for women 30 years and older;
• sexually transmitted infection counseling;
• human immunodeficiency virus (HIV) screening and counseling;
• FDA-approved contraception methods and contraceptive counseling;
• breastfeeding support, supplies and counseling; and
• domestic violence screening and counseling.

The IOM conducted a scientific review and provided recommendations in a report issued July 19. HRSA used the IOM report when developing its guidelines. The IOM’s report even recommended free coverage of voluntary sterilization — but not abortifacient (so-called “Plan B”) drugs, according to an HHS Fact Sheet.

The administration also released an amendment that lets religious institutions choose whether or not to cover contraception services. This regulation is modeled on the most common accommodation for churches available in most of the 28 states that now require insurers to cover contraception. In some areas of the country, religious groups are big employers, so that exemption will be good news for them.

Men Are Wondering: When Do I Get My Free Preventive Services?

Issues could be raised on disparate treatment of men. Most of reform’s mandates for preventive care seem exclusively addressed to children and/or women. What preventive services will be mandated for men?

Now that HRSA has done its job relating to women’s health, there are four more parts to health reform law’s preventive service mandate. Those will require plans to cover — without cost sharing — these items as well:

1)      immunizations recommended by the Centers for Disease Control;

2)      higher rated items recommended by the U.S. Preventive Services Task Force (USPSTF);

3)      preventive care and screenings as set out in Health Resources and Services Administration (HRSA) for infants, children and adolescents; and

4)      breast cancer screening, mammography and prevention measures as recommended by the USPSTF.

The CDC, USPSTF and HRSA will have to specify the exact services to be covered, and presumably those too will be issued as interim final rules with public comment. Whatever free preventive services for men will probably be handled in item (2) above; that is, the “higher rated” services to be recommended by the USPSTF.