Cleaveland: Overlooked benefits of the Affordable Care Act

The SafeSEAL(TM) antimicrobial soft diaphram slips onto any stethoscope effortlessly. Changed only once a week, SafeSEAL(TM)  helps provide protection against harmful bacteria commonly found on stethoscopes. Available in adult, pediatric and infant sizes. (PRNewsFoto)
The SafeSEAL(TM) antimicrobial soft diaphram slips onto any stethoscope effortlessly. Changed only once a week, SafeSEAL(TM) helps provide protection against harmful bacteria commonly found on stethoscopes. Available in adult, pediatric and infant sizes. (PRNewsFoto)

Members of Congress who promote trashing the Affordable Care Act (ACA) overlook vital components of the act that impact preventive care and mental health services.

For preventive services, the ACA mandates coverage of an array of services in the majority of health plans without co-payments, deductibles or co-insurance. Coverage is based upon guidelines formulated by the U.S. Preventive Services Task Force and the Advisory Committee on Immunization Practices.

For children, all recommended vaccines from newborn to age 18 are covered. In addition to the familiar polio, diphtheria, whooping cough, tetanus, influenza, and polio, vaccinations for human papilloma virus (HPV), hepatitis A and B, rotavirus and meningococcal infection are included. Age-appropriate screenings are covered for autism, behavioral assessment, hearing, HIV infection, anemia, blood pressure, lipids, obesity, and alcohol and drug abuse.

For women, breast cancer prevention includes mammography, genetic screening and counseling, and preventive medication where indicated. Cervical cancer screening includes Pap smears and HPV testing. All approved contraceptive methods approved by the Food and Drug Administration, including oral agents and intrauterine devices, are covered, along with patient counseling and education. Companies arguing that contraceptive coverage violated their religious beliefs are excluded from the provision in company-sponsored health insurance plans.

Voluntary sterilization procedures are also covered, as is screening for sexually transmitted disease along with counseling.

Pregnancy-related benefits cover screening and counseling for alcohol misuse, gestational diabetes, iron deficiency anemia, sexually transmitted diseases and urinary tract infections. Counseling and consultation related to breast-feeding, along with equipment rental, are included.

For all adults, screening for cardiovascular disease, including high blood pressure, lipid disorders and abdominal aortic aneurysms, are covered. Screening for adult-onset diabetes, hepatitis B and C, depression and osteoporosis are included, as well as age-appropriate screening for colon and rectal cancer. Guidelines determine when a colonoscopy is indicated.

Preventive medicine saves countless lives and is highly cost-effective. The benefits of preventive medicine are cumulative and will progressively reduce the incidence of such diseases as hepatitis C over time.

Before the ACA was implemented, surveys indicated that the cost of preventive services deterred their use by one-fourth of insured persons and more than one-half of uninsured persons.

Before passage of the ACA, many health insurance plans did not cover mental health services or treatment for addiction. Now, however, access to behavioral health care and treatment for addiction have been designated as essential services must be covered in marketplace health plans and expanded Medicaid programs. Both out-patient and in-patient psychotherapy are included.

Treatment of persons with addiction disorders is critically dependent upon maintenance therapy with medications that block the urge to use such drugs as heroin or prescription opiates. Drugs that block the intense desire for narcotics are costly, and therapy, including counseling, may need to extend for years to sustain abstinence from addictive drugs. Almost 3 million people with addiction disorders have gained coverage under the ACA. This is life-saving care that facilitates productive lives.

Before passage of the ACA, many health insurance plans did not cover mental health services or treatment for addiction.

Perhaps opponents of the ACA do not know about its provisions for preventive care and mental health services. Perhaps they do not care. But before they vote to abolish the ACA, members of Congress should spend time in urban and rural clinics that provide care for people who benefit from preventive services and mental health care. If the wrecking crew decide to proceed with repeal of the ACA, they should solemnly pledge that any replacement will not lead to denial of vital services to vulnerable people.

Contact Clif Cleaveland at ccleaveland@timesfreepress.com.

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