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Women and Health Care in the Early Years of the ACA: Key Findings from the 2013 Kaiser Women's Health Survey

Coverage, Access, and Affordability
  1. Kaiser Family Foundation, Medical Debt Among People with Health Insurance, January 7, 2014.

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Preventive Services
  1. The Patient Protection and Affordable Care Act, Section 2713: Coverage of Preventive Health Services

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  2. U.S. Preventive Services Task Force, USPSTF A and B Recommendations

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  3. Centers for Disease Control and Prevention, Vaccine Recommendations of the ACIP

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  4. Bright Futures and American Academy of Pediatrics, Recommendations for Preventive Pediatric Health Care

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  5. Health Resources and Services Administration (HRSA), Women’s Preventive Services Guidelines

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  6. Health Resources and Services Administration, Women’s Preventive Guidelines

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  7. HHS, Substance Abuse and Mental Health Services Administration, Behavioral Health, United States, 2012

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  8. HHS, Essential Health Benefits.

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  9. U.S. Preventive Services Task Force, Screening for Lipid Disorders in Adults

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  10. U.S. Preventive Services Task Force, Screening for Colorectal Cancer

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  11. U.S. Preventive Services Task Force, Screening for Cervical Cancer 

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Reproductive and Sexual Health Services
  1. Guttmacher Institute. (2013). Unintended Pregnancy in the United States.

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  2. Centers for Disease Control and Prevention. (2013). Sexually Transmitted Infections Among Young Americans.

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  3. Centers for Disease Control and Prevention. (2011). The National Intimate Partner and Sexual Violence Survey.

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  4. Catalano, S. (2012). Intimate Partner Violence, 1993-2010. U.S. Department of Justice, Office of Justice Programs.

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  5. U.S. Preventive Services Task Force. (2008). Recommendations for STI Screening.

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  6. Centers for Disease Control and Prevention. (2014). Sexually Transmitted Diseases (STDs).

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  7. The Institute of Medicine. (2011). Clinical Preventive Services for Women: Closing the Gaps.

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  8. Kaiser Family Foundation. (2012). State Coverage of Preventive Services for Women under Medicaid: Findings from a State-Level Survey.

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  9. The American Congress of Obstetricians and Gynecologists. (2009). Hormonal Contraceptives Offer Benefits Beyond Pregnancy Prevention.

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  10. Dayal, M & Barnhart, KT. (2001). Noncontraceptive benefits and therapeutic uses of the oral contraceptive pill. Seminars in Reproductive Medicine 19(4).

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  11. Foster, D, et al. (2011). Number of oral contraceptive pill packages dispensed and subsequent unintended pregnancies. Obstetrics & Gynecology 117(3).

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Conclusions and Implications
  1. Peipert, J.F., et al. (2012). Preventing unintended pregnancies by providing no-cost contraception. Obstetrics and Gynecology 120 (6). 

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Exhibit 3.1

Majority of women are covered by employer-sponsored insurance (ESI)
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Exhibit 3.2

Over four in ten young women are insured under a parent’s plan
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Exhibit 3.3

Women of color have lower rates of private coverage and higher rates of Medicaid or no insurance
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Exhibit 3.4

Many low-income women are uninsured
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Exhibit 3.5

A higher share of women than men forgo health care needs due to cost
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Exhibit 3.6

Health care costs are a barrier to care for uninsured women, but also for women with Medicaid and private coverage
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Exhibit 3.7

Logistical problems pose barriers to health care for women, particularly low-income women
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Exhibit 3.8

Medical bills affect many aspects of women’s financial stability
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Exhibit 5.1

Women’s knowledge about ACA coverage for preventive services
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Exhibit 5.2

Eight in ten women have had a recent general check up, but rates are lower among some groups
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Exhibit 5.3

Counseling on health behaviors is highest for diet, exercise and nutrition
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Exhibit 5.4

Higher rates of counseling on some topics among women who are younger or poorer health
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Exhibit 5.5

Four in ten women report speaking with their providers about mental health issues, rates higher among some groups
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Exhibit 5.6

Lower utilization of screening tests among uninsured women
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Exhibit 5.7

Rise in rate of cholesterol screenings between 2001 and 2013, rate of pap tests is falling
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Exhibit 6.1

Most women have had a gynecologic or obstetric exam in the past year, except for women who are uninsured
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Exhibit 6.2

Most women obtain gynecologic exams at a doctor’s office, but many also rely on clinics
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Exhibit 6.3

Provider counseling on contraception is more common than other sexual health topics, but there is variation by insurance status
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Exhibit 6.4

Counseling rates for STIs and HIV are higher among Black and Hispanic women compared to White women
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Exhibit 6.5

Counseling on reproductive and sexual health is most frequently reported by women in their early twenties
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Exhibit 6.6

Approximately one-quarter of women have discussed domestic violence with their provider, but rates are higher among Hispanic women and those with Medicaid
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Exhibit 6.7

Many women incorrectly believe that STI testing is routine part of an examination
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Exhibit 6.8

One in five sexually active women are at risk for unintended pregnancy because they are not using contraception
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Exhibit 6.9

Many women use contraception to prevent pregnancy and manage medical conditions
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Exhibit 6.10

Women of color have higher reliance on clinics and health centers for contraceptive care
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Exhibit 6.11

One-third of uninsured women receive birth control from family planning clinics
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Exhibit 6.12

Most women receive a three months’ supply of birth control pills, but one in four receive a longer term supply
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Exhibit 6.13

Most women have heard of emergency contraceptive (EC) pills, but few have used or purchased them
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Exhibit 6.14

One in three women had full coverage for birth control, but one in five had no coverage for contraceptives
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Exhibit 6.15

Among women with private insurance, one in three report plan paid for full cost of contraceptives
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Exhibit 6.16

Many young women place a high value on confidentiality, but are unaware that private plans can send EOBs to parents