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60% of privately insured patients used a preventive service required by the ACA

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The provision requiring various preventive coverages is being challenged in court

An analysis of claims data by the Kaiser Family Foundation estimates that 60% of patients with private health insurance – amounting to about 100 million people – used at least one preventive service that is required to be fully covered by the Affordable Care Act.

The study looked at data from a typical year (2018) prior to the pandemic for its assessment.

A provision of the ACA requires most private health plans to cover many preventive services with no out-of-pocket costs to the patient. The provision is being challenged in federal court. The U.S. District Court in the Northern District of Texas in September ruled that aspects of the requirement were unconstitutional and violated religious rights. The court allowed the provision to remain in effect while it considers a remedy.

The most common preventive services include vaccinations, well woman and well child visits, and screenings for heart disease, cervical cancer, diabetes, and breast cancer, according to KFF. COVID-19 vaccines are also provided at no cost to patients under the ACA’s preventive services requirement, though how many people will take them up in the future is uncertain.

The study shows that women and children are more likely than men to have used at least one no-cost preventive service through their private insurance.

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Jay W. Lee, MD, MPH, FAAFP headshot | © American Association of Family Practitioners