Are Most Pregnancy Related Symptoms Considered Pre-Existing Conditioned Under AHA Re-Write?


A number of news articles and social media posts claim that pregnancy, sexual assault and domestic violence could be considered “pre-existing conditions” that make it hard to keep insurance coverage under the Republican health care bill. Are those alarming claims really true?

The bill doesn’t specifically refer to any of these things, and some of the headlines suggesting that it does are misleading.

But the bill would allow insurers, in limited circumstances, to charge people more if they have a pre-existing condition — a health issue that existed before the patient’s coverage starts, if that person has had a lapse in insurance.

Under the current health care law — the Affordable Care Act, also known as Obamacare — insurers are not allowed to charge more or deny coverage for pre-existing conditions. The GOP health plan the passed the House Thursday — called the American Health Care Act (AHCA) — would allow states to seek a waiver from that rule. It would fund a system of “high-risk pools” to offer assistance to patients instead, but many are concerned that won’t be enough.

Twitter is overflowing with lists of pre-existing conditions, patient testimonials and personal stories of health struggles with the hashtag #IAmAPreexistingCondition. People living with a host of medical conditions are worried about the future of their coverage if the Republican plan becomes law.

Concern has focused in particular on women’s health issues, and especially pregnancy. Claims that rape victims could lose their coverage have also stirred outrage. Here’s a fact check:

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This Telemedicine App Promises Free Birth Control amidst Obamacare Abolishing Threat


Telemedicine startup Nurx has committed to keep the free birth control flowing after the Republicans in Congress and Donald Trump nix Obamacare, as they’ve been proposing for a while now.

“Donald Trump’s first executive order reaffirmed that he is intent on repealing the Affordable Care Act. We hope that in doing so he ensures that women would retain access to free birth control and other preventative services. Anything less would be reckless.” says co-founder and CEO of Nurx, Hans Gangeskar.

He also believes that repealing the Affordable Care Act would cause 24 million people to lose health coverage by 2021 and would have devastating consequences on women’s health.

To do its part to counter those effects, Nurx is offering free birth control to new users who use the promo code ‘AlternativeFacts.’

The  San Francisco, California-based company focuses on making birth control as well as Truvada for PrEP (Pre-Exposure Prophylaxis) more accessible to everyone through their app. With the app, users can get a prescription from a doctor and have their medication delivered right to their door.

According to the National Women’s Law Center, roughly 55 million women now receive contraception and other preventive services with no out-of-pocket costs because of the Affordable Care Act.

In 2015, researchers from the Perelman School of Medicine at the University of Pennsylvania found that the ACA is saving oral contraceptive users an average of $255 a year and $248 for women with an IUD.


Its mission is to be a low cost option for woman and since December 2016, it has offered free pills to new users.

The Free Birth Control Promotion requires users to use the promo code ‘AlternativeFacts’ in order to get $45 of credit toward birth control through Nurx. To get the deal, users must visit, create a Nurx account, pick their brand of choice, and enter promo code ‘AlternativeFacts’ at checkout. The promotion ends February 28, 2017.

According to Nurx’s Medical Director, Dr. Jessica Knox, “Women should not have to jump through unnecessary hoops just to access birth control. The pill remains available by prescription only throughout the United States today, but with our app, we’re making birth control more accessible than ever.”

How the App Works for Birth Control:

● User Chooses Brand – The user selects their brand, answers a few questions, enters their insurance and shipping info.

● Doctor Reviews Submission – a Nurx partner physician reviews the request and writes a prescription.

● Delivered to Customer – The prescribed medication is delivered right to the user’s door.

“Women should be able to access health care on their own terms,” explains Dr. Edvard Engesaeth, a medical doctor and cofounder of Nurx. The app works for both new and existing birth control users and the service and shipping are often free to anyone with health care coverage. For uninsured patients, Nurx waives the consultation fee.

