Department of Health Policy, School of Public Health and Health Services, George Washington University, Washington, DC, USA.
Health Aff (Millwood). 2013 Jul;32(7):1188-95. doi: 10.1377/hlthaff.2013.0224.
The recent health reform law promotes access to preventive care through new insurance coverage requirements. Most private insurance plans, Medicare, and Medicaid expansion programs are required to cover US Preventive Services Task Force A- and B-rated services without cost sharing. However, because the Affordable Care Act treats newly eligible and existing Medicaid beneficiaries differently, all adult Medicaid beneficiaries within a state might not be eligible for the same preventive services. This study reviewed Medicaid programs across the country and found that most states do not cover all of these recommended services as preventive measures for adults. As a result, existing adult Medicaid beneficiaries might not have coverage of the same important preventive services that most other insured people have. In addition, aspects of how preventive services are defined in many states result in confusion about coverage parameters, potentially creating an additional access barrier for existing Medicaid beneficiaries.
最近的医疗改革法案通过新的保险覆盖要求促进了获得预防保健的机会。大多数私人保险计划、医疗保险和医疗补助扩展计划都被要求免费提供美国预防服务工作组 A 级和 B 级服务。然而，由于平价医疗法案对新符合条件的和现有的医疗补助受益人的待遇不同，一个州内的所有成年医疗补助受益人可能没有资格获得相同的预防服务。本研究审查了全国范围内的医疗补助计划，发现大多数州没有将所有这些推荐的服务作为成年人的预防措施来涵盖。因此，现有的成年医疗补助受益人可能无法获得与大多数其他参保人相同的重要预防服务。此外，许多州对预防服务的定义方式导致了对覆盖范围参数的混淆，这可能给现有的医疗补助受益人增加了一个额外的获取障碍。
