NC HEALTH REPORT: More benefits of the Affordable Care Act that you probably didn't know about

April 9, 2014

Last week’s news that seven million Americans had signed up for health insurance through the Affordable Care Act health exchanges was an important boost to (and validation of ) the health law. Now, on top of that impressive number, a new study estimates that another seven million people have gotten new coverage through their employer in the last six months – yet another piece of welcome news about the strength of the employer health marketplace.

But wait, there’s actually more good news. For while the reality of millions more people obtaining health coverage is more than enough to confirm the strength and worth of the health law, there is another major benefit from the Affordable Care Act that affects the majority of Americans who are already insured:  Much better preventive health services.

Though less sexy (and less-well-reported), this benefit is nonetheless real and appreciated by average Americans. In poll after poll, people rank coverage of preventive health services very highly. And thanks to the ACA, all insurance companies must allow people to see a doctor for preventive services and not have to pay expensive co-pays or other cost-sharing for the visit.

Americans are smart about their health care and realize that getting these preventive services can easily and quickly head off more serious health problems down the road.  For example, all health insurance plans are now required to provide coverage without cost-sharing to enrollees for a variety of preventive health services, such as colonoscopy screening for colon cancer, Pap smears and mammograms for women, well-child visits, and flu shots for all children and adults.

How many people did this requirement help? In its first year, the ACA ensured that 71 million Americans (including two million North Carolinians) gained preventive service coverage. Here in North Carolina alone, 1.3 million women can now get affordable mammogram and ob-gyn annual exams. And because of the Affordable Care Act, all maternity care is now covered so women can stay healthy and have healthy babies.  Believe it or not, women in North Carolina used to be charged hundreds or even thousands of dollars a year in extra premiums if they wanted the “luxury” of having their insurance plans cover pregnancy. In contrast, men were charged nothing extra for forgoing maternity coverage since they apparently had little to do with reproduction, at least in the eyes of the insurance industry.

What’s more, thanks to the ACA, as our babies in North Carolina grow, parents do not have to worry about their ability to pay for immunizations, regular check ups, and vision, hearing and speech tests.

Even seniors on Medicare had to pay for certain preventive services before the ACA.  But not any more. Last year alone, 25.4 million seniors received at least one preventive service at no cost to them because of the Affordable Care Act.

The prevention benefits impact everyone in North Carolina. Even if you’re one of the fortunate people who already had insurance, you’ve already got new benefits and protections under this law that you didn’t before like free checkups, cancer screenings, and contraceptive care.

And even though North Carolina is still in the shrinking minority of states that haven’t yet taken advantage of federal dollars to expand Medicaid to our poorest citizens under the ACA, North Carolina can take pride in its national leadership in emphasizing care coordination and prioritizing prevention in Medicaid. Indeed, the state’s Medicaid program received a national award –presented by US Senator Richard Burr – just last year for its excellence in, as the Senator put it, “quality and efficiency.”

Unfortunately, Senator Burr was also one of a group of conservative senators that cooked up an “alternative” to the ACA that is premised upon its repeal. Amazingly, Burr’s replacement health plan would repeal and eliminate all the thousands of prevention benefits of the current ACA and replace them with absolutely nothing.

Fortunately, with each passing day, Burr’s “alternative” looks less and less likely to receive serious consideration. In the end, North Carolinians (like most of their fellow Americans) know that focusing our health system on preventive care is a good thing. Chronic conditions such as heart disease, cancer, stroke and diabetes are responsible for seven in 10 deaths among Americans each year and account for nearly 75 percent of the nation’s health spending.

The Affordable Care Act is moving our entire health system toward more prevention and not just more coverage. And that is an enormously important and beneficial change.
 

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