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Margot Kingston, a women's health nurse practitioner at Families First and Harbour Women's Health of Portsmouth is pleased about the Affordable Care Act's comprehensive coverage for women's preventative care, which goes into effect today.Rich Beauchesne/rbeauchesne@seacoastonline.com

Beginning today, comprehensive preventive care coverage for women goes into effect as part of the latest rollout of reforms under the Affordable Care Act. Under the law, almost all new or renewed private health care plans issued after Aug. 1 must cover comprehensive women's preventive services with no cost sharing, or co-payments.

One local health care practitioner believes the elimination of a co-pay requirement for preventive care is an important shift toward healthier outcomes that will decrease the number and cost of chronic illnesses.

"We have seen there are many women who don't come in for an appointment because of a $10 to $25 co-pay," said Margot Kingston, a women's health nurse practitioner who works at the Families First Health and Support Center in Portsmouth and at Harbour Women's Health. "More women need routine health care but they don't get it because they can't afford the co-payment. No woman should die of cervical cancer because they can't afford a checkup."

According to the U.S. Department of Health and Human Services, in 2011 an estimated 20.4 million American women with private health insurance gained expanded no-cost sharing preventive services, including mammograms, cervical cancer screenings, prenatal care, flu and pneumonia shots, and regular well-baby and well-child visits. DHHS estimates that more than 253,000 women in New Hampshire on private insurance plans are now covered by the expanded preventive care provisions. By 2014, all Americans with private insurance will have a wide range of no co-pay, preventive care services as part of their basic coverage.

This new expansion of preventive services with no cost-sharing will cover so-called well-woman visits, which include contraceptive services and screening for gestational diabetes, domestic violence and sexually transmitted infections.

"This is an important part of the work to improve access and will include all preventive care," said Lisa Kaplan Howe, policy director for the advocacy organization N.H. Voices for Health. "It's incredibly important for women to be able to maintain their health and monitor their health without increasing cost sharing. Frankly, it's also good for insurers because patients who stay on top of preventive health don't cost as much money as those who don't."

Kingston said contraceptive services coverage will also be important as the up-front costs can be prohibitive for many women. In a conference call with New Hampshire journalists, Jennifer Frizzell of Planned Parenthood of Northern New England said that reducing the co-payment cost of preventive services is a critical step in challenging economic times. "We see this every day. Whether to pay for birth control or pay for groceries these are very real choices for New Hampshire women," Frizzell said. "That burden will get easier."

While the new guidelines go into effect today, Kaplan Howe said it can be confusing because actual comprehensive coverage doesn't begin for many with existing policies until they are renewed, which usually happens in the fall and winter. The provisions are also not impacted by the declining number of "grandfathered" group plans that were in effect when the ACA became law in 2010 and are expected to lapse in the next couple of years.

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Key health care act benefit for women starts today