Health Plans to Provide Free Preventive Care

July 20, 2010
Laura Enderle

Last Wednesday, the White House announced new regulations that will require all health insurance plans to provide certain preventive services at no cost to patients.

This article originally appeared online in Pharmacy Times.

In an unveiling ceremony held Wednesday, the White House issued new regulations that will require all health insurance plans to provide certain preventive services at no cost to patients.

The rules, which belong to the Affordable Care Act, will go into effect on September 23, 2010. Patients who enroll in health plans on or after this date will be eligible to take advantage of a long list of “evidence-based preventive services,” according to a news release by the Department of Health and Human Services (HHS).

Copays, deductibles, and coinsurance payments will be eliminated for blood pressure, diabetes, and cholesterol tests; certain cancer screenings; counseling services for smoking, alcohol, depression, and obesity; as well as routine vaccines and flu and pneumonia shots.

The regulations also ensure comprehensive preventive care for children, covering regular physician’s office visits for babies, children, and adolescents up to age 21. These visits will include physicals, immunizations, and screenings and counseling for common childhood conditions. An additional suite of services will be available to pregnant and nursing women.

Although the rules will eliminate out-of-pocket costs for the services offered, the change is likely to raise insurance premiums by an average of 1.5%, the New York Times reported.

Like every aspect of health care reform, the plan has received mixed reviews. Supporters view the services as crucial to reducing the high costs of preventable chronic disease. According to HHS, eliminating cost sharing—a known barrier to the use of preventive care—is an essential first step. “Today, too many Americans do not get the high-quality preventive care they need to stay healthy, avoid or delay the onset of disease, lead productive lives, and reduce health care costs,” said HHS Secretary Kathleen Sebelius. The regulations are needed to “help transform the health care system from a system that focuses on treating the sick to a system that focuses on keeping every American healthy,” she added.

Critics of the plan believe it will open the door to lobbyists and disease advocates, in addition to raising the cost of insurance. In a report for the Washington Post, Christopher Weaver of the Kaiser Health Network wrote that the task force in charge of implementing the plan could become “a political lightning rod.”

“If it doesn't recommend a service,” Weaver argued, “insurers might not pay for it, and advocates might argue the decision is a barrier to care. If the panel does back a service, it might increase patients' access, as well as create new business opportunities.”

Now that the benefits are available, an additional challenge for the administration will be convincing Americans to take advantage of them. “Getting access to early care and screenings will go a long way in preventing chronic illnesses like diabetes, heart disease, and high blood pressure,” said First Lady Michelle Obama. “These are important tools, and now it’s up to us to use them.”

For a complete review of the new services, visit http://www.healthcare.gov/law/about/provisions/services/index.html.