Affordable Care Act Contraception Update

Though the Obama Administration finalized how women covered by most private health plans will have contraceptive coverage without cost-sharing as guaranteed under the Affordable Care Act, there is still confusion over which types and brands of contraceptives will be available without copay. 

Here are the facts.

The ACA requires insurance plans to offer options in each of the five major contraceptive categories: barrier methods, hormonal methods, implanted devices, emergency contraception and permanent methods. Plans can treat contraception much like other prescription drugs, categorizing drugs in a tiered system where some are available for free, while others come with varying co-pays. Plans must cover a specific contraceptive without cost-sharing if it’s ordered by a women’s doctor for medical reasons.

This means that employer health insurance plans don’t have to cover every type of birth control approved by the FDA; they can charge co-pays for some brands or products as long as they offer others for free. Patients should check with their insurers before their doctor’s appointment. Otherwise, they may not know which specific type of contraception their insurer covers until the pharmacy rings it up.

The National Women’s Law Center is establishing a hotline where women can share difficulties with paying for or accessing contraception through their insurers. NWLC plans to release a report with their findings. Stay tuned for updates.

Universal Access to Maternity Care

The National Women’s Law Center (NWLC) filed sex discrimination complaints against five institutions that exclude pregnancy coverage from the health insurance benefits provided to their employees’ dependent children. These complaints are believed to be the first to challenge dependent pregnancy coverage exclusions provided in the Affordable Care Act.

The ACA’s requires that plans provide comprehensive coverage to women, including full coverage for gynecological and maternity care, on the same terms as other benefits. Treating pregnancy differently has long been considered sex discrimination under civil rights statutes such as Title IX and Title VII.

ACOG strongly supports these efforts and has called for universal access to maternity care since 1971. Lend your support by letting your elected officials know your stance. 

http://www.usa.gov/Contact/Elected.shtml  Visit the NWLC website for information on the ACA’s nondiscrimination provision and their complaints filed against each institution.

A BIG STEP FORWARD FOR WOMENS HEALTH

The emergency contraception ping-pong game seems to have ended in a resounding win for women’s health. Following a recent court order, the Obama Administration has announced that it will fully comply with allowing emergency contraception over the counter without age restrictions.

 

For years, ACOG and other women’s health partners have been advocating for over the counter access to emergency contraception without age restrictions. We know all too well that time is of the essence for females facing the possibility of an unintended pregnancy. And unrestricted access to contraceptives is key to reducing abortions.

 

We agreed with the Food and Drug Administration when it ruled for over the counter access and we opposed Department of Health and Human Services Secretary Kathleen Sebelius’ decision to include an age limit to OTC access. ACOG has been working with the advocacy community to overturn Sebelius’ decision.

 

We had good news recently when a panel of the 2nd Circuit Appeals Court ruled that the two pill variant, including Next Choice and other levonorgestral tablets, must be made immediately available over the counter without age restrictions. We had better news soon after when the White House announced that it would give up its insistence on age restrictions and allow the FDA to move forward in the direction that science has pointed to all along.

 

This decision to increase access to over the counter contraception is a powerful one because in spite of our efforts to be there all the time for our patients, decisions impacting long term health will happen WITHOUT our presence. It is so important to make contraception easily available, to remove barriers.

STATEMENT OF POLICY

ACOG has made it a priority to combat legislative interference with the patient-physician relationship. ACOG’s Executive Board recently approved a Statement of Policy formalizing this effort.

Most of us recognize that government serves a valuable role in protecting public health and safety and in the provision of essential health services. However, we at KerismaMD and others, like ACOG, oppose any government interference that threatens communication between patients and their physicians or other health care providers. ACOG also objects to laws that interfere with the patient’s right to be counseled according to the best currently available evidence-based guidelines and the physician’s professional medical judgment.

ACOG President Jeanne A. Conry, MD, PhD acknowledged that “given the relentless legislative assault on the patient-physician relationship that we’ve seen in the past few years—and unfortunately continue to see—we were compelled to issue a formal Statement of Policy.”

Click here to read the full news release accompanying the Statement.

NWLC “Getting the Coverage You Deserve” Toolkit

 At KerismaMD, we want to make all women aware of The National Women’s Law Center’s Toolkit which provides women with information on ACA coverage of preventive services and tools they can use if they encounter problems with this coverage. Includes detailed instructions on how to file an appeal with insurance companies and includes draft appeal letters on a range of preventive services. Click here to view “Getting the Coverage You Deserve.”

