HRSA Expands Preventive Care Coverage Under ACA for Women, Children
The updated preventive care guidelines include coverage of double electric breast pumps without cost-sharing for mothers as well as suicide risk screenings for adolescents.
The Health Resources and Services Administration (HRSA) has updated the preventive healthcare guidelines under the Affordable Care Act (ACA) to expand low-cost coverage of preventive care services for women and children, according to the Department of Health and Human Services (HHS).
The ACA and current HRSA guidelines require certain group health plans to offer coverage for preventive health services with no out-of-pocket costs. The administration has updated these guidelines to include coverage for double electric breast pumps with no co-pay or deductible. The new guidelines also include universal suicide risk screening for adolescents.
“Access to preventive care can help save countless lives and should be available without out-of-pocket costs, especially now during the COVID-19 pandemic,” HHS Secretary Xavier Becerra said in the press release.
“These updated guidelines help ensure that we’re providing critical services to keep families healthy, based on the latest science and data available. The Biden-Harris Administration will continue to build on the Affordable Care Act to make preventive care available to as many Americans as possible nationwide.”
HRSA’s Women’s Preventive Services Guidelines detail health needs that are specific to women and help providers decide which services their patients must regularly receive.
The guidelines are reviewed on a rolling basis by a team of women’s health experts who make up the Women’s Preventive Services Initiative. Following the reviews, the organization offers recommended updates for the guidelines.
In December 2021, HRSA accepted and added updates to the guidelines that center around breastfeeding services and supplies, access to contraceptives and contraceptive counseling, well-woman preventive care visits, human immunodeficiency virus (HIV) screenings, and counseling for sexually transmitted infections (STIs).
In addition to coverage for double electric breast pumps with no cost-sharing, HRSA has added a guideline that offers counseling to prevent and reduce obesity in women between the ages of 40 and 60 years old.
HRSA has also updated its Bright Futures Program, which consists of preventive care guidelines for infants, children, and adolescents. The American Academy of Pediatrics recommends updates on a yearly basis after reviewing scientific evidence and the latest research.
In addition to including universal screening for suicide risk in the depression screening category, HRSA’s changes affect guidance for behavioral, social, and emotional screenings. The administration has added guidelines for assessing the risk of cardiac arrest or death in individuals between the ages of 11 and 21 years. Additionally, the new guidelines include an assessment for the risk of hepatitis B in all infants, children, and adolescents up to age 21.
Starting in 2023, group health plans under the Affordable Care Act must provide coverage for these services without cost-sharing to members.
“We are pleased to release these updated guidelines to expand insurance coverage of preventive services for women, infants, children, and teenagers,” HRSA Administrator Carole Johnson stated in the press release. “By requiring coverage with no cost-sharing for services like double electric breast pumps for new parents and suicide risk screening for adolescents, these guidelines will help save lives and help families save money on out-of-pocket costs.”
A new report from HHS and the Office of the Assistant Secretary for Planning and Evaluation (ASPE) revealed the important role that the ACA has played in increasing access to preventive care, such as vaccinations, cancer screenings, and contraception.
As a result of ACA requirements and HRSA guidelines, more than 150 million people on private health plans, including 58 million women and 37 million children, receive preventive care services with no out-of-pocket costs, according to the report.
The COVID-19 pandemic caused some individuals to delay care due to fear of exposure to the virus or financial concerns. The coverage expansions from HRSA that offer preventive healthcare services with no cost-sharing under the ACA may help ensure women, children, and adolescents have access to care without facing financial barriers.
