The American College of Preventive Medicine (ACPM) is extremely concerned that a case before a federal judge in the Northern District of Texas (Kelley v. Becerra) has jeopardized the coverage of preventive health care services for millions of Americans with private health insurance. These critical preventive services include screening for breast cancer, colorectal cancer, cervical cancer, heart disease, diabetes, preeclampsia, and hearing, as well as access to routine immunizations critical to the health and wellbeing of not only individuals, but also communities.
The case, which is likely to be appealed further, seeks to determine the constitutionality of section 2713 of the Affordable Care Act (ACA), which requires non-grandfathered group health plans and health insurance issuers to provide coverage for preventive health care services without patient cost-sharing.
Research shows that, since the enactment of the ACA, millions of patients have benefitted from increased access to first-dollar reimbursement of preventive services. A January 2022 report from the U.S. Department of Health and Human Services found that more than 150 million people with private insurance – including 58 million women and 37 million children – can receive preventive services without cost-sharing under the ACA. Additionally, the report showed the ACA increased colon cancer screening, vaccinations, use of contraception, and chronic disease screening and studies have shown a reduction in racial and ethnic disparities in the use of preventive care since the ACA was enacted.
ACPM is grounded in evidence-based recommendations related to clinical preventive services and this case would decimate the key aspects of access to these critical services—funding. Evidence strongly suggests that many essential preventive services, such as vaccinations and contraceptives are cost saving. All preventive services, from early cancer diagnosis to smoking cessation efforts, are lifesaving and demonstrate the quality of life indicators that cannot equate to a financial return. We hope the courts will take the individual and public health impact of its decision into account.