Even though preventive care is supposed to be free by law for millions of Americans thanks to the Affordable Care Act, many don’t receive recommended preventive services , especially racial and ethnic minorities and other at-risk patient groups . The Affordable Care Act exempted preventive services from patient cost-sharing for large chunks of the population. This means that if you receive preventive screening and have private insurance, including through the ACA Marketplace, there should be no copay at time of service, and you shouldn’t get a bill later on.
Easy enough, right? Wrong. Our team of health economists has shown that patients spend millions of dollars every year on unexpected bills for preventive care . The main reason for this is that no specific regulations were put in place to determine exactly which services should be exempted, or for whom, or how often.
This omission has left many people on the hook to pay for valuable health care they thought would be free. Now, in our recently published research in the journal JAMA Network Open, we’ve found that the burden of paying for what should be free preventive care disproportionately falls on some patient groups. Inequitable claim denials Looking at data from over 1.
5 million patients, our study demonstrates that insurers deny preventive claims for patients from marginalized communities at higher rates than for those from majority groups. For example, low-income patients were 43% more likely than high-income pa.