Tough Love in the Affordable Care Act (ACA)

After reading several articles about President Obama’s Affordable Health Care Act (ACA), I have surmised that it sounds like the following scenarios:

It is like someone saying–

  • “I love you(.)” in a very serious voice.
  • “I love you, and there’s nothing you can do about it.”
  • “Take care of yourself, you lazy bone, or I will be forced to take drastic actions if you don’t.”

The Affordable Health Care has kindness behind all the threats of fines and levies. The ACA is all about PREVENTIVE CARE. You know the old adage: “Prevention is better than cure.”

Yes, ACA simply wants people to take care of themselves, to live longer, to have themselves checked out frequently without any fees, and to have health insurance like most civilized countries of the world.

In several articles and (specifically) in an article titled, “Understanding the Affordable Care Act and Women’s Health,” WebMD explored the impact of ACA on women’s health and the ways women can benefit from the Act. I have paraphrased, summarized, and quoted the content of the articles with emphasis added where necessary.

“Whether you just want an annual physical exam or are having a baby, the Affordable Care Act requires most insurers to cover a wide range of preventive health services for women. Here’s a look at some of the services that are covered without copays, coinsurance, or deductibles. Check your policy’s benefits for details, because specific coverage is different from plan to plan.”

Calcium

Calcium is all about building strong bones. It’s really important as women age. The Affordable Care Act requires most plans to cover testing for many women over 60, who have a greater chance of getting osteoporosis, or weak bones.

Iron

Iron helps get oxygen to cells. Too little iron leads to anemia, which can make you feel tired. The Affordable Care Act requires most plans to cover anemia screenings for most pregnant women with private health coverage.

Vitamin D

Vitamin D helps your body absorb calcium, which you need for strong bones. If you’re over 60 and have a higher chance of getting osteoporosis, or thinning bones, you can be tested for it without charge under the Affordable Care Act, under most health insurance plans.

Folic Acid

Find folic acid in green, leafy vegetables, fruit juices, nuts, and beans.  Women should get 400 micrograms daily. You can often get that from a serving of fortified cereal or bread. Women should get 600 mcg during pregnancy, or 500 mcg while breastfeeding. If you’re pregnant or plan to be, you should also take a folic acid pill. The Affordable Care Act requires most plans to cover folic acid pills without copays or deductibles for most privately insured women, if their provider gives them a prescription. 

Sodium

A high-salt diet can raise your chances of high blood pressure and stroke. These can lead to heart problems.

The Affordable Care Act requires most plans to cover blood pressure screenings under most private health plans.

Heart Health

A heart-healthy diet helps keep a fatty substance called plaque from building up in the arteries around it. The ACA requires most plans to cover cholesterol and blood pressure screenings under most private health plans. High cholesterol and high blood pressure can eventually lead to heart problems so these screenings are important.

Diet Counseling

Eating a well-balanced diet and staying at a healthy weight are important for your overall health. You can get obesity screening and counseling under most plans, thanks to the Affordable Care Act. Exactly what’s covered depends on your specific insurance plan, but the help is offered without any cost to you.

In addition, nutrition counseling is covered (by ACA) for people who are at high risk of chronic disease — such as heart disease.

Heart disease prevention (ACA)— Get regular blood pressure and cholesterol screening tests for free. Screening covers high blood pressure and tests for type 2 diabetes.

Cancer services — Early screening tests for breast cancer, cervical cancer, and colorectal cancer are covered. This includes:

Breast cancer prevention for women at high risk — Get genetic testing and counseling to help with important choices about treatment. Also, drugs to help prevent breast cancer may be covered with no co-pays or deductibles when a doctor prescribes them.

Tobacco use — Get help quitting smoking or using tobacco. Most health care plans cover screening, where a doctor will ask questions about smoking or use of tobacco and then encourage quitting. Coverage under the Affordable Care Act may include free programs to help with stopping smoking as well as stop-smoking drugs and nicotine replacement therapy.

Osteoporosis — Some women over 60 now don’t have to pay for osteoporosis screening tests, depending on their chances of getting bone disease.

Pregnancy care — Having a baby? Most plans cover, without copays, coinsurance, or deductibles, screening tests for anemia, gestational diabetes, hepatitis B, the blood problem known as Rh incompatibility, and urinary tract infections. Most also cover folic acid supplements as prescribed by a provider and prenatal visits.

Contraception — Many methods of birth control, as well as counseling on how to use contraception, are covered under most health care plans. The types included are ones that are approved by the FDA. This includes diaphragms, sponges, birth control pills, IUDs, and more. For more details, ask a doctor. Also, prescription may be needed even for those that are normally sold over the counter. Some religious employers are exempt from having to provide this coverage.
Weight Loss
Under the Affordable Care Act, there is no exact definition of what obesity counseling must include. Coverage varies from plan to plan, so call your insurer to see what your policy will cover. You may be able to get free help through your health care plan under the Affordable Care Act. Most health insurance plans, including all plans purchased through the Marketplace, now include obesity screening and counseling, with no copays or deductibles.

Other conditions –Most health care plans also cover, free of charge:

  • HIV screening tests and counseling
  • Counseling for sexually transmitted infections if you are at increased risk
  • Domestic and intimate partner violence screening and counseling

Well-woman visits — Most health care plans cover your annual doctor’s visit to help you get the preventive care and tests you need to stay healthy. More than one well-woman visit per year may be covered, if needed.

I fail to understand all the propaganda and negativity surrounding The Affordable Healthcare Act. For example, my previous employer of 19 years, who was supposed to have the power of group rate insurance, failed to secure an affordable monthly health care rate for me.

Little me, one person, I obtained a health care rate through United that was about two thousand dollars per year less than what my previous employer offered me on the group rate plan. This goes to show that group plan is not always the best for an individual, and individual health care plans are supposed to be the most expensive.

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