These tools will no longer be maintained as of December 31, 2024. Archived website can be found here. PubMed4Hh GitHub repository can be found here. Contact NLM Customer Service if you have questions.


Pubmed for Handhelds

PUBMED FOR HANDHELDS

Search MEDLINE/PubMed

  • Title: Clinton reform proposal faces Congressional test on covered services, cost.
    Journal: Wash Memo Alan Guttmacher Inst; 1994 Jan 13; (1):1-3. PubMed ID: 12345517.
    Abstract:
    Common to most of the health care reform proposals currently under consideration in the US Congress is an emphasis on preventive services such as well-baby visits. The Clinton plan, formally known as the Health Security Act (HSA), would exempt preventive care from the deductibles and co-payments applicable to other covered health care services. A weakness of the HSA is its failure to regard the reproductive health benefits package as preventive. Although prenatal and postpartum care are classified as such, family planning visits and other services for pregnant women are subject to deductibles and cost-sharing stipulations for recipients with incomes above the poverty level. Also problematic is the HSA's failure to define the scope of services beyond "voluntary family planning services" and medical devices subject to federal approval. This ambiguity leaves the status of abortion unclear, and implies that drugs, such as oral contraceptives, are not covered. Thus, a woman who attends a family planning clinic to obtain a prescription for oral contraceptives could be required to meet deductibles both for medical visits and outpatient prescription drugs. Similarly, the HSA makes no mention of sexually transmitted diseases prevention. Instead, coverage is provided for "fertility related infectious illness"--a stipulation that enables annual screening for gonorrhea and chlamydia but excludes syphilis. Managed care providers who receive a flat fee regardless of the amount of care provided might be inclined to eliminate screening for all sexually transmitted diseases. Also of concern is the threat that low-income women who currently receive free prenatal medical care through Medicaid would be required to pay a share of their premiums to receive HSA coverage for other areas. The extension of Medicaid benefits to pregnant women with incomes up to 185% of the poverty level substantially increased use of prenatal care by the working poor--a trend that would be reversed under the terms of the HSA.
    [Abstract] [Full Text] [Related] [New Search]