Breastfeeding & Pumping at Work: Know Your Rights

Many American women do not yet know that the current US federal law states about what rights women have to pump their milk at work; and what accommodations they are entitled to get from their employers.
Tom Spiggle, author of You’re Pregnant? You’re Fired!,” who focuses on pregnancy discrimination in the workplace, says that if you are breastfeeding your child, the right to pump milk at work under federal law remains a bit complicated. The Affordable Care Act of 2010, also known as Obamacare, requires employers to allow women to pump breast milk while they are at work, but like many federal regulations covering American workers, it’s shot through with loopholes.
“For the first time, women constitute more than half of the workforce and the fastest growing `segment is women with children under the age of three,” says Spiggle. “Although many workplaces now provide lactation rooms and staggered breaks for breastfeeding mothers, they’re often doing so voluntarily as a good business practice to help retain female employees and not as a matter of law. And a good business practice it is.”
Spiggle says the good news is if a woman is covered under the law, her employer must provide a “reasonable break time” to pump milk each time you need to during the day, which is typically every few hours. That includes any time she would need to retrieve and use any type of breast pump. She must also be given a private space that is not a bathroom where she won’t be bothered by coworkers or customers. (It doesn’t necessarily have to be a dedicated lactation room, however.)
The bad news is a woman’s breast-pumping time doesn’t have to be paid, unless her coworkers also get paid breaks. And not everyone is covered by the new law. For starters, employers only have to meet the requirement if they have 50 or more employees, but as it turns out, only three percent of America’s small businesses (defined as those with fewer than 500 workers) fit that definition in 2010. A company with fewer than 50 employees must comply with the law unless it can prove that it would be an “undue hardship” to do so. The Department of Labor has made it clear that this standard is a very high hurdle to meet.
Also, only those women who are “non-exempt” under the Fair Labor Standards Act (FLSA) are covered. The FLSA is a complicated law, but non-exempt employees are generally hourly workers who must be paid overtime. If you make more than $455 a week and have any supervisory responsibility, you may be exempt and therefore not covered by the breastfeeding law. This big loophole leaves out a lot of breastfeeding mothers.
 “In a perfect world, bosses would be understanding and accommodate nursing moms’ needs during those few months when they are pumping milk,” adds Spiggle. “After all, few people dispute the benefits of breastfeeding for babies. It’s healthier than formula, not to mention cheaper.”

Good review! Hope this clears everything up.

photo: Reuters
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Mom’s Guide to Health Reform and Maternity Coverage

This week, two different U.S. Court of Appeals issued conflicting rulings about how the federal government can subsidize those residents who have signed up for healthcare.
A DC Circuit Court said the federal government went too far offering subsidies and a 4th Circuit Court of Appeals hours in a similar case upheld the subsidies in their entirety.
It all reminded me to share this guide that will help your realize how your old policy may have changed whether it is new, newly covered or discontinued.

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The IRS exempted Pregnant women from “Obamacare” tax penalty

Depending on when you get pregnant, if you don’t already
have health insurance, you
may qualify for an expansion of the Medicaid program
in your state.
It is part of the 2010 Affordable Healthcare Law, sometimes
called “Obamacare”  because it was pushed by President Barack Obama and is part of his bellwether accomplishment for his first term in office, and is having widespread implications into his second term.
The elements of the contentious law gradually go into effect over the years.  Despite efforts to repeal or defund it because of claims it would cost jobs and some to lose their existing coverage, the US Supreme Court
has declared it constitutional, the president signed it into law and Congress
voted it into law  four years ago.
You can fight it or if you’re in need, figure out how it can
help you especially if you find yourself knocked up without adequate healthcare.
Last December, the Internal Revenue Service exempted pregnant women,
among other categories of people, from the penalty all Americans who do
not get insurance by April 1 must pay.
But the law also adds a special coverage just for pregnant women,
depending on the timing of the pregnancy. If you qualify, meet certain income
minimums, your care would be covered for FREE.
If you are not eligible for Medicaid, you
may qualify
for a subsidized low-cost health care form a “Qualified
Healthcare Provider
  • Under AHA, all QHP must provide, with No Co-Pay:
  • ·        
    Maternity care
  • ·        
    Labor and delivery
  • ·        
    Prenatal care, and
  • ·        
    all diagnostic screenings.

States still have flexibility to determine what services are
covered so you should examine and compare plans carefully. 

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President Obama catches a fainting pregnant woman during speech

Today, at the Rose Garden at the White House, a pregnant woman in a red dress standing behind President Barack Obama while he gave a speech about failures of the federal healthcare website fainted. The woman, Karmel Allison, is diabetic. Perhaps over the excitement of going to the White House she skipped breakfast and her blood sugar got too low.
It appears, some were signaling to the president and others nearby that she didn’t look too good and appeared to possibly be about to faint. If you look at the video (below), the woman standing beside the pregnant woman held grabbed the woman’s hand and then cradled her back and around the same time, Obama reached behind the podium and helped prevent her from toppling over.  Just then, someone from the back helped her off of stage. 
Obama retorted, “this is what happens when I talk too long.”
She had a good sense of humor about it it and tweeted out that she was okay:
Interesting. Some conspiracy theorists are already saying the move was planned, though it is unclear, if so, what would be the purpose. 
Perhaps to sway the news coverage away from the website failures and on to the fainting woman? The symbolism of the fall to the failing health system or website? Who knows.
Karmel, a techie and CalTech grad, was diagnosed with diabetes at 9-years old and said she used the California website, CoveredCA, to find healthcare options for herself and her healthy husband.  
The nightly comedian talk shows will have a field day with this one, many predict. 

