Physicians know that preventive medical care saves lives, improves health outcomes, and lowers overall health system costs not only by preventing disease outright, but also by detecting serious illnesses earlier, when more effective treatment options are available.
Providing patients with first-dollar coverage of a broad range of preventive health services remains one of the most critically important aspects of the Affordable Care Act (ACA). That’s why the AMA was eager to join nearly three dozen patient organizations and professional medical societies in an amicus brief (PDF) supporting the continued insurance coverage of preventive care in a case the U.S. Supreme Court will hear this month.
The case, Kennedy v. Braidwood Management Inc., challenges the ACA provision that requires health insurance plans to cover preventive health services at no cost to patients, as recommended by the U.S. Preventive Services Task Force. These services include cancer screenings, such as mammograms and colonoscopies, testing for hypertension and diabetes, flu shots and other vaccines, and regular well-baby and well-child visits, among others.
As our amicus brief points out, studies have shown conclusively that access to no-cost preventive services greatly increases the likelihood that patients will seek these services, allowing physicians to diagnose conditions earlier than they otherwise would. Overwhelming evidence also indicates that when illnesses and disease are detected early on, chances are much greater that those conditions can be successfully treated.
In short, access to affordable preventive health care is fundamental to improving health outcomes. Preventive services also cut long-term health care costs, and reduce the overall burden placed on our health care system, by narrowing the scope and invasiveness of treatment plans and lowering the total cost of treating serious illnesses over the course of patients’ lives.
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Eliminating barriers to prevention
While it is imperfect and the AMA is committed to future reforms, the ACA remains a positive force in health care. Its provisions are closely aligned with the AMA’s vision for health care reform, which includes health insurance coverage for all Americans, along with pluralism, freedom of choice and practice, and universal access for patients.
Coverage of preventive services without cost-sharing is an essential element of the ACA. Data shows that more than 150 million people in our nation have health coverage that is subject to the ACA’s preventive services requirement and are thus eligible to receive this care at no cost.
This fact takes on even greater significance when you realize studies show that shifting even a small portion of the cost onto patients—as little as $1 to $5—causes fewer of them to utilize necessary care. Those on fixed incomes and lower-income individuals are among those at highest risk of foregoing care they need, including preventive care, if zero-cost screenings and testing are made unavailable.
Cost-sharing reduces the use of preventive care; removing this provision of the ACA runs counter to sound public health policy. Providing first-dollar coverage for screenings, testing, counseling and similar interventions continues to save countless lives across the country and throughout our health system. Eliminating this coverage needlessly removes essential tools that physicians use every day to protect our patients and improve their lives through the early detection of cancer, diabetes, hypertension and many other chronic diseases and acute illnesses.
As outlined in the AMA Principles of Medical Ethics, the primary responsibility of every physician is to provide competent medical care to patients while always acting in that patient’s best interests. An adverse decision in Kennedy v. Braidwood will directly harm the patients we serve by causing suffering that could otherwise have been prevented.
