Tag Archives: obamacare

Will Trumpcare Jack Up Your Reproductive Health?

As SuzyKnew! predicted, Trump moved fast to mess up women’s health. While the American Health Care Act  (AHCA) – a.k.a. Trumpcare – is “Obamacare Lite” in that it keeps a lot of the contraceptive coverage ObamaCare provided for insurance plans people get at work (probably because it’s not so easy to get rid of), the bill calls for some deep, cruel and politically-motivated cuts in women’s health. Note: unlike some web sites, SuzyKnew! is all about contraceptive choice, and although we may feature some methods more than others, we believe every Sista’ must chose for herself which method and product is best for her.

So, will the AHCA before congress jack up Sistas’ reproductive health? For access to contraceptives, it depends. How do you cover the cost of your contraception? Through the healthcare insurance you get at work? At a Planned Parenthood clinic or through Medicaid?

If you get your contraception from an employer-based insurance plan and your employer has more than 50 employees, more than likely, you don’t have anything to worry about. No hurry on that IUD insertion you’ve been thinking about. But, if you work for a small employer you might lose your healthcare coverage. It is expected that the Congressional Budget Office will announce that it expects 15 million people to lose coverage under the AHCA because TrumpCare won’t require as many employers to cover their workers.

TrumpCare won’t continue the Medicaid expansion after 2020 – which many believe gave us the gains made in reproductive health, including the lowest number of abortions in decades and fewer teen pregnancies. Of the more than 19 million women on Medicaid, 70 percent of them are of reproductive age.  Medicaid covers 72 million low-income Americans of which 19% are Black and 31% are Hispanic.  According to Guttmacher Institute, a leading research and policy organization committed to advancing sexual and reproductive health and rights in the United States and globally, three-quarters of all public dollars for family planning come from Medicaid and half of all births in the U.S. are covered by Medicaid, including two-thirds of all unplanned births.

Cruelly, but not surprising, the bill would defund Planned Parenthood for a year.  This means Planned Parenthood would not be able to be reimbursed by the federal government for women who pay using Medicaid. This would mean, the organization would lose around $530 million or 40 percent of its budget jeopardizing the group’s ability to keep many of its 650 clinics around the country open. The clinics that remain open will more than likely offer services at higher prices. So, not only will this version of the AHCA significantly reduce women of color’s access to contraceptives but also services for diabetes and cholesterol testing, vaccinations, breast exams, pap smears, STD testing, and of course abortions, which are not paid for using federal dollars. As women of color are more likely to get uterine and breast cancer this reduced access to preventive reproductive health services is especially threatening.

If you get your contraceptives from an individual plan instead of one from work, it may be difficult to find a low-cost plan that covers contraceptives or abortion.  The current AHCA plan will allow insurance companies to offer bare-bones coverage covering only medical catastrophes but not contraceptives or pregnancy like Obamacare. Before, the Affordable Care Act (ACA) or Obamacare, only 12% of plans found on the individual market covered maternity care. So, having a baby will be a lot more expensive under Trump – perhaps cost prohibitive for many. And, avoiding pregnancy will also be more expensive, if you rely on Planned Parenthood or an individual plan.

Using health savings accounts (HSAs) and tax credits, Republicans will prevent tax credits from being used to purchase any insurance plan that offers abortion coverage.  Effectively, this would mean women earning less than $75,000 a year will not have have insurance with abortion coverage  since there is an economic disincentive to spend more on a plan with such coverage. Insurers who want to participate in Trumpcare exchange will have to drop abortion from their coverage, including in states in which abortion coverage in state exchange plans has previously been allowed.

Many predict there will be more unintended pregnancies and women may try to self-abort with reduced access to abortion. Would there be a rise in uterine and breast cancers?

Yes, the AHCA will jack up your reproductive health. And, if you rely on Planned Parenthood for your reproductive and other health services, go get your IUD or implant insertion while you can and while you’re there get a breast exam and pap smear.

And, while the AHCA is only a bill, call your congress representatives to voice your concern. Don’t let Trumpcare become law and do untold damage downtown.

SuzyKnew!

Should You Get An IUD Or Another Long-Acting Birth Control Method Before Trump Takes Office?

A lot of social media sites are urging women to get an IUD, which can cost upwards of $800 without insurance, or another long-acting method like contraceptive implants, before Trump takes office in January. Birth control is free under Obamacare (a.k.a. the Affordable Care Act – ACA) and does not require a co-payment. But, during his campaign, Trump promised to get rid of Obamacare. Now, several weeks before he takes office, Trump is beginning to say he may keep some of the more “popular” provisions of Obamacare (and what… call it “Trumpcare” or something…?)

