Preserving prevention services, and promoting their use

By Dennis Archambault

One of the assets in the Patient Protection and Affordable Care Act (ACA) is its requirement that insurance companies cover prevention services without cost to their beneficiaries. This requirement is based on evidence that prevention services help reduce incidence of disease and improve initial treatment outcomes for cancer, chronic disease, infectious disease, mental health, substance abuse, as well as in eye and oral health. Studies have shown that investing in detection, as an alternative to disease treatment, results in reduced incidence of disease and decreased treatment costs.

Political opponents of the ACA have tried to overturn the law and dismantle its components incrementally. Last month, the Supreme Court rejected the fourth attempt by the Trump administration. In that case, the government asserted that the U.S. Preventive Services Task Force, which advises the government and private sector on which tests have merit and should be covered by insurances, was unlawfully appointed. Ironically, the task force is appointed by the Secretary of Health and Human Services.

Also last month, Robert Kennedy, Jr., Secretary of Health and Human Services, terminated members of the Vaccine Advisory Panel and has announced intention to do the same with the Prevention Services Task Force citing politically motivated decisions, or “wokeness,” by their members. Both of these groups are comprised of health professionals, act independent of government and are considered essential in determining health policy around disease prevention.

The American Medical Association, on July 27, expressed “great concern” regarding this direction in health policy. In a letter to Secretary Kennedy, the AMA said that the prevention task force “plays a critical, non-partisan role in guiding physicians’ efforts to prevent disease and improve the health of patients by helping to ensure access to evidence-based clinical preventive services… Access to these services without cost sharing plays a critical role in keeping patients healthy and reducing the burdens of disease.” Making these services available in the primary care setting is critical to improving the health of patients and their communities.

Despite the required insurance coverage, the use of prevention screenings and testing has actually declined in recent years. A report published by the National Library of Medicine in 2020 notes that less than eight percent of all United States adults received all recommended preventive care. This may be due to access to primary care services, timeliness of recommendations by providers, location/access to primary care tests and screenings, and timeliness of recommendations for testing by primary care providers.

Authority Health Centers actively promotes prevention testing for its patients and collaborates with community health organizations like the American Heart Association and National Kidney Foundation of Michigan to promote community screenings for heart disease and diabetes, two major chronic diseases in our community.

Despite challenges from the political front, providers need to be more effective in gaining acceptance for prevention services among patients. Researchers have found that personal beliefs about prevention also pose significant barriers for acceptance of vaccines and prevention services: “a belief that one was currently healthy; lack of time; a belief that screening procedures were too complicated to understand; physical pain or negative emotions such as fear, anxiety, embarrassment, pain, and discomfort, and having had a negative experience during a previous health checkup.”

While the struggle continues to preserve affordable access to prevention services at the national level, the challenge to actually use persists at the local level.

Dennis Archambault is vice president of Public Affairs for Authority Health.