Dive Brief:
- Commentary appearing this week in the Annals of Internal Medicine has raised debate over the ACA's requirement that insurers cover preventive health care services without co-pay if they are declared by the U.S. Preventive Services Task Force to meet the criteria for an A or B recommendation.
- The three authors, who have previously chaired the USPSTF, suggested that the linkage between the recommendations and mandated coverage has actually "brought both benefit and harm."
- They argued that if the required coverage for preventive services comes at the expense of higher deductibles or copays for services that are not preventive, the linkage may serve to discourage other important healthcare.
Dive Insight:
The debate was sparked by more controversy around the actions of Mylan, which has weathered extreme scrutiny and criticism this year over its EpiPen price hikes and allegations that it improperly classified the EpiPen as generic to avoid paying rebates in the Medicaid Drug Rebate Program, which recently resulted in Mylan's $465 million settlement with the U.S. Department of Justice.
Mylan has been criticized for attempting to lobby the USPSTF to agree the EpiPen meets the preventive care criteria for an A or B recommendation, which the physicians argued are "only distantly related to Mylan's product."
The authors voiced concern that although Mylan appears unlikely to succeed in this particular lobbying effort, the linkage incentivizes those with financial interest to attempt to influence the task force.
"The American public is best served by an independent scientific process free from advocacy and political pressure," the authors wrote. "If the only way to assure such independence is to sever the direct linkage to coverage, then it may be time to consider that option. Perhaps it is time for the USPSTF to inform, but not determine, coverage."