If employers no longer cover certain preventive services, individuals could face higher out-of-pocket costs, while employers won't see a big effect on spending, a report from the Employee Benefits Research Institute found.
The report, published June 26, examined the usage rates and costs associated with several preventive care services that could be affected by a court ruling striking the provision of the ACA that requires most health plans and employers to cover preventive services at no cost to members.
In March, U.S. District Judge Reed O'Connor issued a decision in Braidwood Management v. Becerra, ruling payers and employers cannot be required to cover services recommended by the U.S. Preventive Services Task Force.
The ruling applies to recommendations made after March 2010, when the ACA took effect.
In June, the Biden administration reached a deal to keep preventive coverage requirements in place while the ruling is appealed.
According to the report, if employers choose to impose 20 percent cost sharing for all of the preventive services recommended after 2022, employer spending would fall by 0.48 percent.
Enrollees could face higher copays, especially for HIV prevention drugs, known as PrEP, which would cost enrollees an average of $2,747 each year.
Employers would save 0.08 percent on annual costs if they imposed cost sharing for PrEP, the researchers found. Although the drug is high-cost, a low share of enrollees, .20 percent, use it.
In a June 26 article in Health Affairs, the authors of the study said adding cost-sharing for preventive services would "reverse a growing movement among employers in recent years to expand coverage of clinically effective care without deductibles or copays."
"Re-introduction of patient cost-sharing will have a minimal impact on overall employer health care spending because when spread across the entire pool of covered lives, the costs of covering select preventive services are very low," the authors wrote.
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