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Annual Review of Public Health

Volume 39, 2018

Promoting Prevention Under the Affordable Care Act

Abstract

The Affordable Care Act (ACA) of 2010 placed a substantial emphasis on public health and prevention. Subsequent research on its effects reveals some notable successes and some missteps and offers important lessons for future legislators. The ACA's Prevention and Public Health Fund, intended to give public health budgetary flexibility, provided crucial funding for public health services during the Great Recession but proved highly vulnerable to subsequent budget cuts. Several programs that aimed to increase strategic thinking and planning around public health at the state level have proven to be more enduring, suggesting that the convening authority of the federal government can be a powerful tool for progress, especially when buttressed by some funding. Most important, by expanding insurance and mandating a minimum level of coverage, the ACA both increased access to clinical preventive services and freed up local public health budgets to engage in population health activities.

Keyword(s): Affordable Care Act, capacity, incentives, prevention, public health, reform
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/content/journals/10.1146/annurev-publhealth-040617-013534
2018-04-01
2024-12-12
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Literature Cited

  1. Altman D. 1. . 2016.. The Affordable Care Act's little-noticed success: cutting the uninsured rate. Oct. 12, Kaiser Family Found., Menlo Park, CA:. https://www.kff.org/uninsured/perspective/the-affordable-care-acts-little-noticed-success-cutting-the-uninsured-rate/ [Google Scholar]
  2. Anderson LV. 2. . 2016.. Workplace wellness programs are a sham. . Slate Sept. 1. http://www.slate.com/articles/health_and_science/the_ladder/2016/09/workplace_wellness_programs_are_a_sham.html [Google Scholar]
  3. 3. APHA (Am. Public Health Assoc.). 2007.. A call to action on breastfeeding: a fundamental public health issue. Policy 200714, Nov. 6 , APHA, Washington, DC:. https://www.apha.org/policies-and-advocacy/public-health-policy-statements/policy-database/2014/07/29/13/23/a-call-to-action-on-breastfeeding-a-fundamental-public-health-issue [Google Scholar]
  4. 4. ASA (Am. Suntanning Assoc.). 2017.. Consequences of the 10% ‘tan tax.’ http://americansuntanning.org/wp-content/uploads/2017/02/2017-Tan-Tax-1-Pager-1.pdf [Google Scholar]
  5. Avery K. , Finegold K. , Whitman A. 5. . 2016.. Affordable Care Act has led to historic, widespread increase in health insurance coverage. Issue Brief, Sept. 29, Assist. Secr. Plan. Eval., Washington, DC:. https://aspe.hhs.gov/system/files/pdf/207946/ACAHistoricIncreaseCoverage.pdf [Google Scholar]
  6. Avery K. , Finegold K. , Xiao X. 6. . 2016.. Impact of the Affordable Care Act coverage expansion on rural and urban populations. Issue Brief, June 10, Assist. Secr. Plan. Eval., Washington, DC:. https://aspe.hhs.gov/system/files/pdf/204986/ACARuralbrief.pdf [Google Scholar]
  7. 7. BabyCenter. 2016.. How to buy a breast pump. Updated April, BabyCenter , San Francisco:. https://www.babycenter.com/0_how-to-buy-a-breast-pump_429.bc [Google Scholar]
  8. Bassett MT. 8. . 2009.. Bold steps for the health of Americans: yes we can. . Am. J. Public Health 99::587 [Google Scholar]
  9. Calman NS. , Hauser D. , Chokshi D. 9. . 2012.. “Lost to follow-up”: the public health goals of accountable care. . Arch. Intern. Med. 172::584–86 [Google Scholar]
  10. Casalino LP. , Erb N. , Joshi MS. , Shortell SM. 10. . 2015.. Accountable care organizations and population health organizations. . J. Health Polit. Policy Law 40::821–37 [Google Scholar]
  11. 11. CDC (Cent. Dis. Control Prev.). 2014.. Almost $500 million could be saved annually by making subsidized housing smoke-free. Sept. 9, CDC , Atlanta:. https://www.cdc.gov/media/releases/2014/p1002-smoke-free-housing.html [Google Scholar]
  12. 12. CDC (Cent. Dis. Control Prev.). 2017.. Epidemiology and Laboratory Capacity for Infectious Diseases (ELC) cooperative agreement. Updated Aug. 2 , CDC, Atlanta:. https://www.cdc.gov/ncezid/dpei/epidemiology-laboratory-capacity.html [Google Scholar]
  13. Chernichovsky D. , Leibowitz AA. 13. . 2010.. Integrating public health and personal care in a reformed US health care system. . Am. J. Public Health 100::205–11 [Google Scholar]
  14. Chuang CH. , Mitchell JL. , Velott DL. , Legro RS. , Lehman EB. 14. , et al. 2015.. Women's awareness of their contraceptive benefits under the Patient Protection and Affordable Care Act. . Am. J. Public Health 105::S713–15 [Google Scholar]
  15. Chung S. , Lesser LI. , Lauderdale DS. , Johns NE. , Palaniappan LP. , Luft HS. 15. . 2015.. Medicare annual preventive care visits: Use increased among fee-for-service patients, but many do not participate. . Health Aff. 34::11–20 [Google Scholar]
