Impact of the Affordable Care Act on the Cooper Women’s Care Center

Abstract

INTRODUCTION The Affordable Care Act (ACA) was passed by Congress and signed into law by President Obama in March of 2010. The purpose was to increase access to health insurance, improve and standardize the quality of care in the US, and reduce overall costs of our healthcare system. The law includes several provisions that have direct impact on women and the practices that provide their care. Under the legislation, preventive services for women must be covered by health insurance companies at no cost to the patient. The list of services includes annual well woman visits, HPV testing, annual counseling for STIs and HIV, contraceptive counseling and methods, and screening for domestic and interpersonal violence. Federally sponsored health insurance programs began covering these screenings shortly after the ACA was signed, and beginning August 2012, all new and non-grandfathered private insurance plans were required to cover these services as well. 1 In addition to emphasizing preventive care, the ACA made health insurance mandatory, imposing fines for those who do not obtain insurance. The ACA also facilitated the ability to purchase insurance through exchanges, and provided incentives for individual states to expand eligibility for Medicaid. Prior to ACA, Medicaid eligibility was restricted to low-income children, pregnant women, the elderly, and individuals with disabilities. Thirty-one states and the District of Columbia opted to expand Medicaid, and in those states low-income adults became eligible. In New Jersey, Medicaid was expanded to include all adults with an income below 138% of the federal poverty line. This expansion had the potential to greatly impact women who had previously been uninsured as well as the providers who serve Medicaid enrollees. Currently there is mixed evidence on the impact of ACA on services provided and how it may have changed the populations accessing care. Lau and colleagues found that post-ACA, young adults had 1