Obamacare Drives Women to Get Tubes Tied
NEW YORK ( MainStreet) An apparent glitch in the Affordable Care Act championed by President Obama could put women's health at needlessly greater risk by providing couples with a financial incentive to choose tubal ligation over vasectomy. Because tubal ligation usually entails general or spinal anesthesia and is a more invasive surgery than vasectomy, it's riskier and several times more costly.
Democrats are loath to acknowledge the error in the ACA, commonly called "Obamacare," and Republicans are more eager to scrap the law than correct specific sections. The problem will become more apparent with each graduating class of women entering the workforce and enrolling for new insurance policies .
"It's absolutely, incredibly outrageous and irresponsible to be putting women at risk by promoting a surgery with higher mortality rate, or any mortality in the American context , said Dr. Marc Goldstein , who serves as Distinguished Professor of Reproductive Medicine and Urology at Weill Cornell Medical College of Cornell University and Senior Scientist with the Population Council's Center for Biomedical Research. "In the U.S. there has never been a documented death from vasectomy but every year there are 10 to 20 women in this country alone who have died from tubal ligation surgery."
Goldstein, who is in active practice as surgeon-in-chief of male reproductive medicine and surgery and director of the Center for Male Reproductive Medicine and Microsurgery at the New York Presbyterian Hospital Weill Cornell Medical Center, noted that tubal ligation also has a much higher failure rate than vasectomy.
Goldstein has seen first-hand how national reproductive policies can go awry; he says that in 1986 he was the first American doctor trained in China's "no scalpel" vasectomy technique in exchange for performing reversal surgeries on officials who were forcibly vasectomized under Mao Zedong.
Section 2713 of the ACA requires that private insurers -- except existing policies that are "grandfathered in" -- cover a wide range of preventive health services at no cost to the patient. The law is interpreted by the Department of Health and Human Services and put into practice through its regulations. An amendment by Senator Barbara Mikulski (D, Md.) led to the inclusion of many forms of reproductive healthcare for women, but no parallel provision was made for men . The HHS clarification of the law specifically excluded male condoms and vasectomies . The result is that the seldom-used female condom is covered by the Affordable Care Act, but not the ubiquitous male condom that many women rely on for prevention of pregnancy and disease. More gravely, under the Affordable Care Act tubal ligations are essentially free while vasectomies can still carry a price tag, possibly nudging couples to opt for the more involved surgery .