While ACA ruling is appealed, Michigan insurers will cover preventive screenings
- Oops!Something went wrong.Please try again later.
Michigan insurance companies pledged Thursday to continue to fully cover preventive health services while legal challenges wend through the courts over a controversial ruling from a federal judge who struck down a provision of the Affordable Care Act last week that requires no-cost preventive screenings, Gov. Gretchen Whitmer's administration told the Free Press.
It means that while the ruling in Braidwood Management Inc. v. Becerra is appealed, the 2.1 million Michiganders who could have lost full coverage of preventive services will be able to continue to get them at no cost at least until a final decision in the case is rendered — whether that's in the 5th Circuit Court of Appeals or the U.S. Supreme Court. The services in question include colon and lung cancer screenings, and preventive drugs for breast cancer, heart disease and HIV.
Whitmer said Thursday that 100% of the health insurance plans in the individual, small group and large group markets in Michigan, which includes plans sold on the Health Insurance Marketplace, have agreed to continue covering the screenings at least in the interim.
“Preventive health care saves lives, and that’s why we are taking immediate action to ensure this critical coverage is continued,” Whitmer said in a statement. “No one should have to wait for a court decision to decide whether they can afford to go see a doctor. As the legal process moves forward, we will continue to take proactive steps to protect people’s health care.”
Whitmer on Monday had directed the state Department of Insurance and Financial Services to move immediately to protect Michiganders from the potential loss of health insurance coverage for preventive services.
“It is important for our members to know that their care and coverage does not change because of the court’s decision,” Dr. James Grant, senior vice president and chief medical officer of Blue Cross Blue Shield of Michigan, said in a statement.
“Access to no-cost screenings, counseling services and preventive medications is critical to early detection, breaking down barriers to care and improving overall health. Blue Cross Blue Shield of Michigan supports maintaining these preventive services in place without cost sharing until all appeals to the court’s decision are finalized.”
More: Gov. Whitmer fears impact of ruling that free ACA screenings are unconstitutional
More: Nearly 4 in 10 Michigan nurses say they plan to quit, new survey shows
Which insurance companies have agreed to continue covering the preventive services?
According to Whitmer's office, they are:
Aetna Life Insurance Company, Aetna Health of Michigan Inc.
Blue Care Network of Michigan
Blue Cross Blue Shield of Michigan
Cigna Health and Life Insurance Company
Health Alliance Plan, Alliance Health and Life Insurance Company
Humana Insurance Company
Humana Medical Plan of Michigan
McLaren Health Plan Community
Meridian Health Plan of Michigan, Inc.
Molina Healthcare of Michigan
Nippon Life Insurance Company of America
Oscar Insurance Company
Physicians Health Plan
Priority Health
UnitedHealthcare Insurance Company Inc. and UnitedHealthcare Community Plan Inc.
US Health and Life Insurance Company
Wellfleet Insurance Company
What should I do if my insurance company isn't among them?
Michiganders with self-funded group health plans offered by some large private employers should contact their insurer or employer to understand any potential changes to their insurance coverage.
If you are scheduling preventive health care services and have questions, contact your insurer or employer. For further assistance, visit Michigan.gov/HealthInsurance or call 877-999-6442 8 a.m.-5 p.m. Monday through Friday.
Tell me more about last week's ruling
U.S. District Judge Reed O'Connor of the Northern District of Texas ruled last week in Braidwood Management v. Becerra that the ACA's requirement that private health insurance companies cover services recommended by the U.S. Preventive Services Task Force at no cost to patients is unconstitutional. He said the task force members are volunteers who are not appointed by the president or confirmed by the Senate, as required.
The ruling is effective immediately and applies nationally, allowing insurance companies the right to deny full coverage of any preventive health services recommended by the task force after March 23, 2010 — the day former President Barack Obama signed the ACA into law.
That means patients could soon find that their insurance companies will no longer fully cover statin drugs to prevent heart disease, preventive chemotherapy for those at high risk for breast cancer, lung cancer screenings or colonoscopies for people between the ages of 45-49 — a newly changed recommendation as the rate of colon cancer has risen in recent years among younger Americans.
Separately, O'Connor also ruled that ACA-mandated coverage of HIV pre-exposure prophylaxis, also known as PrEP, is unconstitutional and violates Braidwood Management's right to religious freedom.
Although the ruling takes effect immediately, it's unlikely most health insurance companies will withdraw full coverage of these health services right away. That's because health plan contracts typically span the full calendar year and changes to coverage or costs typically don't change midyear.
More:Simple lung cancer screening test is easy, painless — and could save your life
More: Thousands miss out on HIV-prevention treatment in Michigan, nationally
What's happening with appeals, longer-term solutions?
The U.S. Department of Justice has appealed the ruling, seeking a stay from the 5th Circuit Court of Appeals. It could potentially be considered by the U.S. Supreme Court.
In a letter Whitmer sent Monday to Anita Fox, director of the Department of Insurance and Financial Services, she pledged to call on the Legislature and Congress to codify full coverage of these preventive health services “to help ensure that Michiganders can continue to have access to these critical services without having to worry about whether they can afford it. The time to act is now. No person in Michigan should have to choose between paying their bills and protecting their health.”
Contact Kristen Shamus: kshamus@freepress.com. Follow her on Twitter @kristenshamus. Subscribe to the Free Press.
This article originally appeared on Detroit Free Press: Michigan insurers will cover preventive screenings during ACA appeals
