HRSA Updates ACA Preventive Care Guidelines to Improve Care for Women and Children

The U.S. Department of Health and Human Services (HHS) announced that the Health Resources and Services Administration (HRSA) has updated comprehensive preventive care and screening guidelines for women and for infant, children, and adolescents. Under the Affordable Care Act (ACA), certain group health plans and insurers must provide coverage with no out-of-pocket costs for preventive health services within HRSA-supported comprehensive guidelines.

Among the updates, for the first time the guidelines will require insurers and plans to provide coverage without a copay or deductible for double electric breast pumps. Other updates to women’s health services include well-woman preventive care visits, access to contraceptives and contraceptive counseling, screening for HIV, and counseling for STIs. HHS also approved a new guideline aiming to prevent and reduce obesity in midlife women through counseling.

For infants, children, and adolescents, updates include adding universal suicide screening risk for individuals ages 12 to 21 and new guidance for behavioral, social, and emotional screening. HRSA additionally accepted new guidelines for assess risks for cardiac arrest or death for individuals ages 11 to 21 and assessing risks for hepatitis B virus in newborn to 21-year-olds

Insurers and health plans subject to the requirements will be required to provide coverage without cost-sharing of new and updated services beginning in 2023.

Relatedly, the HHS Office of the Assistant Secretary for Planning and Evaluation (ASPE) recently issued a report highlighting how the ACA has increased access to preventive care for millions of Americans, including vaccinations, contraception, and cancer screening. The ASPE report estimates that more than 150 million with private insurance, including 58 million women and 37 million children, are receiving preventive services with no cost-sharing, as required by the ACA.

Additional information from HHS is available here.