The Patient Protection and Affordable Care Act, signed into law earlier this year, is beginning to bring about changes to the nation’s health care system. In July, a summit between the U.S. Departments of Labor, the Treasury, and Health and Human Services came together to issue new Preventive Regulations, in accordance with the President’s health care reform bill.
The new regulations require non-grandfathered health care plans to provide complete coverage of many preventive services for newborns, children, and adults, regardless of whether deductible costs are met. These regulations will apply for the first plan year on or after September 23, 2010.
The government has put these regulations in place in order to increase patients’ access to numerous services, such as diabetes and cholesterol tests, prostate and other cancer screenings, child/adult vaccinations, pre-natal services, and routine checkups for children and infants. In the past, many patients were required to cover deductible costs or share the cost of these services, but now preventive care will be covered on a full first-dollar basis. The new regulations only apply to in-network providers.
The Department of Health and Humans Services, or HHS, hopes that the increased access to high-quality preventive care will lead to earlier detection of disease and improve Americans’ overall health, essentially lowering health care costs. In the United States, seven out of every 10 deaths are caused by chronic diseases, such as cancer, diabetes, and heart disease. HHS estimates that 75% of the country’s health care dollars are spent on fighting diseases and illnesses that can be prevented. Additionally, the HHS states that Americans receive preventive services about half as much as they need to.
Here are a few health care services that will be covered under the new regulations:
Preventive Care. The U.S. Preventive Services Task Force selected a variety of services to be covered, including screenings for colon and breast cancer, screenings for high blood pressure and cholesterol, checkups during pregnancy, help for smokers trying to quit, and other high-priority preventive care services.
Vaccinations. Routine vaccinations selected by the Advisory Committee on Immunization Practices for children and adults are fully covered by the new regulations. These vaccines include Hepatitis A and B, MMR, Meningococcal, Tetanus, flu shots, and others.
Care for Children. All new plans will now cover the preventive services recommended by the American Academy of Pediatrics in their “Bright Futures” guidelines. Services include access to pediatricians until the age of 21, regular wellness checkups, hearing and vision screenings, developmental assessments, vaccines, and care that addresses childhood obesity.
Women’s Care. Health screenings for anemia and other risk factors in pregnant women are covered, along with screenings for breast cancer and osteoporosis in older women, as well as other preventive measures. An independent council of doctors and medical experts is currently working on new preventive care guidelines for women.
Prescription contraceptives are not currently listed as a covered preventive service, but officials from the Planned Parenthood Federation of America hope that contraceptives will begin to receive first-dollar coverage within the next year or two.
Information on all of the covered services can be found on the www.healthcare.gov website.