Angela Eyraud, Public Interest Fellow, NARAL Pro-Choice Colorado
Thanks to Obamacare – the President’s health reform law – American women who get their insurance through a private insurance company will have more affordable access to basic and essential preventive health care with no out-of-pocket expenses beyond their premiums.
Beginning August 1, for new health insurance plans, these women cannot be charged co-payments, deductibles, or co-insurance for office visits and prescriptions related to a range of women’s preventive health care needs, including certain reproductive health services like tests for the human papillomavirus (HPV).
Under the no-out-of-pocket expenses for essential preventive health care provision of Obamacare, women aged 30 and older are eligible for HPV DNA testing without any additional out-of-pocket costs beyond the premiums they pay for their insurance. An HPV DNA test is more advanced than Pap smears in detecting HPV and its associated diseases, like cervical cancer. A woman may choose to have this (free) test even if her Pap smear results are normal, although the HPV DNA test is administered no more than once every three years.
HPV has multiple types and can lead to various diseases. The most common HPV-associated diseases are genital warts and cervical cancer. HPV also can lead to other cancers, such as vulvar, vaginal, penile, and anal cancers. Approximately 20 million Americans are currently infected with HPV, with 5.5 million new infections per year. The prevalence of HPV is so high in the U.S. that at least 50% of men and women are expected get it at some point in their lives. (Not all cases of HPV lead to disease – the body may take care of the virus itself with no adverse side effects.) Preventive services related to HPV are critical in preventing infection, spreading the virus, and treating any diseases resultant from it.
HPV DNA tests are important for many reasons. To begin with, free HPV DNA testing under Obamacare is only for women at least 30 years of age. Because the current FDA-approved vaccinations for HPV are only approved for those 26 years old and younger, the likelihood that women aged 30 years and older have not received an HPV vaccine is high, as is the likelihood of HPV infection in these women compared to those who have been vaccinated. Additionally, while condoms reduce the risk of HPV, they do not fully protect against infection and HPV-associated diseases like genital warts. This means HPV can still be passed on despite the use of barrier methods of contraception. Furthermore, a person can be infected with HPV for years and not show any outward physical signs or symptoms, which increases the chances of (unknowingly) further spreading HPV. Finally, the earlier HPV and any associated diseases are identified, the better: the earlier cervical cancer is detected and diagnosed, the more treatable it is. Women who routinely use preventive services can identify problems and markers before cancer and other diseases even develop.
With 4,000 of the 12,000 women who are diagnosed annually with cervical cancer dying in the U.S., preventive services like HPV DNA testing can truly begin to improve the health and well-being of many American women. Cost-sharing models that impose co-pays, deductibles and other beyond-premium charges previously made preventive care inaccessible and unaffordable for millions of Americans. And because women are more likely to need preventive services but are less able to pay for them, these cost-sharing models disproportionately stopped women, and particularly women of color, from getting essential preventive health care. Beginning August 1, the health of women – regardless of age, race, or income – will improve as a result of the increased affordability and accessibility of preventive health care services.