The Affordable Care Act’s New Rules on Preventive Care

Chronic diseases, such as heart disease, cancer, and diabetes, are responsible for 7 of 10 deaths among Americans each year and account for 75 percent of the nation’s health spending – and often are preventable. The Affordable Care Act – the health insurance reform legislation passed by Congress and signed into law by President Obama on March 23 – will help make prevention affordable and accessible by requiring health plans to cover recommended preventive services without charging a deductible, copayment or coinsurance.

High-quality preventive care helps Americans stay healthy, avoid or delay the onset of disease, lead productive lives, and reduce costs. And yet, despite the proven benefits of preventive health services, too many Americans go without needed preventive care because of financial barriers. Even families with insurance may be deterred by copayments and deductibles from getting cancer screenings, immunizations for their children and themselves, and well-baby check-ups that they need to keep their families healthy.

President Obama and First Lady Michelle Obama believe a focus on prevention will offer our nation the opportunity to improve the health of all Americans and reduce health care costs. It is an idea that enjoys strong bipartisan support among elected officials as well as among many sectors of society –teachers, business leaders, doctors, nurses and parents. From the Recovery Act to the First Lady’s Let’s Move Campaign to the Affordable Care Act, the Administration is laying the foundation 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.

Last week, the Departments of Health and Human Services (HHS), Labor, and the Treasury issued new regulations requiring private health plans to cover evidence-based preventive services and to eliminate cost sharing for preventive care. For new health policies beginning on or after September 23, 2010, preventive services that have strong scientific evidence of their health benefits must be covered and plans can no longer charge a patient a copayment, coinsurance or deductible for these services when they are delivered by a network provider.

This announcement builds on other provisions in the Affordable Care Act that support prevention, including the creation of a first-ever National Prevention and Health Promotion Strategy and a Prevention and Public Health Fund to invest in prevention initiatives and, this year, policies to increase the number of primary care professionals to help ensure access to these services. By eliminating cost sharing for preventive care, the new law also helps make it easier and more affordable for seniors on Medicare and Americans enrolled in Medicaid to access critical preventive screenings and services.

For a complete report and what this means to you, check out the PDF found here.

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