WOMEN IN SEVEN STATES can now use a mobile app to receive birth control prescriptions without health insurance or doctor’s visits. Lemonaid offers affordable reproductive healthcare for uninsured women in California, Florida, Michigan, New York, Ohio, Pennsylvania, and Washington.
Lemonaid is a telemedicine app for people of all genders. For just $15, users can video chat with a doctor about birth control options, urinary tract infections, acid reflux, male pattern baldness, and erectile dysfunction, among other conditions. Lemonaid’s doctors write prescriptions and send them to the pharmacy of the user’s choice.
Insured users may use Lemonaid in conjunction with their healthcare plans, and may have their costs reimbursed by their insurance providers. Where the app really shines, however, is in its offerings for uninsured women.
Wait. Uninsured women? Don’t all women, except those in violation of the law, have healthcare coverage in the wake of the Affordable Care Act (ACA)? I mean, this is America, after all. Unfortunately, there are plenty of people left uninsured in the U.S., largely due to their states’ failure to expand Medicaid.
One of the first provisions of the ACA was to require states to expand their Medicaid programs, so that individuals would still have medical coverage, even if they did not earn enough to qualify for tax allowances to reduce the cost of health insurance. Under this provision, states that did not expand coverage would lose their federal Medicaid funding.
This was one of many aspects of the ACA that were challenged in court. According to the National Conference of State Legislatures, “on June 28, 2012 the [Supreme C]ourt ruled that Congress may not make a state’s existing Medicaid funds contingent upon compliance with Medicaid expansion.”
At the time of this writing, half of the states in the U.S. have not expanded their Medicaid programs. Florida and 18 other states have no plans to do so. Michigan and five others are currently in the process of expanding their taxpayer-funded insurance programs.
These states have notorious insurance gaps, filled with people who make too much money for Medicaid, but too little for an ACA allowance. Although these folks do receive exemptions from tax penalties for the uninsured, that does nothing to fix their primary problem, which is being uninsured and without options. States with these gaps are not required to offer free clinics or other medical facilities for their uninsured populations.
Just how large are those uninsured populations? On average, 11.6 percent of individuals have no healthcare coverage in states that have not expanded Medicaid. That number drops to 8.5 percent for the 25 states and the District of Columbia that widened taxpayer-funded coverage for low-income individuals. In the states covered by Lemonaid, an average of 9.1 percent of individuals are uninsured. But in Florida, which did not implement a Medicaid expansion, a whopping 15 percent of the population have no health insurance.
Those are big, surprising numbers, even for someone who navigates the Healthcare Marketplace on a regular basis. It’s unlikely that we’ll see a 0 percent uninsured rate, until the U.S. transitions into single-payer healthcare. Some people simply refuse to sign up, even when they can receive healthcare coverage at a more affordable rate than the end-of-year tax penalty they’ll wind up paying. Still, it’s difficult for this progressive to reconcile the fact that roughly one in 10 people remain uninsured in the richest country in the world.
For women without health insurance, Lemonaid provides accessible doctor visits at affordable rates. Although $15 may seem steep for those familiar with the realities of poverty, it’s a far cry from the $120 I paid my GP for a prescription visit the last time I was uninsured.
That’s not to say that Lemonaid is only helpful to uninsured women, however. Busy schedules, demanding jobs, and threats of termination can make taking time off to see a doctor an expensive and grueling decision. With Lemonaid, women can conduct appointments on their commutes or lunch breaks, no doctor’s excuse required. As a woman living in a rural area, let me tell you: I’d much rather have a short video chat with one of Lemonaid’s doctors than drive myself the 20-odd miles to my GP’s office.
The creators of Lemonaid intend to expand their app’s coverage area outside of the seven states above. It’s important to remember, however, that any apps like this one cannot effectively reach across the U.S. without increased awareness and advocacy of remote access to physicians and counseling. Telemedicine can offer contraceptives and abortion care to women living in areas with few-to-no clinics, or those who cannot afford to miss work.
If legislation prevents women in your state from remotely accessing reproductive healthcare, consider writing to your representatives with information on Lemonaid and other telemedicine opportunities. Safe and effective contraceptive access is essential to women’s equality, family prosperity, and our country’s integrity in an increasingly feminist world.