WASHINGTON (Reuters) - A range of preventive care services will soon be available at no extra cost to consumers under new health insurance plans, U.S. health officials said on Wednesday.
Under the new rules, insurance companies will be required to cover mammograms, immunizations, colonoscopies and other preventive services without charging customers through a deductible or a co-payment.
The new requirements, included in the landmark healthcare overhaul that Congress passed in March, are among a number of measures in the law intended to reduce health care costs.
“Unfortunately, too many Americans don’t get the preventive care they need to stay healthy and keep healthcare costs down for all of us,” said Kathleen Sebelius, the secretary of health and human services.
The coverage will go into effect on September 23.
The Obama administration has been actively promoting the benefits of the massive healthcare industry overhaul ahead of the November midterm elections.
Chronic diseases such as heart disease, cancer and diabetes can often be prevented, but are still responsible for seven of 10 deaths among Americans each year, according to the White House. These diseases also account for 75 percent of the nation’s health spending.
Identifying health risks early can help prevent serious illnesses, officials said, but more needs to be done.
One in eight children has not visited a doctor in the last year, Sebelius said, and one in five women over 50 has not received a potentially life-saving mammogram in the last five years.
“So our challenge is to remove the obstacles between Americans getting the preventive care they need,” Sebelius said.
Dr. Tim Gardner, a past president of the American Heart Association, said the change would save lives.
“Many Americans have not had access to adequate screening and prevention services because of a lack of adequate health insurance coverage for those kinds of services,” Gardner said.
A spokesperson for America’s Health Insurance Plans, an industry group for health insurance companies, said the rules did a good job of expanding access for preventive services, while keeping coverage affordable.
“They didn’t broaden the scope out beyond what the legislation had intended and that is something that’s positive,” said Robert Zirkelbach, a spokesperson for AHIP.
The group represents both small insurers and large insurance companies such as Aetna Inc and Humana Inc.
It is unclear what effect the rules will have on insurers, Zirkelbach said. Eliminating co-payments could shift that cost to the premiums and the expanded coverage also does not apply to all insurance plans.
Under the healthcare overhaul law, many “grandfathered” plans are exempt from the rules.
Only new plans or those that significantly cut benefits or raise costs will be affected, although more and more plans are expected to lose grandfather status each year.
Other prevention efforts will go into effect next year. Medicare patients will have access to free prevention services, including annual wellness visits. State Medicaid programs will also cover programs aimed at getting pregnant women to stop smoking.
A list of covered services can found at: www.healthcare.gov/law/about/provisions/services/lists.html
Reporting by Jon Lentz; editing by Andre Grenon