REDUCE SODIUM TO IMPROVE HEALTH

As health experts fight among themselves about how much sodium is safe to eat, the reality is that most of us can get by on far less salt (our biggest source of sodium). In fact, much of the salt in restaurant meals and packaged foods is overkill, just excess salt used to pander our palates in the simplest way. But gradually shaving off a little salt here and a little salt there is critical to good health, not just as a way to lower blood pressure but to keep the heart, kidneys, and bones healthy. It’s also a way to let other flavors shine through in foods and open your palate to a whole new world of flavor. 
 

Our bodies need sodium to help maintain water and mineral balances and blood volume. But too much of a good thing (sodium in this case) can have negative effects on your health, such as an increased risk for high blood pressure (which contributes to heart disease and stroke). While most of us get enough sodium each day to meet our bodies' needs (about 1,500 milligrams), the average person consumes way too much! Experts recommend that adults consume less than 2,300 milligrams of sodium daily—that's about 1 teaspoon of salt.

Sodium is a mineral that occurs naturally in foods that you eat every day, including meats, nuts, grains, and dairy. Salt and sodium are not the same things—but salt is made from sodium (and chloride). What you might not realize, however, is that “hidden” sodium found in processed foods (in the form of salt) makes up the largest proportion of the sodium that adults consume (in addition to any salt that you add yourself).

Cutting back on sodium is one action you can take to reduce your risk of high blood pressure and its related complications. Keep in mind that your taste buds are probably accustomed to a strong taste of salt, so limiting your consumption might take a little getting used to, but your health is worth it! Here are some sodium-cutting tips you can try today:

• Introduce additional flavor to your foods with herbs and spices like garlic, oregano, basil, pepper, thyme and sesame. These all add flavor without the extra sodium. If a recipe calls for salt, cut the amount called for in half and taste it before adding more. 
• Make healthy choices at the grocery store. Processed foods (anything in a box or bag) tend to be high in sodium because it helps preserve foods longer and increase flavor. Always read labels for the foods you buy, including the sodium content on the nutrition facts label and the ingredients list. 
• Remember that "low-fat" or "low-calorie" doesn't mean healthy. These diet foods can also be higher in sodium because manufacturers hope that added sodium, a flavor-enhancer, will bring back the flavor that is missing since fat and other higher-calorie ingredients are removed. This is especially true for frozen dinners, which are often loaded with extra salt. 
• Choose low-, no- or reduced-sodium versions of your favorite soups, frozen meals, canned foods, and snacks. Even butter is available without added salt! 
• Choose fresh or frozen veggies over canned varieties, which often contain added salt to help increase shelf life. If you can't find sodium-free varieties of canned vegetables, rinse the can's contents in a colander under water before cooking to remove excess salt. 
• Olives, pickles and other items packed in brine are saturated in salt, as are many smoked and cured meats, like salami and bologna. Limit your intake of these high-sodium foods and be on the lookout for lower-sodium varieties. 
• Fast foods are high in more things than just fat. Many of these meals, sandwiches and fries contain more than your daily recommended intake of sodium in just one serving. When consulting restaurant websites to make healthy choices, pay attention to sodium levels as well. By keeping your portions in check (order a junior burger or small French fry instead of the big burgers and super fries) will help control your sodium (and caloric) intake. 

The chart below lists common salty foods. Notice how quickly sodium can add up with just a few foods!

Food	Portion	Sodium
Baking soda	1 tsp	1,259 mg
Mini pretzels	10 minis	1,029 mg
Soy sauce	1 Tbsp	902 mg
Frozen pepperoni pizza	1 serving	902 mg
Dill pickle	1 medium	883 mg
Frozen chicken pot pie	1 serving	857 mg
Shredded cheddar cheese	1 cup	702 mg
Baking powder	1 tsp	488 mg
Hamburger	1 sandwich	474 mg
Sauerkraut	1/2 cup	469 mg
Canned peas	1 cup	428 mg
Ham	1 slice	373 mg
Biscuit	1 whole	304 mg
Bacon	1 slice	303 mg
Salted mixed nuts	1/4 cup	205 mg
Ketchup	1 Tbsp	190 mg
Hard salami	1 slice	186 mg
White bread	1 slice	170 mg
Mustard	1 Tbsp	168 mg
Potato chips	1 ounce	168 mg
Saltine crackers	5 crackers	161 mg
Tortilla chips	1 ounce	150 mg
Italian salad dressing	1 Tbsp	116 mg
Salted butter	1 Tbsp	82 mg