The ACA has required health insurers to provide many medical screenings and other preventive services with no out-of-pocket cost to health plan members. But a recent court decision could upend that.
Spending on ACA-mandated preventive services is relatively small but not insignificant. It is 2% to 3.5% of total annual expenditures by private employer health plans, or about $100 to $200 per person, according to theSeveral large commercial insurers and health insurance trade groups did not respond to requests for comment or declined to comment about what payers will do if the courts end the preventive services mandate.
One service of particular concern is preexposure prophylaxis for HIV, or PrEP, a highly effective drug regimen that prevents high-risk people from acquiring HIV. The plaintiffs in the lawsuit in Texas claimed that having to pay for PrEPSince 2020, health plans have been required to fully cover PrEP drugs and associated lab tests and doctor visits that otherwise can cost thousands of dollars a year. Of the 1.
, executive director of the HIV + Hepatitis Policy Institute."If first-dollar coverage went away, people won't pick up the drug. That would be extremely damaging for our efforts to end HIV and hepatitis."
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