Is Planned Parenthood your go-to provider for well-woman care, birth control and other services? If so, Obamacare might give you several options -- including continuing to use those services or switching to a new doctor.
Each year, about 3 million women and men visit Planned Parenthood's 750 health centers across the United States, according to the reproductive health services organization. And 1 in 5 U.S. women has used Planned Parenthood at least once.
Planned Parenthood, which provides contraceptives, abortion services, Pap smears, and testing for HIV and other sexually transmitted infections, has publicly expressed support for the Affordable Care Act, the federal health care law that passed in 2010. Planned Parenthood already is providing education to its patients about how health care reform will affect them.
How Obamacare will affect Planned Parenthood
Experts say the ACA will work in tandem with Planned Parenthood and other clinics and health centers.
"Planned Parenthood is a trusted provider that offers the full range of reproductive health services for women," says Judy Waxman, vice president for health and reproductive rights for the advocacy organization National Women's Law Center (NWLC). She notes that many women, especially young women, use the organization as their main health care provider. "I don't see any reason why women would stop going there just because they get health insurance."
In fact, the ACA requires health insurance plans sold in exchanges, the health insurance marketplaces that will operate in each state, to have adequate health care provider networks that include what the ACA calls "essential community providers," says Adam Sonfield, a senior public policy associate for the Guttmacher Institute, a nonprofit organization that provides research, policy analysis, and education on sexual and reproductive health.
These essential community providers will vary by health insurance plan but could include Planned Parenthood and other health centers, clinics and county health departments, according to Sonfield. Including these providers in insurance plan provider networks will allow many patients to keep using their current providers and will also help mitigate the shortage of primary care providers, Sonfield says.
But that doesn't mean every Planned Parenthood health center will be included in the provider network for every health plan, Sonfield says. Patients who use Planned Parenthood or another provider and want to continue to do so should check to see if their provider is included in the network of any health insurance plan they might buy.
"Provider network is one factor to strongly consider when signing up for a plan," Sonfield says.
How Planned Parenthood and Obamacare will work together
Planned Parenthood, other community health care providers and the ACA will work together to give women more choices in three key areas. Here's how.
1. Preventive services.
The ACA requires health insurance plans to offer preventive services from in-network health care providers with no cost sharing. That means the patient does not have to make a copayment or use coinsurance -- the portion of the cost of care the patient usually pays -- even if the deductible has not been met.
Preventive services for women include well-woman visits, cervical cancer screening for sexually active women, and testing for STIs -- such as HIV, chlamydia and gonorrhea -- for sexually active or higher risk women. According to the National Institutes of Health, those at higher risk for gonorrhea include: patients who have had gonorrhea before, patients with other STIs, those with new or multiple sex partners, sex workers and drug users. Women who have an insurance plan that includes Planned Parenthood as an in-network provider will be able to get these services there with no out-of-pocket costs, Waxman says.
The federal health care reform law also requires most health insurance plans to cover the full range of U.S. Food and Drug Administration-approved contraceptives with no cost sharing. FDA-approved contraceptives include various types of birth control pills, intrauterine devices (IUDs), the vaginal contraceptive ring, birth control injections and surgical sterilization.
Planned Parenthood offers contraceptives, and 71 percent of clients use its services to prevent unintended pregnancy, according to Planned Parenthood. Women whose insurance plan includes Planned Parenthood as an in-network provider will be able to get these services there at no cost, Sonfield says. Women whose plans don't include Planned Parenthood in the provider network could check with their insurance company to see if they can still get contraceptives there without cost sharing -- or go to an in-network provider, he says.
In contrast to preventive care and contraceptives, the ACA doesn’t require health insurance plans to cover abortion. "There are no guarantees that plans will cover abortion," Sonfield says. So far, 22 states have passed laws restricting abortion coverage for plans sold in their state exchanges, Sonfield says. Some states, such as Louisiana and Tennessee, bar insurance plans from covering abortion in all cases. Abortion is covered by many private health insurance plans now, but about two-thirds of women with insurance pay out of pocket for various reasons -- in some cases because they are concerned about confidentiality, Sonfield says.
Women seeking abortion services can call their health insurance provider to see if their plan covers abortion and, if so, get a referral, Sonfield says. Women without an insurance plan that covers abortion could research local providers, which might include Planned Parenthood, and pay out of pocket. A first trimester abortion can cost about $300 to $950, according to Planned Parenthood, which offers services on a sliding scale based on income.
However, Planned Parenthood clinic closures in some states will affect women's access to the services the organization provides in some areas, Waxman says. For example, Planned Parenthood in July announced it would close three clinics in Texas due to funding cuts and abortion restrictions that recently became law in that state.
"It's a slam to women and women's health," Waxman says.