Coverage for Preventive Services Struck Down

You have probably forgotten that Obamacare (the Affordable Care Act) ensured that Health Insurance Companies cover preventive services. This includes immunizations, screening tests for cancer (mammograms, colon cancer, prostate cancer), blood pressure, diabetes and cholesterol tests, physical exams and well-baby, well-child visits, HIV and mental health services. Americans have benefited from this mandated coverage since 2010.

A Federal judge in Texas, who once said the ACA was unconstitutional, has struck down the requirement that preventive care be covered and that decision could affect more than 150 million people who would lose these "free" services. I say "free" because they are now covered under the exorbitant premiums that Insurance companies charge.

Insurers say that they will not claw back on this coverage that people have come to expect. But I see changes in formularies, co-pays, deductibles and requirements for pre-authorization that seem to change month by month. I have absolutely no doubt that these preventive services will be whittled away one-by-one if this ruling is allowed to remain.

The ruling stemmed from a case brought by six individuals and two Christian-owned businesses who argued that they should not be mandated to offer coverage of HIV PrEP because they did not want to encourage "homosexual behavior."

My specialty society, the American College of Physicians has issued a strong statement calling for this decision to be reversed. "Instead of attacking the coverage that patients have, we should be looking for ways to bolster the ACA and increase access to care." the College says. The US repeatedly ranks last in health outcomes compared to to other industrialized nations and this will further widen the gap.

Today (Friday March 31), President Biden appealed the decision and it will be heard in the US Fifth Circuit Court of Appeals. "All preventive services are kind of up for grabs as we go through the appeals process," said Laurie Sobel, associate director for women health policy at Kaiser Family Foundation.

It may ultimately go to the US Supreme Court.