When Health Insurance Gets in the Way of Health Care

by Lisa Codispoti, Senior Advisor
and Brigette Courtot, Policy Analyst
National Women’s Law Center

This post is part of a weekly series on Women and Health Reform.

Yesterday, we learned that one-quarter of American young women ages 14 through 19 have a sexually transmitted infection (STI). Educating adolescents about the risks of STIs, and how to protect against them, is one way to respond to this shocking statistic –- an earlier NWLC blog post covered why comprehensive sex education should be promoted over ineffective abstinence-only programs. Another important way to prevent the spread of STIs is by ensuring that all sexually active people are regularly screened for these infections.

So, shouldn’t it be as easy as possible to get an STI screening? We thought so, but then we got this e-mail from a co-worker:

“During my recent annual visit with a new gynecologist, I was shocked by the doctor’s response to my request that she screen me for STIs along with my annual Pap test. Although my gynecologist didn’t exactly dissuade me from getting screened, she warned against having it done during my annual visit. In her experience, insurance companies often refuse to pay for STI screening done during an annual exam; insanely enough, she finds that insurance companies are more likely to cover STI screening when the patient returns for a second pelvic exam.”

What?!? Let’s be honest – what woman wants to endure more than one pelvic exam a year? Raise your hand ... we thought not! And there’s the time and expense to consider as well. Although our co-worker has health insurance and we work for an organization that would allow time off to return for a second pelvic exam, not all women are nearly as fortunate: 18 percent of women in the United States lack health insurance coverage, and D.C. only recently became the second city in the country to require employers to grant employees paid sick leave.

A good part of our health reform efforts involve expanding meaningful health insurance coverage to uninsured women and their families. But getting the right health care at the right time can be difficult even for those of us with comprehensive health coverage. As we continue to consider how to change our health care system in ways that will improve women’s health, the role of timely preventive care (including STI screenings) can’t be emphasized enough. Our health system should be designed in a way that encourages preventive care, instead of making it more difficult. Insurance company billing practices should not dictate whether we get the health care that we need.

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