Preventive health services protected in Washington state

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Preventive healthcare services, like immunizations and screenings, must be covered by your insurance.

Getting preventive services like immunizations and cancer screenings without cost sharing is one of the most popular benefits of the Affordable Care Act.

In response to the efforts to repeal all or parts of the federal law, our state legislature added them to state law in 2018. This action locked in the preventive service benefits as they existed in 2016. Washington has added additional services since then:

  • Colorectal and lung cancer screenings for certain groups
  • Blood pressure screenings
  • Pre-exposure prophylaxis HIV medication

See the latest list of recommended preventive services for adults.

This year, the legislature took another step in protecting access to these services by extending the requirement to include preventive services recommended as of Jan. 8, 2024. Insurance companies must review their benefits each year; they can add any new recommended services and can remove any that are no longer approved. Here’s the full text of the bill.

This is good news for Washington consumers, especially considering recent and pending court actions.

An article describing the pending court case against the preventive services benefit of the Affordable Care Act.
kffhealthnews.org

U.S. District Judge Reed O’Connor ruled in 2023 (Braidwood Management v. Becerra) that the preventive services requirements violated the Constitution because they came from a volunteer task force (the U.S. Preventive Services Taskforce) and not from constitutionally appointed officials. The 5th U.S. Circuit Court of Appeals in New Orleans heard the case in March and a decision is expected soon.

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WA State Office of the Insurance Commissioner
WA State Office of the Insurance Commissioner

Written by WA State Office of the Insurance Commissioner

Washington state Insurance Commissioner Mike Kreidler regulates the insurance industry and protects insurance consumers.

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