Planned Parenthood® Action Center

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  What does it mean to say “health care reform passed”?

  After more than a year of committee hearings, town halls, high-stakes negotiating, and vote counting, the Patient Protection and Affordable Care Act (H.R. 3590), commonly referred to as the "health care reform bill," passed in the House by a vote of 219-212. President Obama signed the bill on March 23, 2010, and it is now law.

  
  

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  What role did Planned Parenthood play in passing the legislation?

  Planned Parenthood shaped and lobbied for key portions of the bill related to women’s health. As the nation’s leading provider of and advocate for reproductive health care, Planned Parenthood remained focused on our top two goals throughout the health care reform debate: 1) ensuring that women would have access to essential community providers like Planned Parenthood through health plan networks and 2) expanding coverage for comprehensive reproductive health care services, including protecting insurance coverage for abortion.

  
  

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  What does the health care reform bill provide women?

  The new law offers major advances for women’s reproductive health. It extends health care coverage to tens of millions of women and families.

  • It guarantees access to affordable, lifesaving screenings for breast and cervical cancer.
  • It protects women against gender discrimination by private insurers, meaning women cannot be charged more than men are charged for similar insurance policies.
  • It ends the practice of dropping coverage because of pre-existing conditions, such as breast cancer and pregnancy.
  • It significantly increases private insurance and Medicaid coverage of reproductive health care, including family planning.
  • Women now have guaranteed direct access to ob/gyn services and no longer need a referral or prior authorization from their health insurance company.

  
  

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  How does the health care bill address abortion coverage?

  Planned Parenthood and leaders for women’s health in Congress were successful in beating back the Stupak abortion ban, which would have effectively banned private health insurance coverage for abortion in the proposed exchanges to be established in each state by 2014. Unfortunately, the bill retains the problematic Nelson abortion provision, which would require the following:

  • If a health plan chooses to provide coverage for abortion, it must collect two payments from all enrollees — one payment for abortion coverage and one payment for all other coverage.
  • Health plans are required to deposit those payments into separate allocation accounts made up of private funds and ensure that abortion care is only paid for using private accounts designated for abortion payments.

  To learn more about the Nelson abortion provision, see our Q&A from late 2009, prior to the passage of the final health care reform bill.
  
  Planned Parenthood continues to be deeply concerned about the inclusion of restrictions on private health insurance coverage for abortion and is working with our allies in Washington, DC, to fix this harmful provision and mitigate its impact.

  
  

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  What is the impact of President Obama’s Executive Order on Abortion Coverage?

  The Executive Order — which was signed by President Obama on March 24 — does not go beyond the scope of the Senate Nelson provision or the Hyde Amendment. The Executive Order is made up of two directives:

  • A directive that implements the segregation requirements already in the health care reform bill
  • A directive that clarifies that the Hyde amendment applies to new community health center funding inAthe bill and requires the Department of Health and Human Services to ensure that grant recipients are aware of that limitation, which states that no federal funds can be used for abortion care.

  
  

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  What does the bill say about preventive care?

  Beginning in six months, new health insurance plans must cover — at no cost-sharing for patients — important preventive health care services. This means affordable health insurance coverage is guaranteed for women’s preventive screenings and care, such as breast and cervical exams. In addition, health plans will be required to cover an “essential health benefits package,” which will ensure all health plans cover a basic set of health care services from categories such as hospitalization, prescription drugs, maternity care, and mental health care. The Secretary of Health and Human Services will decide which specific services will be required in each category, and Planned Parenthood is working to make sure birth control is included. The bill further establishes a National Prevention, Health Promotion, and Public Health Council to develop a strategy to improve the nation’s health and creates a Prevention and Public Health Fund.

  
  

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  How will Medicaid change under the new law?

  The health care reform bill requires states to expand Medicaid coverage to everybody with an income at or below 133 percent of the federal poverty level — an individual with an income of $14,404 or a family of four with an annual income of $29,326. All newly eligible adults will be guaranteed a benefit package that includes family planning. The federal government will pay for most of the implementation costs of the Medicaid expansions.

  
  

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  What implications does the bill have for evidence-based sex education?

  The bill provides a $75 million-per-year funding stream to states for a new mandatory, evidence-based, medically accurate, age-appropriate sex education program called Personal Responsibility Education for Adulthood Training. Unfortunately, the bill also includes a renewal of $50-million-per-year funding of Title V abstinence-only education for states until 2014.