Health Equity & Access Weekly Roundup: October 26, 2024

Women’s Awareness of ACA Preventive Services Remains Low Amid Ongoing Legal Challenges

Fourteen years after the Affordable Care Act (ACA) mandated no-cost preventive services for women, many remain unaware of these benefits. According to the 2024 KFF Women’s Health Survey, nearly 30% of women do not know that the ACA requires private insurance and Medicaid expansion programs to fully cover preventive care like annual checkups, mammograms, and contraceptives. Awareness is especially low among younger women, contraceptive users, and privately insured individuals, leading some to pay out-of-pocket for covered services.

The federal government continues issuing clarifications to promote ACA-mandated coverage, but ongoing legal challenges—such as Braidwood Management Inc. v Becerra—threaten the future of these provisions by challenging the authority of the US Preventive Services Task Force and citing religious objections.

Engage, Educate, Empower: Transforming Kidney Care

In this episode of Managed Care Cast, Jeff Giullian, MD, MBA, chief medical officer at DaVita Kidney Care, discusses 4 critical areas in kidney care: prevention, social support, integrated care, and patient support. He highlights the importance of managing chronic kidney disease in high-risk populations and DaVita’s community education programs that promote kidney health resources. Giullian emphasizes how integrated care teams play a vital role in managing comorbidities, enhancing patient outcomes, and reducing health disparities.

Biden-Harris Administration Proposes New Rule to Expand Affordable Contraception Coverage

The Biden-Harris administration has introduced a proposed rule to enhance contraception coverage under the ACA, expanding no-cost access to both over-the-counter and prescribed FDA-approved contraceptives for millions of women.

This move aims to safeguard reproductive freedom amid increasing restrictions following the Supreme Court's Roe v Wade decision reversal. Key aspects include ensuring insurance plans disclose OTC contraception coverage and addressing health equity by improving access for marginalized groups, including women in rural and low-income areas. However, the proposed rule may face legal challenges from conservative groups and pushback from insurers.

Social Determinants of Health Linked to Higher Health Care Costs, Payer Expenditures

A new study published in JAMA Network Open reveals the significant impact of social determinants of health (SDOH) on health care spending across Medicare, Medicaid, and private insurance in the US. Researchers found varied cost drivers across insurance types linked to factors like education, social isolation, neighborhood quality, economic stability, and medical discrimination. For instance, Medicaid costs were higher for socially isolated individuals, Medicare expenses increased in neighborhoods lacking parks, and private insurance costs rose among those who experienced medical discrimination. These findings emphasize the importance of SDOH in shaping health care costs, suggesting that policy adjustments targeting these root causes could improve cost management and health equity.

Infant Mortality Increases Across the US Following the Dobbs Decision, Study Finds

New data show a sharp rise in US infant mortality rates, particularly among infants with congenital anomalies, following the Supreme Court's Dobbs decision, which restricted abortion access. The study found a 7% increase in overall infant mortality and a 10% increase among infants with congenital conditions, with approximately 247 excess deaths likely linked to high-risk pregnancies being carried to term. This trend echoes findings from Texas after its abortion ban, suggesting that abortion restrictions could contribute to higher infant mortality rates by limiting options for terminating high-risk pregnancies. As abortion laws continue to shift, researchers call for further investigation into the long-term health effects on both mothers and infants.