Democratic Committee Leaders Write to Health Insurers Regarding Coverage of Preventive Care
House and Senate Leaders Requested Information from 12 of the Nation’s Largest Health Insurers and Trade Associations Following a Texas District Court Decision Striking Down the ACA’s Preventive Coverage Protections
WASHINGTON – House and Senate Democratic Health Committee leaders wrote to 12 of the nation’s largest health insurers and trade associations representing employer-sponsored health plans today requesting information regarding how they plan to respond to the Northern District of Texas’s decision in Braidwood Management Inc. v. Becerra striking down the Affordable Care Act’s (ACA) requirement that most health plans and issuers cover preventive services recommended by the U.S. Preventive Services Task Force (USPSTF) with an A or B rating without cost-sharing.
The letter was signed by House Energy and Commerce Committee Ranking Member Frank Pallone, Jr. (D-NJ), House Ways and Means Committee Ranking Member Richard E. Neal (D-MA), House Education and the Workforce Committee Ranking Member Robert C. “Bobby” Scott (D-VA), Senate Finance Committee Chairman Ron Wyden (D-OR), and Senate Health, Education, Labor, and Pensions (HELP) Chairman Bernie Sanders (I-VT).
“The Republican-appointed judge’s decision to strike down the ACA’s preventive services coverage requirement nationwide is inconsistent with the law and is of dubious legal merit,” the Committee leaders wrote. “We request information regarding your planned response to this decision, including whether consumers will experience interruptions in coverage and whether your company [or member companies] will continue to cover recommended preventive services without cost-sharing until all appellate review is concluded, including review by the Supreme Court.”
Under the ACA, most health plans cannot charge consumers copayment, co-insurance, or deductible for preventive services, including mammograms, lung cancer and skin cancer screenings, screenings for pregnant women and newborns, and HIV pre-exposure prophylaxis (PrEP). As a result of the ACA’s consumer protections, more than 150 million Americans with private health coverage receive access to life-saving preventive services without out-of-pocket costs, including 58 million women and 37 million children.
The five Committee leaders wrote that the Republican-appointed judge’s decision to invalidate the ACA’s preventive services requirement nationwide puts lives at risk and will result in loss of access to lifesaving care.
“We are very concerned that the decision will unnecessarily cause confusion, force consumers to pay out-of-pocket, and result in patients foregoing preventive services screenings and treatment altogether,” the Committee leaders continued. “There is evidence that even modest cost-sharing deters patients from accessing care and exposure to cost-sharing reduces the use of preventive care. We are very concerned that the decision will roll back the significant health care gains that have been made under the ACA and will worsen racial and ethnic inequities.”
The House and Senate Committee leaders requested the 12 health insurers and trade associations respond by April 19 regarding whether they intend to cover all recommended preventive services without cost-sharing until all appellate review in the case is concluded.
The Committee leaders sent the commitment request letters to the following companies:
Alliance of Community Health Plans
America’s Health Insurance Plans
Blue Cross Blue Shield Association
Purchaser Business Group on Health
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