Maintain coverage of preventive services without cost-sharing
PAN’S POSITION:
Protect and maintain access to clinical preventive services without cost-sharing through private insurance.
The Affordable Care Act (ACA) preventive services coverage policy has become an established part of health coverage for most people in the United States. Millions of individuals have benefitted from increased access to care and coverage of clinical preventive services without cost-sharing. Congress and the administration should protect and maintain this access.
Section 2713 of the ACA requires private insurance plans to cover recommended preventive services without any patient cost-sharing such as copayments, deductibles, or coinsurance.
The ACA requires private plans to cover four broad categories of services for adults and children:
- Evidence-based screenings and counseling
- Routine immunizations
- Preventive services for women
- Preventive services for children and youth
In addition, individual and small group plans in the health insurance marketplaces, also known as exchanges, are required to cover an essential health benefit (EHB) package that includes a full range of preventive services.
Congress and the administration should maintain coverage of these preventive services and take steps to ensure there is no additional cost-sharing or removal of benefits in public and private health insurance.