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VOICES

Young Women and Reproductive Health Care

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Sandra Fluke testifies before Congress on access to contraceptives and women's health. Young women have a lot to lose from the various amendments proposed to block provisions in the Affordable Care Act that make contraceptive coverage more affordable.

CREDIT: AP / C-SPAN

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Endnotes are available in the PDF and Scribd versions.

Policymakers often treat reproductive health care differently from other forms of health care, but ask any young woman, and she will tell you that gynecological care is a fundamental part of her health care. This year’s debate in Washington around contraception has at times missed the most important issue: When we talk about young women’s health care, most of the time we are talking about their reproductive health care.

Yet some conservative, religiously affiliated universities and nonprofit organizations are trying to opt out of an Obama administration regulation that requires health plans to cover contraception with no cost-sharing such as co-pays and deductibles. Because women now make up the majority of students enrolled in higher education, and because women comprise the majority of staff at nonprofit institutions, it is important to look at the health needs of these women.

This fact sheet presents some important information about the health care services that these women need and use.

Reproductive and sexual health is a primary health care need for young women

Contraception is the fundamental reproductive health care need for young women

Young women are least likely to be able to afford contraception

Obamacare protects young women’s reproductive and sexual health and well-being

The Affordable Care Act addresses many barriers that young women face in accessing affordable reproductive health care. Most importantly, the law guarantees that contraceptives and other preventive care be covered by insurance without cost-sharing. This requirement will eliminate co-pays and deductibles for preventive care in new private insurance plans with plan years that begin on or after August 1, 2012. For young women who are in school, the health reform law also extends this requirement to student health insurance plans.

The law, however, allows religiously affiliated nonprofits and universities that object to contraception to take advantage of a one-year waiver. Thus women who work or attend school at these institutions may have to wait for no-cost contraceptive coverage, but they will eventually have coverage directly from their insurer whenever their plan year begins after August 1, 2013.

The Affordable Care Act also allows young adults to stay on their parent’s health plan until age 26. To date, this provision has enabled more than 1.1 million young women to gain or keep coverage through their parent’s insurance.

In addition, Obamacare bans gender discrimination in the health insurance marketplace starting in 2014. It requires that maternity coverage be covered; prohibits coverage exclusions for gender-related pre-existing conditions such as breast cancer, Cesarean sections, and sexual assault; and outlaws the practice of gender rating so that insurance companies can no longer charge women higher premiums than men. Until the Affordable Care Act is fully implemented in 2014, a 22-year-old woman in the individual insurance market may be charged one-and-a-half times more for her insurance coverage than a man her age for a plan that often does not cover all of her reproductive health needs and other gender-specific conditions. These higher premiums compound the cost-barriers to contraceptive access and other reproductive health services.

Finally, Obamacare eliminates the need for a woman to obtain a referral from a primary-care physician in order to visit her OB-GYN, and it provides no-cost coverage for annual well-woman visits. These provisions acknowledge that gynecological visits are a funda- mental part of women’s primary care.

The bottom line is that for young women, reproductive health and family planning services are basic, primary health care needs. Insurance coverage that denies access to these preventive services denies young women a basic pillar of their health care that supports a healthy and stable transition to adulthood and could compromise their health in the long term. Young women have much to celebrate in the Affordable Care Act’s treatment of reproductive care as a cornerstone of women’s health care.

Jessica Arons is Director of the Women’s Health and Rights Program at the Center for American Progress. Lucy Panza is a Policy Analyst and Lindsay Rosenthal is a Special Assistant with the program. The co-authors would like to give a special thanks to the Center for American Progress’s Women’s Health and Rights Intern, Elizabeth Rich, for her research contributions to this fact sheet. This piece was originally published here.

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