Chattanooga Times Free Press

Overlooked benefits of the ACA

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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 test-

ing. All 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 violates 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 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 that 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.

 ??  ?? Dr. Clif Cleaveland
Dr. Clif Cleaveland

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