By Anya Prince
One of the major goals of the Affordable Care Act, also known as health care reform, is to expand access to preventative care. Health care reform has provisions to reach this goal in a variety of ways. For example, the law increases access to preventative care by requiring most insurers to provide certain preventative procedures free of cost to patients. This means that you must be able to get certain preventative coverage without paying any copays, deductibles, or co-insurance. It is important to note that not all health insurance companies or health plans must comply with this law. If you have insurance through a health plan that was created or purchased on or before March 23, 2010, your insurer may be considered “grandfathered” and therefore be exempt from this requirement. For more information about preventative services and grandfathered plans, visit: www.healthcare.gov/law/provisions/preventive/index.html.
Beginning on September 23, 2010, health insurers had to begin covering certain preventative services at no cost to patients. These services include colorectal cancer screenings, BRCA counseling about genetic testing, mammography screenings, chemoprevention counseling, and cervical cancer screenings. For a full list of these services, visit www.healthcare.gov/law/about/provisions/services/lists.html. While these provide important cost savings to many individuals there remain some gaps in the system. For example, colorectal cancer screenings are only available for individuals over 50 and mammographies for those over 40. For individuals with family histories of these cancers or who are at high-risk for these cancers, the preventative services provision in the law does not provide for preventative screenings at an earlier age. Therefore, there is still more work to be done to expand access to essential preventative care services.
Recently, important progress has been made in the expansion of access to preventative services. On August 1, 2011, the U.S. Department of Health and Human Services announced an expansion of the preventative services that insurers must cover free of cost. The Institute of Medicine provided recommendations on preventive measures that meet the unique health needs of women. Last Monday, HHS adopted these recommendations. This means that any plan starting on or after August 1, 2012, must cover seven additional preventative services. These include annual well-woman visits, gestational diabetes screenings, HPV DNA testing for women over 30, sexually-transmitted infection counseling and HIV screening and counseling, contraception and contraceptive counseling, breastfeeding support, supplies, and counseling, and domestic violence screenings. This important expansion of preventative services will help many women to lead healthier lives and to stop diseases before they develop.
For more information about the recent expansion of preventative services visit:
http://www.iom.edu/Reports/2011/Clinical-Preventive-Services-for-Women-Closing-the-Gaps.aspx and www.healthcare.gov/news/factsheets/womensprevention08012011a.html
For more information about health care reform and other cancer-related legal issues, contact the CLRC at 866-843-2572 or visit www.CancerLegalResourceCenter.org.