Medicaid is missing the mark when it comes to healthcare prevention efforts aimed at helping recipients ward off cancer, heart disease, and other potentially deadly diseases, according to new research by the George Washington University School of Public Health and Health Services.
The study, which appears in the journal Health Affairs, notes that under the Patient Protection and Affordable Care Act most private insurance plans, Medicare, and Medicaid expansion programs are required by law to cover preventive services such as screening tests for colorectal cancer, high blood cholesterol, HIV infection, and diet counseling that can prevent obesity.
But state Medicaid plans are not required to cover such care for adults already enrolled in Medicaid — and the report suggests those adults will not have access to the full range of preventive services.
"Preventive services save lives by detecting diseases before they can progress," said lead researcher Sara Wilensky. "Why should some Medicaid beneficiaries be left out when it comes to coverage for this kind of care?"
To reach their conclusions, Wilensky and colleagues reviewed Medicaid policies in all 50 states and the District of Columbia from June 2012 through November 2012. The results showed most states do not cover all of the preventive services recommended by the U.S. Preventive Services Task Force, an independent panel that looks at preventive care and offers guidelines for health plans and providers.
The researchers also found some gaps in coverage. For example, while most states provided coverage for screening mammograms, not all Medicaid programs offered such care to existing beneficiaries. In addition, wide variations were noted in coverage of tests for sexually transmitted diseases (STD) and the test for the AIDS virus.
"The Affordable Care Act guarantees millions of low-income Americans access to mammograms, colonoscopies, and other lifesaving preventive services, but that assurance does not extend to people who currently have Medicaid coverage," said Chris Hansen, president of the American Cancer Society Cancer Action Network, which helped fund the study. "States have a responsibility to ensure that all people in Medicaid have access to preventive care for a life-threatening disease such as cancer."
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