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Preventive care coverage required by ACA, but not SSD-Medicaid?

When the Affordable Care Act (often called Obamacare) was under debate in Congress, one of the most important cost-saving measures proposed was increased coverage for preventive care services and management of chronic illnesses. According to the health policy journal "Health Affairs," low-income people, who are the majority of the uninsured, seek care from hospitals and emergency rooms more often than they go to primary care doctors. Essentially, low-income people without adequate insurance can’t afford to go to seek preventive medical services, so they don’t get treatment until they are acutely ill. Not only does this cost the health care system more than $30.8 billion a year, it promotes poorer health outcomes for patients.

So, when the ACA was passed, an agency called the U.S. Preventive Services Task Force issued recommendations for what preventive and chronic care services health insurers should be required to provide, without cost-sharing, for all beneficiaries. Unfortunately, a new study found that existing Medicaid beneficiaries -- which includes Social Security disability recipients -- may not be receive those very same services under the ACA’s Medicaid expansion.

The study, which was funded in part by the American Cancer Society Cancer Action Network and performed by researchers at the George Washington University School of Public Health and Health Service, appears in the July issue of “Health Affairs.” It reviewed health services covered by Medicaid in all 50 states and the District of Columbia over six months late last year and found that coverage of the preventative services recommended by the task force was spotty, at best.

While almost all states covered mammograms, only 36 states covered pap smears. Less than half of states covered routine cholesterol screenings, and a dozen states provided no Medicaid coverage for adult well visits -- meaning that adults couldn’t see a doctor unless they were already sick.

As of 2009, people with disabilities, including those on Social Security disability, reportedly made up 15 percent of all Medicaid beneficiaries. Are the poorest and sickest in our nation going to be the last to receive the preventive health care services that so significantly improve health outcomes -- and save billions?

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