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Q & A With Sarah Lueck: How the Health Reform Law Improves Access to Preventive Care Services


Today, we sat down with Health Policy Analyst Sarah Lueck to discuss the great news that millions of Americans will soon be able to receive preventive health care services free of charge because of the new health reform law.

Sarah, let's start with a basic question: what is preventive care?

Preventive care includes things like screenings, vaccinations and regular doctor visits that keep people healthy.

The White House recently issued rules to help implement the preventive care provisions of the health reform law. Can you tell us about these new rules?

Under the new rules, insurers will have to provide screenings for chronic illnesses like diabetes and cancer, routine vaccines for adults and children, and other recommended care for kids, such as regular doctor visits. As a result, we’re likely to see fewer unnecessary deaths from diseases like cancer and diabetes, reduced spending on costly and avoidable illnesses, and a healthier population overall.

How will the new rules help the population become healthier?

People don’t seek preventive services like colonoscopies and screenings for cervical cancer as much as they should. The out-of-pocket costs that people must pay for these services under their insurance plans are one reason why.

Better access to preventive care should help more people to stay healthy, and miss fewer days of work or school due to illness.

Research also shows that some preventive services even reduce health costs over time. One example of this is vaccinating children to help avoid costly illnesses.

When do the new rules kick in and how many people will they help?

The rules take effect on September 23rd of this year. Insurance companies will start to cover these preventive care services at no charge when their new plan years begin, anytime after that date.

The Administration estimates that about 41 million people will be enrolled in plans subject to the new rules in 2011.

Are there any plans that aren’t covered by the new rules?

The new law does not apply to plans that are “grandfathered.” Those are plans that existed on the date the Affordable Care Act was signed into law that haven’t changed a lot since. The law exempted grandfathered plans from some of the new requirements so that people can keep the coverage they have if they like it. These new rules also do not apply to Medicare and Medicaid, which have their own requirements related to preventive services.

Sarah, what’s the bottom line?

This is one of the first provisions of the new health reform law to take effect and it’s going to help millions of people access care and stay healthy.

You can download a podcast of this conversation here or on iTunes. Click here for our series on moving forward with health reform.