Kansans should continue to seek preventive care — things like cancer screenings — despite a court ruling Thursday that could let insurance companies off the hook on paying for that care, say health policy experts and advocacy groups.
The federal district court ruling in Texas could prevent the Biden administration from enforcing provisions of the Affordable Care Act, or Obamacare, requiring insurance plans to pay for screenings for depression, diabetes, HIV and a range of other conditions.
In that case, the judge ruled for a business that challenged the recommendations on what should be covered under the ACA because the panels setting those guidelines aren’t appointed by elected officials. The plaintiffs also contend some of the federal government’s requirements violate religious rights.
“This is not the potential fatal blow to the ACA like previous court cases, but it would limit a very popular benefit that tens of millions of people use,” said Larry Levitt, Kaiser Family Foundation executive vice president for health policy.
That would include Kansans seeking preventive care, including cancer screenings, some pregnancy-related care and PrEP — an HIV prevention pill.
What services?
Coverage for preventive screenings would revert back to recommendations made when the ACA took effect in 2010.
An estimated 100 million people use preventive services the ACA requires insurers to cover without copays or deductibles. The ruling applies to services recommended by the U.S. Preventive Services Taskforce.
“It does not overturn women’s health services recommended by” other agencies, Levitt said.
Lung screenings, mammograms and colonoscopies have all had updated recommendations within the last 10 years. If the challenge to the landmark health insurance law stands, insurance companies would not be required to incorporate those updates in their coverage policies.
The American Cancer Society Cancer Action Network estimates roughly 17,000 Kansans will get new cancer diagnoses this year.
“Removing barriers, such as financial roadblocks, makes early detection more accessible and affordable and helps save lives,” said Megan Word, the organization’s government relations director.
She said early detection increases the likelihood of survival and could ultimately reduce the cost of treatment.
The ruling could also threaten zero-cost coverage for certain screenings during pregnancy, including for high blood pressure. Preeclampsia is one of the leading causes of maternal mortality nationally and in Kansas. It disproportionately impacts Black women.
Sharla Smith, an associate professor at the University of Kansas Medical Center, said pregnant women might forgo those screenings if they’re concerned about cost.
