The American College of Preventive Medicine (ACPM) is concerned and disappointed by the ruling made in a case in the Northern District of Texas (Braidwood v. Becerra) which removes requirements for essential 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, anxiety and depression, HIV, and hearing, as well as access to routine immunizations critical to the health and wellbeing of not only individuals, but also communities.
The decision, which is likely to be appealed further, ruled that 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, is unconstitutional. The law requires all services that receive an A or B recommendation from the U.S. Preventive Services Task Force (USPSTF) be covered.
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 implementation of the ACA strongly associated with increased colon cancer screening, vaccinations, use of contraception, and chronic disease screening; studies have also 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 decision would decimate a key contributor to access for these critical services — first dollar reimbursement. Preventive services, from early cancer diagnosis to smoking cessation efforts, are lifesaving and demonstrate better clinical outcomes and enhanced quality-of-life indicators. We urge the Appeals court to take the individual and public health impact of this ruling into account.