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Why Kate Middleton’s posh UK birth cost almost Half an average US birth

Well we are finally starting to see some US perspectives to the recent royal birth of Kate Middleton and Prince William‘s baby. Earlier today, New York Times Correspondent, Elisabeth Rosenthal tweeted this:

It does open up room for debate as to charges related to having a baby in the United States. In a piece reacting to that tweet, The Week dug into the reasons behind the differentials in an article published this  afternoon.
In sum, it comes down to the way pregnancies are billed. The UK has a flat fee where in America, every pill, anesthesiologist, neonatal nurse, pillow, Vitamin K shot, epidural, monitor usage and even TV access is billed individually and those costs are easy to add up as each pregnancy is different. Not to mention, some costs are most likely artificially inflated to offset administrative costs and other non-health care related expense. 
A chart that accompanied the piece revealed how stark the price difference is in the US compared to other “developed” nations:
It speaks volumes as we are undergoing continuous debate over healthcare costs in America. We are also in the wake to the implementation and roll out of the Obamacare, the Affordable Care Act healthcare overhaul law.
Everyone should be doing their own individual research now to see how health costs will affect their lives now and in the future, especially those who are currently expecting or trying to conceive.

Parents’ portion of the bill, premium costs may fluctuate up or down in coming months. 

Better to be knowledgeable than caught off guard and with a major bill!

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Study: More women using midwives, PAs & Nurse practitioners for maternity care

More women are opting to use midwives, nurse practitioners and physician assistants for their maternity care, a new study from the American College of Nurses Midwives revealed.
During a webinar last week, some mothers shared how their birthing experience was made even more smooth by the presence of one of these medical professionals in the room who provided support and education about the labor and delivery process even more so than her doctor. 
Many times women succumb to medical intervention because they are not fully aware of all the options and that some decisions are made that are not based on medical reasoning but perhaps convenience and expediency.
The study, published in the September 2012 issue of the Journal of Midwivery & Women’s Health  showed that the percentage of pregnant women getting midwife, NP and PA care increased by 48% over the past ten years.  The research also indicated that there has been a 30% increase in women getting both care from an obstetrician and a midwife, NP or PA.
For years, there had been some stigma attached to getting maternity care from midwives, but this study reveals that attitudes and practices are changing. 

“These findings are especially positive as we continue our work with the American Congress of Obstetricians and Gynecologists, encouraging collaborative maternity care models that integrate services by different types of clinicians,” said Avery, coauthor and immediate past president of ACNM. “Collaborative practices in existence today are experiencing better outcomes for mothers and infants and increased work satisfaction for OB-GYNs and midwives.”
Experts state that in the United States, the implementation of the new Affordable Care Act (Obamacare) will require more PA, midwives and Nurse Practitioners to be trained to accommodate a growing demand from the public. More people will have insurance and be required to obtain insurance under the law implemented in 2010 and recently upheld by the US Supreme Court. 

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Will the next Republican president outlaw IVF? Unplanned Pregnancy STATS

Yesterday was the 39th anniversary of the Roe v. Wade US Supreme Court decision which made abortion legal in the United States. Almost 40 years later the Pro-Life and Pro-Choice sides are still fighting. It is at the helm of many of the political fights today. I got an email last night sharing with me President Obama’s commitment to protect a “woman’s right to choose” and respect “the law of the United States.”  Meanwhile, two of the Republican frontrunners who may or may not outseat Obama have pledged to define life at conception which, according to how some interpret it, would perhaps mean outlawing in vitro fertilization (IVF). Some US presidential candidates, including frontrunner Mitt Romney have pledged to defend the idea that life begins at conception, the heart of personhood laws protecting unborn babies. If that is the case, any scientific process like IVF which may destroy unused fertilized embryos that are not implanted could arguably be considered murder if the law is changed to recognize that life begins at conception.
In church yesterday, the priest all but said all Catholics have a moral obligation to vote AGAINST any pro choice politician. And a news blast I got from the Democatic National Committee shared the fact that the infamous Affordable Care Act (called Obamacare by those who hate it) now requires all plans to offer no cost access to birth control even religious affiliated hospitals though churches and religious institutions are exempt. Quite a conundrum and moral conflict for many.
Without sharing my personal opinion on this issue, just thought I’d share an excerpt from a recent article I did on the effect and impact of unplanned pregnancies. 
Clearly, something needs to be done in the near future, because the debate is ugly and will only get uglier from here. The excerpt from my piece on The GOP v Planned Parenthood that appeared in the Communities section of The Washington Times read:
Guttmacher Research studies show that married women, professional women and women from mid to upper income brackets have fewer unplanned pregnancies.   

