On Aug. 1, 2011, the Department of Health and Human Services (HHS) released new health plan coverage guidelines that will require health insurance plans to cover women's preventive services such as well-woman visits, domestic violence screening, and U.S. Food and Drug Administration (FDA)-approved contraception, without charging a copayment, coinsurance or a deductible.

 

Authorized under provisions of the Patient Protection and Affordable Care Act, these guidelines, developed by a committee of the Institute of Medicine of the National Academies, expand the previous list of preventive services that must be covered without charging a copayment, coinsurance or a deductible to include:

• Well-woman visits
• Screening for gestational diabetes for all pregnant women
• Human papillomavirus DNA testing for all women 30 years and older
• Annual sexually transmitted infection counseling for all sexually active women
• Annual counseling and screening for HIV for all sexually active women
• FDA-approved contraception methods, sterilization procedures and contraceptive counseling
• Breastfeeding support, supplies, and counseling, including costs for renting breastfeeding equipment
• Domestic violence screening and counseling  

New health plans and non-grandfathered plans and issuers are required to provide coverage consistent with these guidelines in the first plan year (in the individual market, policy year) that begins on or after August 1, 2012.

Week of August 8, 2011

After one of its more bruising battles in recent memory, Congress finally passed a debt ceiling agreement (see below) last week and soon after headed out of town for its summer recess -- not to return until September 7.  While it appears that the deal exempts key health care programs, such as Medicaid, and avoids cuts to health care reform law initiatives,  Politico.com is warning that the pots of money attached to the Affordable Care Act (ACA) are still in danger of getting trimmed. The deal calls for a Congressional "super committee" to find another $1.5 trillion in savings over 10 years. If the committee fails to find at least $1.2 trillion in cuts or Congress fails to pass its recommendations, across-the-board cuts will be triggered. Politico says many health reform law programs are not exempt from such cuts. The Wall Street Journal says that Medicare could be impacted as well, through cuts to Medicare providers. Some warn, however, that patients indirectly would also feel the impact. The pressure will be on the super committee to avoid this scenario, but deals on spending have been hard to come by in this Congress. 

 

President Obama signed into law last week the Budget Control Act of 2011 (BCA), a debt limit/deficit reduction measure that also establishes a powerful, joint select committee of Congress to develop additional deficit cuts. The BCA immediately addresses federal spending and the deficit by capping discretionary spending through 2021; allowing the President to raise the debt ceiling by as much as $2.1 trillion to $2.4 trillion through 2013; and creating a Congressional Joint Select Committee on Deficit Reduction to propose a longer-term deficit reduction plan that yields an additional $1.2 trillion to $1.5 trillion in savings over 10 years through both tax and entitlement reform.

In addition, the agreement includes an enforcement mechanism to ensure budget savings, should the debt reduction plans stall in Congress. This "sequestering" mechanism would impose across-the-board cuts of up to $1.2 trillion if a debt-reduction plan saving at least that much fails to pass Congress before January 15, 2012.  The sequester would be divided equally between defense and non-defense programs, and it would exempt Social Security, Medicaid, unemployment insurance, programs for low-income families, and civilian and military retirement. Medicare cuts would be limited to no greater than 2 percent of the program's cost.  Any such cut would come from payments to providers and insurance plans. Finally, as part of the compromise, both the House and Senate will vote on a balanced budget constitutional amendment before the end of the year.