The Affordable Care Act and Reproductive Health

The new Journal of Health Politics, Policy, and Law appeared in my mailbox. It includes a useful symposium on the policy and politics of reproductive health:

Lynn Paltrow and Jeanne Flavin, “Arrests of and Forced Interventions on Pregnant Women in the United States, 1973–2005: Implications for Women’s Legal Status and Public Health.

Miranda Waggoner, “Motherhood Preconceived: The Emergence of the Preconception Health and Health Care Initiative.

Amanda Dennis, Kelly Blanchard, Denisse Córdova, Britt Wahlin, Jill Clark, Karen Edlund, Jennifer McIntosh, and Lenore Tsikitas, “What Happens to the Women Who Fall through the Cracks of Health Care Reform? Lessons from Massachusetts.”

Amy Dworsky, Kym Ahrens, and Mark Courtney. “Health Insurance Coverage and Use of Family Planning Services among Current and Former Foster Youth: Implications of the Health Care Reform Law.

Debra Stulberg. “The Patient Protection and Affordable Care Act and Reproductive Health: Harnessing Data to Improve Care.

Oh yeah. Here’s one more: Adam Sonfield and Harold Pollack on reproductive health issues here:

After nearly a century of failed or incomplete legislative efforts, the Patient Protection and Affordable Care Act (PPACA), enacted by Congress in March 2010, establishes the principle that every American is entitled to affordable and effective health insurance coverage regardless of income or health status. Although many aspects of the act have received broad attention, its impact on reproductive health has received considerably less scrutiny, except when debated through the specific lens of particularly polarized ideological concerns. If fully implemented as planned, the PPACA has the potential to improve reproductive health in the United States in at least three ways: increasing the number of women and men with insurance coverage; increasing the value of insurance coverage for addressing reproductive health needs; and improving access to reproductive health services and information more generally. Several PPACA provisions stand out as having particular importance for reproductive health, including Medicaid family planning expansions, standards for an essential health benefits package, expanded coverage for contraception and other clinical preventive services, and teen pregnancy prevention programs. All these potential gains, however, are threatened by political, economic, and logistical challenges to the PPACA and by flaws in the legislation itself.

Our piece was almost two years in the making on the slow academic brew. I’m struck by the number of issues here that never reached the public discourse. The abortion issue dominated during the legislative debate. Then religious institutions’ coverage of contraception consumed much of the oxygen during the 2012 campaign. Much more was going on. And there were many more reproductive health provisions contained within the apparent junk DNA of the health reform bill.

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