Family Planning (Pregnancy, Well Baby)
08/05/2009
Family
planning, the process of delaying or accommodating pregnancy, is a growing
concern for both health insurance companies and reproductive health advocates. The main focus on both sides of the
issue is what defines comprehensive care.
Traditionally, insurance companies have distinguished family planning
care as providing customers access to contraception. However, through activism and legislation, that definition
is gradually expanding to encompass a wider range of preventative services.
In the
current health insurance market, many states require private insurers who offer
prescription drug coverage as part of their comprehensive health plans to
include the full range of FDA-approved contraceptives. This covers pills and injections as
well as devices like birth control patches, rings and IUDs. It is important to note, however, that
19 of the 27 states with these laws in place allow certain employers—like
religious organizations or churches—to withdraw coverage for contraceptives for
employees. Furthermore, many
health insurance plans do not offer equal coverage for these drugs; women may
have to pay more out of pocket for birth control prescriptions than for other
medications.
Perhaps the
biggest complaint against private insurance companies is that the scope of
coverage for family planning services is generally narrow and doesn’t include
counseling, education, or many clinical procedures like contraceptive device
implantation. This often leads
women to choose a method of contraception based solely on cost rather than
suitability.
While most
private health insurance plans cover contraceptives on some level, all
state-sponsored public plans are required by law to provide comprehensive family
planning coverage. These plans pay
the full cost of prescriptions and many clinical services, allowing a large
number of women, and especially the poor, greater access to care. Yet these public health plans are not
without their own problems.
In many
states the regular income levels for Medicaid eligibility are very low. This excludes a large number of poor
women simply because they are not “poor enough.” Care is generally offered to women who already have young
children, which does not help women who wish to avoid a first pregnancy. Some states do offer Medicaid waivers
that expand income limits and include women who do not already have
children. These waivers have
proven moderately effective in reaching a greater portion of the population, but
the area that remains lacking for Medicaid programs is provider
reimbursement. Delayed or
incomplete payments negatively impact doctors and clinics, threatening the
financial stability of these providers and their ability to care for
patients. Timely reimbursement
would also encourage private physicians to work with Medicaid, thereby giving
even more women access to quality family planning resources.
Family
planning is a very personal issue that involves obtaining detailed information
about a woman’s sexual history and reproduction objectives. Services such as counseling, community
outreach, education, language assistance and interpretation, and care that is
sensitive to cultural differences are all integral to the process. These services make up a more complete
picture of family planning and reproductive care, and should be increasingly
present as part of overall comprehensive health insurance packages, whether
from private or public insurers.
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03/04/2007
A study
published in the February 21 issue of The Journal of Neuroscience offers new hope for multiple sclerosis patients. In tests involving mice, injections of the pregnancy-related hormone prolactin resulted in repair of damage to myelin, a fatty substance that helps nerve fibers conduct electrical impulses. (In MS, the immune system is believed to attack the myelin protecting the nerve cells, which disrupts the ability of the nerves to conduct electrical impulses to and from the brain.
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03/02/2007
In Carey,30
the court decided that a statute requiring youth under sixteen to obtain contraception from physicians was not constitutional where “appellants assert[ed] no medical necessity for imposing a medical limitation on the distribution of nonprescription contraceptives to minors.”31
Without research to support the age distinction made by Plan B, the courts are left to conclude that the FDA's regulation of this contraceptive is based more on politics than actual concerns with the physical harm of minors.
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03/01/2007
Today, 1 in 8 infants, or about 13%, is born before the usual 40-week gestation period, according to the March of Dimes, compared with 9.4% in 1981. A baby born before 37 weeks of pregnancy is considered a preterm, or premature, birth. Preterm birth is the nation's leading cause of infant death, responsible for more than one-third of infant deaths before age 1, according to the Centers for Disease Control and Prevention.
"The rate of preterm births is going up, and we don't always know why," says Mary Ames-Castro, MD, an Assistant Professor of Obstetrics and Gynecology at the Medical College of Wisconsin.
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