A federal court ruling that the Affordable Care Act can't ensure no-cost preventive care for services like cancer screening exams has left a lot of people with a lot of questions.
for certain current or former smokers, and screening for hepatitis C in adults ages 18 to 79, updated in 2020.Each insurer and self-insured employer will decide whether to reinstate copayments or other cost sharing for these services. Even if they do, it may take time for them to go into effect, especially given that policies are now in the middle of a plan year, making them contractually hard to change.
“It will depend on your employer and what they want to do, and depend on whether you have a collective bargaining agreement and a whole lot of other variables,” saidThat type of varying coverage was “exactly what the ACA was designed to get away from, in order to make this more uniform for all of us,” Rosenbaum added.Even with the ruling, at least 15 states have laws requiring coverage of preventive services without cost sharing,at Georgetown University’s Center on Health Insurance Reforms.
But state rules apply only to ACA plans and job-based plans offered by employers who buy coverage from an insurer. Most large employers — and a growing number of smaller ones — self-insure and are not subject to state coverage rules.Congress could resolve the matter with a simple fix to the ACA, said Fendrick of the University of Michigan. “Give the task force recommendations approval by the secretary of the Department of Health and Human Services and it’s done,” he said.
Still, even though the preventive services coverage is very popular with consumers, the politics of changing the ACA are challenging, especially in a sharply divided Congress. In the meantime, the case will go through the appeals process, and a final resolution could take months or even years., while plaintiffs will likely seek to broaden it, by challenging the parts of the judge’s ruling that went against them. Specifically, the individuals and employer who brought the case wanted the ruling also to cover recommendations made by other agencies, including the set of women’s health recommendations that include contraceptives.
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