Massachusetts: Health Connector Board takes steps to keep access to vital preventive services at no cost to state residents

via the Massachusetts Health Connector:

The Massachusetts Health Connector Board of Directors voted on Thursday, May 11, to ensure that health insurance plans used by five million Commonwealth residents to meet the state’s individual mandate continue to deliver high-value preventive services at no cost to consumers. This vote follows a March 2023 decision by a federal District Court in Texas to limit the scope of preventive services covered under the Affordable Care Act.

The proposed regulation amendments guarantee that Massachusetts residents with health insurance plans meeting state Minimum Creditable Coverage (MCC) standards will continue to receive key preventive services like cancer screenings, HIV prevention, and cholesterol-lowering medication without cost-sharing. These proposed regulation amendments protect coverage standards that are current practice in the Commonwealth.

Massachusetts leads the nation in health care coverage, with 97 percent of residents having health insurance. State standards, like the ones protected by today’s vote and the corresponding change in regulations, ensure residents can continue to access vital preventive services at no cost despite a recent federal court ruling.

“Here in Massachusetts, we will always stand up against efforts to restrict access to health care – from preventive care to reproductive freedom. We are committed to protecting people’s civil rights and freedom,” said Governor Maura Healey. “I applaud the Health Connector Board of Directors for taking this critical step today to ensure that Massachusetts residents can continue to access preventive services – like cancer screenings, mental health screenings and contraception – at no cost.”

“MCC standards ensure five million people in Massachusetts have access to quality health insurance that covers important and necessary health services, including vital preventive care,” said Secretary of Health and Human Services Kate Walsh. “These amended regulations guarantee that these services and care remain no-cost for Massachusetts residents, continuing Massachusetts’s longstanding commitment to protecting access to high-value health care.”

The March 2023 federal court decision limited the scope of services covered by the Affordable Care Act’s requirement that health plans cover a broad range of preventive services without cost-sharing. These services have been offered at no cost by insurers to their members for the past decade due to the Affordable Care Act, and Massachusetts residents have come to depend on these services and protections as a standard part of robust, high-quality coverage.

The proposed updates affect MCC standards, and insurance plans must continue to offer these services without cost-sharing to meet MCC requirements. The state’s individual mandate requires everyone in Massachusetts with access to affordable health insurance to enroll or face a penalty.

The U.S. Preventive Services Task Force identified a number of important services that should be covered at no cost to consumers, including lung and skin cancer screenings, PrEP for HIV prevention, statins to lower cholesterol, and medications and certain screenings to reduce breast cancer. Services at risk following the federal court ruling include those items, Hepatitis B and C screenings, and anxiety screening for children.

With today’s vote, the Health Connector, which is the independent state authority that governs MCC, will commence a regulatory amendment process. Notice of a public hearing on the proposed amendments is forthcoming.