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An Ounce of Prevention

Millions of Americans will soon be able to receive preventive health care services free of charge under rules the White House issued yesterday to help implement the health reform law.  The new rules will likely mean fewer unnecessary deaths from diseases like cancer and diabetes, reduced spending on costly and avoidable illnesses, and a healthier population overall.

Many preventive services — from colonoscopies to screenings for cervical cancer — are underutilized, studies show, and the out-of-pocket costs that people must pay for these services under their insurance plans are one reason why.

Under the new rules, insurers will have to provide services such as screenings for chronic illnesses (including diabetes and cancer), routine vaccines for adults and children, and other recommended care for children, such as regular doctor visits.

Better access to preventive care should produce better health outcomes and fewer absences from work and school due to illness.  Research also shows that some preventive services reduce health costs over time.  An example is pediatric immunization, which helps avert childhood illnesses.

The Administration estimates that about 31 million people will be enrolled in employer-sponsored health plans subject to the new rules in 2011.  At least 10 million additional people will have policies purchased in the individual market that are subject to the rules.

In order to help people keep the coverage they had at the time of health reform’s enactment, the rules do not apply to plans that are considered “grandfathered” because they existed on March 23, 2010 and have not been changed significantly. The rules also do not apply to Medicare and Medicaid, which have their own, separate requirements related to preventive services.