Existing Medicaid beneficiaries left off the Affordable Care Act's prevention bandwagon

Health Aff (Millwood). 2013 Jul;32(7):1188-95. doi: 10.1377/hlthaff.2013.0224.

Abstract

The recent health reform law promotes access to preventive care through new insurance coverage requirements. Most private insurance plans, Medicare, and Medicaid expansion programs are required to cover US Preventive Services Task Force A- and B-rated services without cost sharing. However, because the Affordable Care Act treats newly eligible and existing Medicaid beneficiaries differently, all adult Medicaid beneficiaries within a state might not be eligible for the same preventive services. This study reviewed Medicaid programs across the country and found that most states do not cover all of these recommended services as preventive measures for adults. As a result, existing adult Medicaid beneficiaries might not have coverage of the same important preventive services that most other insured people have. In addition, aspects of how preventive services are defined in many states result in confusion about coverage parameters, potentially creating an additional access barrier for existing Medicaid beneficiaries.

Keywords: Access To Care; Health Reform; Medicaid; Prevention.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Cost Sharing / legislation & jurisprudence
  • Financing, Government / legislation & jurisprudence
  • Health Care Reform / economics
  • Health Care Reform / legislation & jurisprudence
  • Health Services Accessibility / economics
  • Health Services Accessibility / legislation & jurisprudence*
  • Humans
  • Insurance Coverage / economics
  • Insurance Coverage / legislation & jurisprudence
  • Medicaid / economics
  • Medicaid / legislation & jurisprudence*
  • Patient Protection and Affordable Care Act / economics
  • Patient Protection and Affordable Care Act / legislation & jurisprudence*
  • Preventive Health Services / economics
  • Preventive Health Services / legislation & jurisprudence*
  • State Health Plans / economics
  • State Health Plans / legislation & jurisprudence
  • United States