Preventive Services Coverage and Cost-Sharing Protections Are Inconsistently and Inequitably Implemented
Summary
The Consumer Representatives to the National Association of Insurance Commissioners (NAIC) released a report today identifying significant gaps in insurance plan compliance with the Affordable Care Act’s (ACA’s) preventive services coverage and cost-sharing protections. The report assessed challenges in access to a subset of ACA preventive services: smoking cessation, pre-exposure prophylaxis (PrEP) for the prevention of HIV, colorectal cancer screening, and postpartum depression screening. The report identified a number of steps state insurance regulators can take to improve enforcement and noted that these protections remain the law of the land despite ongoing legal attacks. The report calls for regulators to monitor insurance plan documents to ensure that preventive services descriptions are easy-to-find and accurate. Recommendations also include increasing oversight of plan coverage policies to ensure they are in line with clinical guidelines for preventive services.
