美国避孕覆盖政策:历史和当前的挑战。

IF 2.8 2区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
Carol S Weisman, Diana Velott, Amy Zheng, Sarah Horvath, Douglas Leslie, Cynthia H Chuang
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引用次数: 0

摘要

背景:州和联邦政策旨在通过在公共和私人健康保险中提供避孕费用的覆盖范围来扩大获得避孕的机会。然而,避孕覆盖的障碍仍然存在,预计在2022年美国最高法院对多布斯诉杰克逊妇女健康组织一案作出裁决后,这种障碍将会增加。本文描述了这些政策的历史和当前的挑战。方法:我们使用公开的来源和公共数据集,构建了从联邦避孕权建立到2024年,联邦和州在公共和私人健康保险中提供避孕费用覆盖的政策年表。按照历史学家和社会科学家的描述,我们将避孕技术和实践的发展史与政治和法律挑战结合起来。结果:在1873年《科姆斯托克法案》(Comstock Act)的限制下,经过近一个世纪的限制,联邦政府确立了避孕权,此后,三次避孕覆盖政策制定浪潮试图通过让消费者更负担得起避孕措施来增加避孕机会。这些浪潮包括各州在医疗补助计划中扩大避孕覆盖范围的选择;通过国家避孕保险公平法,以确保私人健康计划中避孕保险的平等;以及《平价医疗法案》的全国避孕覆盖要求及其随后的修改、澄清和编纂。多布斯案之后,对避孕措施覆盖范围的挑战包括努力将某些避孕措施重新定义为堕胎药,并恢复《科姆斯托克法案》的一些限制。免费提供预防服务的要求也受到威胁。结论:避孕覆盖政策将受到避孕和流产获取面临的持续挑战以及避孕技术和分娩方式的变化的影响。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Contraception Coverage Policy in the United States: History and Current Challenges.

Background: State and federal policies have aimed to expand access to contraception by providing coverage of its costs in both public and private health insurance. Yet barriers to contraception coverage remain and are expected to increase after the 2022 U.S. Supreme Court decision in Dobbs v. Jackson Women's Health Organization. This paper describes the history of these policies and current challenges.

Methods: We constructed a chronology of federal and state policies providing coverage of the cost of contraception in both public and private health insurance, from establishment of the federal right to contraception through 2024, using published sources and public datasets. We aligned the chronology with the history of the development of contraception technology and practices, as described by historians and social scientists, and with political and legal challenges.

Results: Following establishment of a federal right to contraception after nearly a century of restrictions under the 1873 Comstock Act, three waves of contraception coverage policymaking sought to increase access to contraception by making it more affordable to consumers. These waves included options for states to expand coverage for contraception within the Medicaid program; passage of state contraception coverage equity laws to ensure parity for contraceptive coverage in private health plans; and the Affordable Care Act's national contraceptive coverage requirement and its subsequent modifications, clarifications, and codifications. Post-Dobbs, challenges to contraception coverage include efforts to redefine certain contraceptives as abortifacients and to resurrect some of the restrictions of the Comstock Act. The requirement of no-cost coverage of preventive services is also threatened.

Conclusion: Contraception coverage policy will be impacted by ongoing challenges to contraception and abortion access, as well as changing contraceptive technology and modes of delivery.

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来源期刊
CiteScore
4.50
自引率
6.20%
发文量
97
审稿时长
32 days
期刊介绍: Women"s Health Issues (WHI) is a peer-reviewed, bimonthly, multidisciplinary journal that publishes research and review manuscripts related to women"s health care and policy. As the official journal of the Jacobs Institute of Women"s Health, it is dedicated to improving the health and health care of all women throughout the lifespan and in diverse communities. The journal seeks to inform health services researchers, health care and public health professionals, social scientists, policymakers, and others concerned with women"s health.
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