Most employers intend to keep preventive services even after Texas ACA ruling
Seventy-two percent expect to keep things as they had been, 6% expect to be more selective, and 22% don't know how they will move forward.
Photo: Blanchi Costela/Getty Images
At the tail end of March, a ruling by a federal judge in Texas invalidated much of the Affordable Care Act's coverage of preventive care without cost sharing, but a new survey from the National Alliance of Healthcare Purchaser Coalitions showed that about 72% of employers expect to continue providing coverage for all preventive services at 100%.
The Texas ruling blocks preventative care coverage, including for HIV, cancer and a range of reproductive health interventions mandated in the ACA. The decision in Braidwood v. Becerra in the U.S. District Court for the Northern District of Texas applies nationwide; most health insurance plans are no longer required to cover many preventive healthcare services at no cost to the consumer.
While 72% of employers expect to keep things as they had been, 6% expect to be more selective, and 22% don't know how they will approach coverage for preventive care services.
Christian-owned businesses and six individuals in Texas brought the lawsuit to the Texas court, claiming that the requirements in the ACA were unconstitutional. The requirement to cover preexposure prophylaxis (PrEP), medication for HIV prevention, violates their religious rights, the plaintiffs said.
The court's decision drew criticism from a number of organizations, including AHIP.
"Every American deserves access to high-quality affordable coverage and healthcare, including affordable access to preventive care and services that help avoid illnesses and other health problems," said AHIP President and CEO Matt Eyles in March.
The U.S. Department of Justice appealed the court's decision shortly after it was handed down.
WHAT'S THE IMPACT
The National Alliance survey uncovered a number of other findings, mostly related to vaccinations and immunizations. For instance, while 76% of employers agreed that keeping up-to-date based on current COVID-19 guidelines is core to their immunization strategies going forward, 81% agreed that the pandemic has increased the urgency of focusing on all vaccinations for employees and their families.
Ninety-six percent of respondents agreed that employee engagement in primary care is a critical health strategy to improve immunization uptake. And 81% believe that employers are a trusted source for vaccine information, compared to 62% for health plans.
With the end of the public health emergency, only 14% are planning to cover over-the-counter tests at 100%, and 33% won't cover them; going forward, COVID-19 treatment will be covered consistent with similar non-COVID services by 71%, and another 24% envision covering it at 100%.
In tracking immunization rates, 79% of employers have vaccine information rates for their workforce on COVID-19, and 63% have information on influenza vaccinations.
THE LARGER TREND
The DOJ's appeal in the Texas case was filed March 31.
Dorian Smith, national practice leader for Mercer's Law & Policy Group, said in a statement that the Texas decision eliminated constitutional grounds for coverage requirements for preventive services, but that doesn't mean insurers would stop coverage.
"Even before the ACA, no- or low-cost preventive services were already a common benefit in employer group health plans, and we do not expect to see employers scale this back in the short-term, as a commitment to workforce health and wellness has only grown in recent years," Smith said. "Importantly, employers will still be allowed to voluntarily provide coverage for preventive services without participant cost-sharing. The ruling only removes the requirement, not the ability, for employers and insurers to provide such no-cost coverage."
Twitter: @JELagasse
Email the writer: Jeff.Lagasse@himssmedia.com
