In a groundbreaking move, the U.S. Department of Health and Human Services announced last week that, as part of the Affordable Care Act, it would for the first time ever require new health insurance plans to include coverage for the costs of a wide range of preventive health services for women without co-pays. At Answer, we were particularly delighted to see sexually transmitted disease (STD) counseling, HIV counseling and testing, and FDA-approved contraceptive methods included on the list of preventive services. Finally, an administration that has elevated the health needs of women and their families to where it needs to be!
I truly do believe this decision is unprecedented. At the same time, however, having worked in the nonprofit sector for nearly 25 years, my social justice autopilot is permanently set on “who’s missing?” So when I read the announcement, the first question that came to my mind was, “What about all the people who do not have health insurance?”
In 2010, 39 percent of people ages 64 and younger had no health insurance, according to the Centers for Disease Control and Prevention (CDC). This is the highest rate since 1997. That translates to roughly 48 million people. Hispanic and African-American individuals were, as always, disproportionately represented among those who did not have insurance. And when the CDC says “uninsured,” that means no private health insurance, Medicare, Medicaid, Children’s Health Insurance Program, state-sponsored or other government-sponsored health plan or military plan. Unfortunately, none of these people would benefit from the Affordable Care Act’s provision.
Historically, uninsured individuals could go to their local family planning organization for their health care needs, but not any more. Not when more and more state governments continue to irresponsibly eviscerate the funding budgets for those organizations, many of which are the only places women and men go to for their health needs. This remains one of the biggest oversights and tragedies of the conservative agenda to eliminate family planning services. In doing so, they are often eliminating the only health care some people will ever have access to or receive. And the fewer preventive services that are available, the higher the cost down the line for treatment and care for the illnesses that can result—for women AND men. See, according to the HHS announcement, “Women are more likely to need preventive health care services.” But according to the CDC, boys and men are more likely than girls and women to be uninsured. This issue affects everyone, regardless of gender or age.
So as we celebrate this bold move—and truly, we must—we cannot rest on our laurels for very long. We must remember that well-woman visits are invaluable for early detection, diagnosis and treatment of illnesses for which the uninsured remain disproportionately at risk simply because they do not have access to these services. We must remember that at the same time that well-woman visits are imperative, so too are preventive and well-care services for boys and men. And in the same breath with which we celebrate victories like this, we need to remember those who are habitually forgotten and neglected, and whose lives can be made or broken based on politics and reckless cuts to invaluable programs and services.