A group of doctors has recommended that the Affordable Care Act expand the list of women’s medical services that women should be able to receive at no cost.
There are currently eight core women’s services that insurers are required to cover without charging a copay. In addition to birth control, insurers must cover the full cost of “well-woman visits, screening and/or counseling for sexually transmitted infections, domestic violence and gestational diabetes as well as breastfeeding support and supplies,” according to NPR.
Unlike many other provisions of the ACA, those requirements apply to all health plans, including those purchased outside of the ACA marketplace. They have been in effect since 2012.
The National Academies of Sciences, Engineering and Medicine, after spending five years studying the issue, recommended that women also receive free mammograms every one or two years starting at age 40. Currently, women generally are not advised to begin getting screened for breast cancer until 50 unless they are deemed to be at a higher-than-average risk due to family history of the condition.
If doctors need to run any subsequent tests associated with the mammogram, such as a biopsy, they should also be free to the patient, said the group.
Women should continue to receive mammograms at least once every two years until at least age 75, the report said. After that age, it added, “the decision to discontinue screening mammography should be also based on a shared decision making process that includes the women’s health status and longevity.”
The value of a number of cancer screenings, including mammograms, has come under a cloud of skepticism in recent years. A major study published in 2014, based on 90,000 women over a 25-year period, found that breast cancer patients who had received mammograms were no more likely to survive the disease than those who had not.
“The decision to have a mammogram should not be a slam dunk,” Dr. Russell P. Harris, an expert on cancer screenings at the University of North Carolina, told The New York Times at the time.
Separately, the report recommended that health plans also cover male contraception, such as condoms and vasectomies, for free.
"The best contraceptive method for a woman at a particular time may be her partner," Adam Sonfield of the Guttmacher Institute, a nonprofit that focuses on reproductive health, told NPR.