Wednesday, October 2nd, 2013
The Affordable Care Act, which is at the center of the debate that’s brought Washington to a standstill this week, requires insurance companies to pay for breast pumps and lactation consulting services for new mothers, as part of a women’s health initiative that is meant to encourage breastfeeding. As The New York Times reports, though, insurance companies aren’t getting the services to enough women since the new rules took effect January 1:
Despite the law, many new mothers have found it nearly impossible to get timely help for breast-feeding problems since Jan. 1, when health insurers began updating their coverage. While a 2011 Surgeon General’s report hailed lactation consultants as important specialists, few insurers have added them to their networks.
Some insurers simply point women to pediatricians not necessarily trained in lactation. Even then, women often must locate help on their own, leading to delays that jeopardize a mother’s milk supply.
Breast-feeding advocates fear this mandate is falling victim to bureaucratic foot-dragging, cost-saving and ambivalence.
“It’s abysmal, the state of lactation services being provided by insurance companies currently,” said Susanne Madden, a founder of the National Breastfeeding Center, which last month published an unsettling assessment of the breast-feeding policies of insurers nationwide. Twenty-eight out of 79 received D’s or F’s.
New mothers face a number of obstacles in breast-feeding, including insufficient milk or a painful infection. Problems must be resolved quickly: when a baby is hungry, there is little time to wrangle with an insurer over payment for a breast pump or a lactation consultant. A delay can mean that mothers turn to formula, don’t establish an adequate supply, or quit.
Image: Breastfeeding mother, via Shutterstock
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Thursday, April 18th, 2013
The new health care rules initially seemed to apply differently to children who were part of the foster care system past the age of 18, but provisions that are coming into effect next year will change that, enabling former foster kids to be covered the same way as other young adults. More from CNN:
While many young adults are now covered by the Affordable Care Act, able to remain on their parents’ insurance until age 26, the rules are different for those like [22-year-old Nathan] Cox-Reed, who grew up in the foster care system.
There are more than 400,000 children in foster care in the United States, the Department of Health and Human Services said last year. All are provided with health care coverage as long as they are wards of the state.
When foster kids turn 18, they age out of the system and instantly lose their coverage.
That’s about to change, when another part of Obamacare takes effect on January 1, 2014. Medicaid coverage will be extended for former foster youth until they reach 26, as long as the individual was in foster care and enrolled in Medicaid until the age of 18.
“I definitely think it would be a big relief, and I would definitely feel more secure as far as my health goes,” Cox-Reed said.
But there’s a catch. Cox-Reed has dreams of traveling across the nation and becoming a filmmaker. A future relocation could jeopardize his medical coverage.
States will only be required to keep former foster children on Medicaid if they continue to reside in the state where they were in foster care originally.
This part of the provision is “an incredibly troubling aspect,” said Washington attorney Brooke Lehmann, who founded the child and family advocacy group Childworks. Young adults can be highly mobile as they move for educational purposes, job opportunities and a host of other reasons, she said.
“You can’t be on a film set if you are uninsured,” Cox-Reed said. “You could get hurt. I definitely think [being uninsured] is limiting and it’s a letdown, because what if I do get a job out of state? I might not be able to take it.”
While “it’s a great provision,” said Joan Alker, co-executive director of the Georgetown Center for Children and Families and a professor at the Georgetown University Health Policy Institute, limiting extended Medicaid enrollment because of relocation could threaten the provision’s effectiveness.
Image: Teenager at doctor’s office, via Shutterstock
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Monday, January 28th, 2013
A number of religious organizations are filing lawsuits to challenge the provision of the new health care law that requires employers to cover birth control in their health plans. The flurry of lawsuits may mean the question will eventually be presented to the U.S. Supreme Court, legal analysts are saying. The New York Times reports:
In recent months, federal courts have seen dozens of lawsuits brought not only by religious institutions like Catholic dioceses but also by private employers ranging from a pizza mogul to produce transporters who say the government is forcing them to violate core tenets of their faith. Some have been turned away by judges convinced that access to contraception is a vital health need and a compelling state interest. Others have been told that their beliefs appear to outweigh any state interest and that they may hold off complying with the law until their cases have been judged. New suits are filed nearly weekly.
“This is highly likely to end up at the Supreme Court,” said Douglas Laycock, a law professor at the University of Virginia and one of the country’s top scholars on church-state conflicts. “There are so many cases, and we are already getting strong disagreements among the circuit courts.”
President Obama’s health care law, known as the Affordable Care Act, was the most fought-over piece of legislation in his first term and was the focus of a highly contentious Supreme Court decision last year that found it to be constitutional.
But a provision requiring the full coverage of contraception remains a matter of fierce controversy. The law says that companies must fully cover all “contraceptive methods and sterilization procedures” approved by the Food and Drug Administration, including “morning-after pills” and intrauterine devices whose effects some contend are akin to abortion.
As applied by the Health and Human Services Department, the law offers an exemption for “religious employers,” meaning those who meet a four-part test: that their purpose is to inculcate religious values, that they primarily employ and serve people who share their religious tenets, and that they are nonprofit groups under federal tax law.
Image: Lawsuit paperwork, via Shutterstock
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