Will the Affordable Care Act Affect Women’s Right to Decline “Optional” Screening Tests?

Some women are questioning how the Affordable Care Act will affect their right to informed consent in regards to pap tests/pelvic exams.  Some of the questions women are asking include the following:

Will insurance company policies require pap tests as part of the qualifying exam?

Will doctors use health insurance forms as a means to coerce women into unwanted pap tests?

If women are required to undergo pap tests in order to qualify for health insurance does this mean that men will be required to undergo prostate exams?

Will women and men no longer be able to decline screening tests that are currently considered “optional”?

The lack of clarity and lack of information is causing many women no small amount of anxiety, especially those women with a history of having been harmed by physicians’ practices, or who have chosen to decline screening in the past.  Perhaps even more importantly, if the answer to any or all of the above questions is “yes”, then what is to be done about it?

Thank you Lynne for suggesting an additional forum to help track women’s experiences under the new health care act.


  1. I’ve read through the entire ACA – hundreds and hundreds of pages of it – and there is absolutely NOTHING in the text ANYWHERE that even mentions paps or pelvics or any other screening tests, much less sets forth a requirement to have them.

    The only gyn related law that is on the books in regards to health care is that women are allowed to see a gyn when they wish, without a referral from their PCP, and that has been on the books for years now.

    As to whether insurance companies will require it: none of the government plans (Medicaid, Medicare and Tricare – that is for military) ever have, and I doubt they ever will. What private insurance companies require differs per company. Women always have the right to choose another insurance carrier. The ACA also has a loophole that if it would cost you more than 8% of your income to get health insurance, you can opt out without the penalty fee.

    Also, now that insurance companies are not allowed to disqualify you based on your health or pre-existing conditions, they can’t require ANYTHING like a physical before they cover you.

    • So you don’t need to get a physcial (whatever that would entail) to get insurance? That’s good to hear! The tactic of “enforcing an impression” is very common (particualrly in America).

      There definitely seems to be a lot of coercion with that subject (I know I’ve heard of them backing women into all kinds of exams in order to get insurance). I’ve even heard of people getting fired for smoking outside of work! These groups really think that they own these other people.

      Not to rub it in your face, Diane, but I remember your story about how they backed all the girls in your high school into pelvic exams & said that it was graduation & getting into college was dependant on it. I worry very severely on that- maybe making one thing or another a requisite for school or whatever when I have a family (not that a requistite can’t be dissolved, but “Your mandate is abrogated” isn’t too common a phrase or philosophy in this country).

    • You are confusing me with someone else, because I never posted a story about everyone in my HS having to get pelvics. Ever. Whoever that happened to, it wasn’t me. If my high school had ever suggested such a thing my mother would have burned the place down. I also went to a school for the academically gifted, and nobody would have been stupid enough to fall for a “you need this to graduate/get into college” line…

      One of the mandates with the ACA is that it allows everyone to get insurance, regardless of pre-existing conditions – it would be pointless to require physicals. I’ve seen nothing to suggest otherwise on the exchange. None of the insurance companies I’ve ever dealt with over my life (which include Blue Cross, GHI. Tricare and Medicaid) have ever required it either.

  2. According to the Obamacare Facts website which was put up by our current administration, Insurance providers do have to cover you regardless of pre-existing conditions. However, the price of that premium is in question. They have to cover you and your premium has to be in a “reasonalble” price range. Premiums may also differ based on age and smoking, and other health status, but again, within reason. They cannot turn you down and do have a right to a higher permium based on that information.

    So how are they going to determine premiums if they “cannot require anything from you”? This has never been put in black and white but I seriously doubt that the insurance companies are going to simply hand out questionaires and take everyone’s word for it.

    Again in the Obamacare fact website it states that if your insurnace is 8% of your income and you insure yourself, or if your insurance is 9.5% of your income and you get it from your employer, that is considered “reasonable” under Obamacare. “IF” your insurance is costing you more you become eligible for subsidies from the government, NOT an exemption. The examption would only occur if after subsidies you fall over that 8%.

    If you fall under that category you probably qualify for Medicaid. Medicaid and Medicare recipients fall into another category other than the people who have to go to the exchanges or seek insurance on their own.

    Finally, the exchanges ARE private insurance policies. However they are subsidized by the government, and besides having to comply with the new policies that every insurance policy has to comply with (free preventive care, ambulatory care etc.), they are regulated by the government and must comply with those standards.

    That is where the debate lies right now. According to the California booklet, each insurance company that receives subsidies must require certain things of its enrollees, and the first is, and I quote “To ensure that each enrollee has had a wellness exam within the first year of enrollment”.

    That phrase is subjective. What kind of exam and how extensive? These are the questions that I would like answered. Anyone who has information regarding this issue PLEASE give us the info.

    I wish Ashley would answer back and tell us of her experience. Providing us with what was on that sheet for her to be covered by her employer would help.

    • Just read in the paper about a propaganda project for obamacare set up. It was saying it was like something out of Orwell or the Soviet Union. It’s like some kind of funds or a project in Hollywood for this purpose.

      Not exactly related to a law imposing tests on women, but related to the situation.

    • Just read an article (ObamaCare’s Latest Whopper by Betsy McCaughey at the New York Post) that was saying that the government would be more or less dictating what doctors did. Might be a problem, anyway- but especially if they’re putting such a focus on “preventative care” (whether the things categorized as “preventative care” actually work that way or not). Doesn’t say anything too specific, but it might be worth reading.

      It’s also very worrisome that all this is tied in legally. There’s now more things to be HELD LIABLE for, whether you did anything “wrong” or not. Maybe something gets labeled as “unpaid” even if it was (just like parking tickets) or maybe someone else’s problem gets linked to your name (crossed information, mistaken identity, etc…). All these things being electronically recorded definitely allows for problems due to glitches, viruses, hackers and identity thieves- at the very least.

      It’s very confusing what is & is not a law to begin with, but you’re only dealing with actions anyway. Maybe something ObamaCare-related is now a trumped-up charge complete with accessorie charges for other people. All kinds of complex charges & exemptions & timeframes make for a very complicated court case to defend.

      • Something new that connects to Obamacare: Apparently, the FDNY has “reserved the right” to distribute people’s personal health information (PHI- which includes addresses, phone numbers, medicine, etc…). They were saying this could be used for business, military/national defense, and law enforcement!

        Apparently, PUBLIC health services are exempt from that federal law about medical confidentiality. So, when someone goes in an ambulance & they get information about the person it goes to whoever, potentially the highest bidder. There was some mention of using this for fund-raising, too- so maybe this gets used to con people out of money so it can be used to cause problems (more than there already are, anyway). It, supposedly, can only be done with your consent- but we all know that it might not go that way functionally.

        Add this to the fact that, in America, pharmaceutical companies aren’t liable for what they do. Maybe this information can be used to design things to cause chronic illnesses to make more money & misery off of? Maybe doctors get financial incentives for using these things on people? Maybe this is something that is now easier to apply broadly as well as individually?

        It really seems like they’re trying to get profiles on people for some reason. Having a lot of information on individuals would give information on groups, as well. They might do something harmful that blankets a large group or go after someone specifically (in whatever situation that happens to be). That’s happened before somewhere hasn’t it?

      • This just proves (again!) that we should avoid giving our personal information to the medical establishment whenever possible.
        Personally, I don’t go to doctors mainly for this reason: I can’t rust my private information to the medical system; and they don’t let me exercise my right to anonymous medical help which is technically should be available in Australia.
        So… I don’t see doctors and stay healthy (perhaps, precisely because I don’t see to doctors).

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