The Affordable Care Act of 2010 greatly expanded women's access to free preventive services, particularly for sexual and reproductive health. Men didn't fare nearly as well.
The ACA guidelines' promise of free contraception may have generated the most controversy, but the law also provides many other services for women, including free screening for HIV, chlamydia and gonorrhea, and pregnancy-related benefits such as screening for gestational diabetes, and breast-feeding support, supplies and counseling.
Under the law, new health plans or those whose benefits have changed substantially are required to provide four types of preventive care without any co-payments or other forms of cost-sharing: services recommended by the U.S. Preventive Services Task Force, immunizations recommended by the Centers for Disease Control and Prevention's Advisory Committee on Immunization Practices and preventive services and screenings for women and for children that are recommended by the Health Resources and Services Administration.
Sen. Barbara Mikulski, D-Md., championed adding women's preventive services recommended by HRSA following an outcry over a Preventive Services Task Force recommendation that regular mammography screening for most women begin at age 50 rather than age 40. In a separate amendment, she successfully pushed to reinstate the earlier recommendations that called for mammography screening starting at age 40.
The new law requires most health plans to begin providing free contraceptives to women when their new plan year begins this fall or next year. It covers all FDA-approved methods, including permanent ones such as tubal ligation. But since its scope is limited to women's services, it does not offer free coverage for vasectomies.
Men's health specialists say both men and women could have benefited from such a requirement. Even though they're generally simpler and less expensive than female sterilization, cost can be a factor that deters men from getting vasectomies.