It’s not an understatement to say women are straight up scared.  Gynecologists, Planned Parenthood and other health clinics around the country report a massive increase in calls, emails, and texts asking for birth control – especially the long-acting, reversible kind, before Trumpism spreads across our land. Women want birth control that can outlast a Trump presidency.(SuzyKnew! has to stop here and say: What a shameful way to start a presidency by making so many Americans terrified!)

Others, such as the NY Times, say not to worry. Trump can’t reverse everything the first day he walks into office. They say it will take months – maybe years – to unravel everything. Selecting a contraceptive method – especially a long-term one – shouldn’t be done hastily, and an IUD, depending on the type, can last from 3 – 10 years.

Courtesy of RHrealitycheck.org
Courtesy of RHrealitycheck.org

Just over 11% of U.S. women using birth control chose IUDs. But, the highly-effective method is becoming more popular – and affordable with ACA. However, there can be side effects when you go from one type of birth control like the pill, the most popular method among U.S. women, to another method like the IUD, implant or injectable. Different contraceptive methods affect your body and menses differently. Of course, you could have your IUD removed if things weren’t working for you. But, do some “googling” and know what to expect before making a change to an IUD or implant, and of course check in with your healthcare provider.

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It is clear the most vulnerable part of the ACA is the requirement that health insurers cover contraception for all women without a co-payment. Kaiser Family Foundation claims before Obamacare, 28 states covered contraception and 85% of employer plans covered contraception.

But, what about co-payments? And, 28 out of 50 states isn’t that great of a ratio. Plus, the devil is in the details

And, ladies, ladies, ladies…

Do you trust this man not do something crazy?  And fast? It took him just over a week after becoming president-elect to appoint alt-right, white nationalist Steve Bannon as his chief strategist and select Jeff Sessions as his nominee for Attorney General. Just sayin’…

SuzyKnew! just wants to make sure you have the info. It’s up to  to you to decide what to do next.

Your thoughts, ladies…?

Obamacare For SuzyKnew! Readers ASK AN OBGYN

Your friendly doctor

Dear SuzyKnew,

 I hear a lot about how Obamacare helps older people and sick people with large medical bills.  I’m a healthy single woman in my mid thirties.  I have no kids and only see my doctor once or twice a year when I get sick with a bad cold and for my birth control pills.   How does Obamacare help me?  

 Thanks, Sandra

 Dear Sandra,

Obamacare required all insurance companies to dramatically upgrade their plans to include all Americans and to provide preventative healthcare.  There are LOTS of benefits for you.  The US Department of Heath and Human Services (the government agency that implements healthcare policy) has a great info graphic explaining the benefits to women.   Here are a few benefits that will apply to you:

1)    You are entitled to free check ups and screenings for diseases like breast and colorectal cancer, diabetes, asthma, heart disease and HIV.  The idea here is that if a disease is found early, you and you doctor can work together to keep it in check.   If you are able to manage a chronic disease, then you won’t end up in the hospital.  Makes sense, right?

2)    I’m guessing that even if you had great insurance before, you were still paying for your birth control pills.   Birth control can be very expensive, costing the average women $600/year. Under Obamacare, all FDA-approved birth control methods are available without co-pays. This includes pills, birth control shots, implants, intrauterine devices (IUDs), and sterilization procedures. (See About.com Contraception to see which birth control option may fit your lifestyle/health condition)

3)    Down the road, if you do decide to have a baby, you will be covered.   Many older plans offered maternity benefits as an expensive add on. Young women found themselves in a catch 22- Do I pay for maternity benefits before I need them? But what if I get pregnant and don’t have coverage?  Too often this resulted in delayed care.  The new law solves this problem by providing maternity coverage as an essential benefit.  And if you do become a mom, Obamacare covers the costs of breastfeeding equipment without a copay, and requires your workplace to offer break time and a nice place (not a bathroom) to pump breast milk.

4)    Obamacare increases coverage for mental health, social work and substance abuse services.   These vary by individual plan, so if you are currently under the care of a mental health counselor or doctor, you will want to look at this carefully when choosing your new plan.   Some good basics are covered, but not as comprehensively as primary medical care.

This is all very good news for our country, and especially for American women.   Many experts and leaders have said that Obamacare is the single greatest achievement for women’s healthcare in their lifetimes.   Take good care, and go see your doctor to get all the preventative care services you now have access to!

 A Note to our Readers: This question is most  relevant to SuzyKnew’s readers in the United States where historic healthcare legislation is being implemented.   Known as “Obamacare”, after President Obama, this law provides essential services to improve the health of all Americans.  For an overview see www.whitehouse.gov