Assault on Cost-Sharing Prohibition Mandated by the ACA Research Paper

Pages: 4 (1324 words)  ·  Bibliography Sources: 4  ·  File: .docx  ·  Level: Master's  ·  Topic: Healthcare

CONTRACEPTIVES: A NURSE PRACTITIONER'S PERSPECTIVE

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The Contraceptive Debate: A Nurse Practitioner's Perspective

The Contraceptive Debate: A Nurse Practitioner's Perspective

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The most recent healthcare legislation to be enacted into law at the federal level is the Patient Protection and Affordable Care Act (ACA) of 2010, but the provisions and mandates included in this law are coming online over a period of years. In 2013, the ACA authorized the provision of preventive services in women's health, including free access to contraceptive services (Sonfield, 2013). The key point in this provision is the elimination of cost-sharing, which was a common practice for most private health care plans prior to ACA implementation. The overall goal is to eliminate economic barriers to preventive healthcare, including contraception. As Annas and colleagues (2014) point out, the wording of the ACA does not guarantee cost-free access to CONTRACEPTIVES, but does mandate the free provision of preventive services for women's health more generally. The minutiae of exactly what would be covered were worked out after the ACA was enacted, by the Health Resources and Services Administration (HRSA) within the Department of Health and Human Services (HHS). The HRSA relied on recommendations made by the Institute of Medicine (IOM), which included a list of 20 contraceptives, among which were two intrauterine devices and the emergency contraceptives Plan B. And Ella. All the contraceptives on the list were FDA-approved and not considered to be abortifacients.

Research Paper on Assault on Cost-Sharing Prohibition Mandated by the ACA Assignment

Around the time the ACA women's health provisions were implemented, two private corporations, the Hobby Lobby and Conestoga Wood Specialties, challenged the contraceptive mandate on religious grounds (Annas, Ruger, & Ruger, 2014). Based on their beliefs, the two IUD devices and emergency contraceptives were abortifacients, thereby violating their antiabortion stance. According to the Supreme Court, owners of closely-held corporations would experience an undue burden on their free exercise of religion if the government required them to pay for these contraceptives, since the justices responsible for the majority opinion could not find a compelling government interest for guaranteeing the employees of these corporations access to these four contraceptives.

All three female Supreme Court justices dissented, along with one male justice (Annas, Ruger, & Ruger, 2014). The author of the dissenting opinion, Justice Ginsburg, highlighted a number of perceived weaknesses in the majority opinion, including the possibility that the ruling could open the floodgates to all kinds of ACA challenges based on a long list of religious objections. For example, Catholic owners of a closely-held company could object to the provision of all contraceptives. Within the dissenting opinion, Justice Ginsburg gets to the heart of the matter from the perspective of women's health. The ACA provision, as interpreted by Annas and colleagues (2014), is about moving the healthcare system closer to gender equality and Justice Ginsburg seems to agree. In her words, putting "health care decisions . . . including the choice among contraceptive methods . . . In the hands of women, with the aid of their health care providers," moves American society closer to the ideal of healthcare gender equality (as cited by Annas, Ruger, & Ruger, 2014, p. 864). Equal access to preventive services for everyone, including low-income individuals, was the purpose of the prohibition against cost-sharing. The ACA therefore attempts to improve the health of all Americans by lowering gender- and economic-barriers to preventive services.

Preliminary evidence suggests the cost-sharing prohibition is having an impact. An online longitudinal survey found that the number of privately-insured women no longer paying out-of-pocket expenses for access to contraceptive services increased from 15 to 40% immediately after the ACA provision was implemented (Finer, Sonfield, & Jones, 2014). While this improvement suggests the ACA is having the intended effect, the authors of this study noted that they found evidence for contraceptive preferences by providers based on cost. The authors of the online survey continued to collect data and published updated results recently (Sonfield, Tapales, Jones, & Finer, 2015). Based on these new findings, which covers the period from late… [END OF PREVIEW] . . . READ MORE

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"Assault on Cost-Sharing Prohibition Mandated by the ACA."  Essaytown.com.  February 5, 2015.  Accessed October 1, 2020.
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