Dr. Raine: The Affordable Care Act, an OB/Gyn Perspective

Me & My OBGNovember 13, 2013Articles, Hear from Our Doctors

There has been quite a bit of discussion over the past several weeks about the issues and troubles with the Affordable Care Act (ACA).  Last week, as the President apologized for difficulties in ACA implementation, many Americans took to the web voicing their displeasure.  For 12 hours after the President’s address, my Twitter feed was the political equivalent of “he said, she said,” and unfortunately, from time-to-time, things got ugly.  That’s the great thing about living in America. We can say what we want without fear of retribution, imprisonment, or death.  And because of this freedom to question our leaders, many people on both sides of the political spectrum have chosen to voice their opinions at every opportunity, all while the President tries to salvage the one piece of legislation that will forever be attached to his name.  As in most things in life, the truth about the relative merits and pitfalls of the ACA likely lies somewhere in the middle.

All of this partisan bickering was on my mind as I boarded a flight to Africa, where I would spend the next six weeks working to improve the lives and health of women and children.  I was headed to a place where the majority of people do not have access to basic health care.  In Malawi, there are fewer than a dozen Obstetricians and Gynecologists for a country of 14 million people.  When women cannot access safe, high quality healthcare, they find themselves unable to plan and space their pregnancies resulting in increased maternal mortality.  This is as true in the United States as it is in Malawi, though lack of affordable health care rather than lack of providers tends to be the largest barrier to obtaining services in the United States.  So while we can all agree that the ACA is far from perfect, the underlying goal of increasing health care access is an important one.

Historically, women have paid more to obtain the same health care coverage as men.   However, under the ACA, being a woman is no longer considered a preexisting condition.  In fact, women can no longer be charged higher health care premiums just for being a woman.  Free access to preventative services such as an annual examinations, pap smears, and mammography are required at no additional cost to the woman.  Other preventative services that must be provided free of charge (excluding the insurance premium, of course) include FDA-approved contraception, prenatal care, breastfeeding equipment and counseling, smoking cessation medications, and domestic violence screening and counseling. It is estimated that approximately 19 million uninsured women will become eligible for health care coverage via the Health Insurance Marketplace.   So while our new health care system under the ACA has challenges to overcome, recognizing the importance of quality health care for women is not one of them.

Dr. Susan Raine was selected as the McCain Fellow for District XI for 2013. 

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