However close to half of all pregnancies in the United States are unplanned and poor women are five times more likely to have an unplanned pregnancy and six times more likely to have an unplanned birth, according to Guttmacher Institute‘s recent analysis of government data.

A 2011 Guttmacher study notes that woman cohabitating outside of marriage also experience unintended pregnancies at a higher rate than married women. One obvious reason is that in an uncommitted relationship where couples are having sex regularly, a pregnancy is most likely not to be planned.

Professional and/or educated women have lower rates of unintended pregnancies as woman control their reproduction, many opting out of having children all together.

Approximately 26% of pregnancies in women with college degrees are unplanned compared to nearly half of all pregnancies for women with less than a college degree.  The Center for Work-Life Policy concludes that childlessness has increased across most demographic groups but is still highest among professionals. And analysis of census data conducted by the Pew Research Center, indicate that about one quarter of all women with bachelor’s degrees and higher in the United States wind up childless.

Race is also a factor in unplanned pregnancies as well. Accidental pregnancy among white woman is approximately 40% compared to 67% of black women and 53% of Hispanics. 

 Unplanned pregnancies in teens

 When unplanned pregnancies occur in teens, the impact is severe for all involved.  Studies indicate that

  • A teen that gets pregnant is less likely to graduate from high school, and will receive some public benefit within 5 years of delivering a child.
  • A teen mom is also less likely to return to school and earn a college degree.
  • Daughters of teen moms are three times more likely to become a teen mom
  • Sons of teen moms are three times more likely to be incarcerated.

Whether conceived by a teen or full adult woman, the impact of an unplanned pregnancy is devastating on the mother and child. 

Research shows that women with unplanned pregnancies are more likely to smoke, drink, and go without prenatal care. Their births are more likely to be premature. Their children are less likely to be breastfed, and more likely to be neglected and to have various physical and mental health effects.

In a recent issue of Indianapolis Women magazine, Caitlin Finnegan Priest, MPH, Indiana Perinatal Network, pointed to statistics that noted the majority of unplanned pregnancies are born to unmarried women, outside a two-parent family, and the children are more likely to be raised poor, drop out of high school, have lower grade point averages, lower college aspirations and poorer school attendance.

The pivot point requires learning why is it that professional women are better able to control their reproductive system. Could the difference be that they are having more abortions?

Not so, according to research. At least half of American women will have an unintended pregnancy by age 45 and nearly half or 43% of those pregnancies end in abortion, according to Guttmacher.

As could be expected, studies say that these numbers are highest among poor, a group that aborts babies at a higher rate.

Another Guttmacher study noted that between 2000 to 2008, the percentage of women under the poverty line getting abortions jumped 60 percent from 27 to 42 percent.

Consequently, the higher and disproportion unplanned pregnancy rates among minorities also result in a higher abortion rate.   

In the United States, the abortion rate for black women is almost five times, and for Hispanics two times, that for white women, a 2008 Guttmacher points out.

Thoughts on any of these stats?

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Panel recommends no co-pay for contraception, impassions Catholics

Tuesday, an independent panel of doctors and health experts recommended that coverage in health plans  include a wide-range of birth control options including Plan B, the controversial pregnancy prevention option.  It was among a list of 8 recommendations made. Specifically, it asked for “the full range of Food and Drug Administration-approved contraceptive methods, sterilization procedures, and patient education and counseling” to be approved.
The recommendations have gotten many religious groups upset because they say their faith prevents them from supporting certain methods and that by the government mandating coverage for all women of these contraception, it is infringing on their religious values.
“I strongly oppose the Institute of Medicine’s recommendation today,” Cardinal Daniel DiNardo, chairman of the Committee on Pro-Life Activities of the United States Conference of Catholic Bishops, said in a written statement. “Pregnancy is not a disease, and fertility is not a pathological condition to be suppressed by any means technically possible.”
Some groups like Planned Parenthood and Reproductive Rights Action League have cheered and welcomed the recommendations.
Dr. Vanessa Cullins, vice president for medical affairs at Planned Parenthood Federation of America, said in a written statement, “Covering birth control without co-pays is one of the most important steps we can take to prevent unintended pregnancy and keep women and children healthy.”
Many in the Catholic community say, if adopted, these types of recommendations would be one step closer to mandating coverage for abortion.

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