150 Million Americans Are at Risk of Losing Free Preventive Healthcare. What Does That Mean for You?

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By Amie Knowles

April 4, 2023

The recent ruling by a federal judge in Texas means that insurance companies may no longer have to pay for healthcare services like cancer screenings, heart disease screenings, prenatal care, and treatments to help prevent diseases like HIV.

Nearly half of America’s population is feeling the sting of the potential end of guaranteed free preventive health care. 

District Judge Reed O’Connor, a federal judge in Texas, recently struck down portions of the Affordable Care Act (ACA). The impacted areas of the law are ones that required insurers to cover lifesaving preventive services without cost sharing. 

It’s important to note that the US Justice Department filed a notice of appeal; health insurance companies have said there wouldn’t be immediate changes in coverage. 

However, this ruling means that for 150 million Americans, insurance companies may no longer have to pay for important health care services like cancer screenings, heart disease screenings, prenatal care, and treatments to help prevent diseases like HIV.

Coming Together Over Concern

On March 31, health advocates and legal experts expressed concern over the ruling in an online press conference. 

If upheld, O’Connor’s decision could have a negative impact on a formerly covered person’s finances. Protect Our Care—a social welfare nonprofit dedicated to making high-quality, affordable and equitable healthcare a right for everyone in America—noted that the change could increase costs for patients by “thousands of dollars a year.” 

Another concern is that the ruling could create major obstacles to care.

Leslie Dach, chair of Protect Our Care, cautioned in the conference that the change could result in “more Americans [getting] sick’; he warns that “more Americans will die, and more Americans will have to make painful choices between their health and paying for other essential needs like food and shelter.”

Lisa Lacasse, president of the American Cancer Society Cancer Action Network, noted that in the 13 years since the ACA went into effect, eliminating cost barriers for preventative screenings has resulted in higher screening rates.

“From a cancer perspective, certainly, our work is all about lowering the cancer burden nationwide,” Lacasse said. ”And prevention is one of the most important interventions.”

According to the American Cancer Society (ACS), some cancers can be found early, before they can grow and spread. That’s why regular cancer screenings are important. 

“This no-copay provision of the Affordable Care Act related to preventive services has been instrumental in increasing screening rates—and critically important from a mortality reduction standpoint for cancer,” Lacasse said.

Lacasse expressed that she and many of her colleagues planned to urge the federal government to engage on the topic. Meanwhile, she encouraged people not to cancel their upcoming preventive screenings or to go ahead and schedule them if necessary. 

“For those who are in the middle of their insurance plan year, the likelihood of their coverage changing is probably low, at this point,” Lacasse said. “So, please know that we are going to be very much encouraging patients to continue on their guideline related screenings.

“Really A Major Challenge”

Also at the press conference, Sinsi Hernández-Cancio, vice president for health justice at the National Partnership for Women and Families, explained the drastic effect the ruling could have on women’s health. The nonprofit organization works to improve the lives of women and families by achieving equality for all women.

“While this extreme holding doesn’t impact ACA’s lifesaving women’s-specific preventive services, it will still harm women’s access to lifesaving care and worsen existing health inequities…It craters the full spectrum of preventive care we all need to be healthy and thrive,” Hernández-Cancio said. “The result is that a long list of preventive healthcare that is of dire importance to women’s health across their lifespan no longer falls under the ACA’s no-copay coverage requirements. Examples of this include screening for depression, screening for diabetes, screening for heart health.”

Media outlets including NBC News and CNN stated that O’Connor’s decision would likely not impact mammograms to detect breast cancer or some of the other most commonly used preventive services. Still, the ruling will likely lead to preventable health issues going undetected.

Dr. Georges Benjamin, executive director of the American Public Health Association, provided pivotal closing remarks at the event.

“This is really a major challenge to the health of our nation,” Benjamin said. “I got to tell you, the take-home message for this is that more preventable cancer, more preventable cardiovascular disease, and more preventable vaccine-preventable deaths are guaranteed because of this decision. And this is both an unhealthy decision that is wrongly decided, and it must be overturned.”

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