  16. Costich JF. , Scutchfield FD. , Ingram RC. 16. . 2014.. Population health, public health, and accountable care: emerging roles and relationships. . Am. J. Public Health 105::846–50 [Google Scholar]
  17. DiBenedetto JC. , Blum NM. , O'Brian CA. , Kolb LE. , Lipman RD. 17. . 2016.. Achievement of weight loss and other requirements of the Diabetes Prevention and Recognition Program. . Diabetes Educ. 42::678–85 [Google Scholar]
  18. Erwin PC. , Brownson RC. 18. . 2017.. Macro trends and the future of public health practice. . Annu. Rev. Public Health 38::393–412 [Google Scholar]
  19. Etheridge EW. 19. . 1992.. Sentinel for Health: A History of the Centers for Disease Control. Berkeley/Los Angeles:: Univ. Calif. Press [Google Scholar]
  20. Farley TA. 20. . 2009.. Reforming health care or reforming health. . Am. J. Public Health 99::588–90 [Google Scholar]
  21. Fraze T. , Lewis VA. , Rodriguez HP. , Fisher ES. 21. . 2016.. Housing, transportation, and food: how ACOs seek to improve population health by addressing nonmedical needs of patients. . Health Aff. 35::2109–15 [Google Scholar]
  22. Freidman AS. , Schpero WL. , Busch SH. 22. . 2016.. Evidence suggests that the ACA's tobacco surcharges reduced insurance take-up and did not increase smoking cessation. . Health Aff. 35::1176–83 [Google Scholar]
  23. Ganguli I. , Souza J. , McWilliams JM. , Mehrotra A. 23. . 2017.. Trends in use of the US Medicare annual wellness visit, 2011–2014. . JAMA 317::2233–35 [Google Scholar]
  24. Goodman A. 24. . 2009.. President Obama's health plan and community-based prevention. . Am. J. Public Health 99::1736–38 [Google Scholar]
  25. Gordon T. 25. . 2012.. State and local budgets and the Great Recession. Dec. 31 , Brookings Inst., Washington, DC:. https://www.brookings.edu/articles/state-and-local-budgets-and-the-great-recession/ [Google Scholar]
  26. Haberkorn J. 26. . 2012.. Health Policy Briefs: The prevention and public health fund. . Health Aff. Feb. 23. http://healthaffairs.org/healthpolicybriefs/brief_pdfs/healthpolicybrief_63.pdf [Google Scholar]
  27. Hall KS. , Fendrick AM. , Zochowski M. , Dalton VK. 27. . 2014.. Women's health and the Affordable Care Act: high hopes versus harsh realities?. Am. J. Public Health 104::e10–13 [Google Scholar]
  28. Hamman MK. , Kapinos KA. 28. . 2015.. Affordable Care Act provision lowered out-of-pocket cost and increased colonoscopy rates among men in Medicare. . Health Aff. 34::2069–76 [Google Scholar]
  29. Han X. , Yabroff KR. , Guy GP Jr.. , Zheng Z. , Jemal A. 29. . 2015.. Has recommended preventive service use increased after elimination of cost-sharing as part of the Affordable Care Act in the United States?. Prev. Med. 78::85–91 [Google Scholar]
  30. Horwitz JR. , Kelly BD. , DiNardo JE. 30. . 2013.. Wellness incentives in the workplace: cost savings through cost shifting to unhealthy workers. . Health Aff. 32::468–76 [Google Scholar]
  31. Jain N. , Rademaker A. , Robinson JK. 31. . 2012.. Implementation of the federal excise tax on indoor tanning services in Illinois. . JAMA Dermatol. 148::122–24 [Google Scholar]
  32. Jensen GA. , Salloum RG. , Hu J. , Ferdows NB. , Tarraf W. 32. . 2015.. A slow start: use of preventive services among seniors following the Affordable Care Act's enhancement of Medicare benefits in the U.S. . Prev. Med. 76::37–42 [Google Scholar]
  33. Johns DM. , Bayer R. 33. . 2016.. The paradox of authority—transformation of the USPSTF under the Affordable Care Act. . N. Engl. J. Med. 375::1710–12 [Google Scholar]
  34. Johnson SR. 34. . 2016.. Passage of Cures Act comes at expense of preventive health funding. . Modern Healthcare Dec. 7. http://www.modernhealthcare.com/article/20161207/NEWS/161209925 [Google Scholar]
  35. 35. Kaiser Family Found. 2013.. The Affordable Care Act three years post-enactment. Issue Brief, March 26. Kaiser Family Found., Menlo Park:. https://kaiserfamilyfoundation.files.wordpress.com/2013/04/84291.pdf [Google Scholar]
  36. Knight MA. , Kershenbaum AD. , Buchanan M. , Ridley J. , Erwin PC. 36. . 2014.. The effects of the changes in Section 317 rules for administration of federally purchased vaccines. . Am. J. Public Health 104::e42 [Google Scholar]
  37. Koh HK. , Sebelius KG. 37. . 2010.. Promoting prevention through the Affordable Care Act. . N. Engl. J. Med. 363::1296–99 [Google Scholar]
  38. Lau JS. , Adams SH. , Park MJ. , Bsocardin WJ. , Irwin CE Jr. 38. . 2014.. Improvement in preventive care of young adults after the Affordable Care Act: The Affordable Care Act is helping. . JAMA Pediatr. 168::1101–6 [Google Scholar]
  39. Lister SA. 39. . 2005.. An Overview of the U.S. Public Health System in the Context of Emergency Preparedness. CRS Rep. Congr . Washington, DC:: Congr. Res. Serv., Libr. Congr. https://fas.org/sgp/crs/homesec/RL31719.pdf [Google Scholar]
  40. Maclean JC. , Pesko MF. , Hill SC. 40. . 2017.. The effect of insurance expansions on smoking cessation medication use: evidence from recent Medicaid expansions. NBER Work. Pap. 23450 [Google Scholar]
  41. Madison K. , Schmidt H. , Volpp KG. 41. . 2013.. Smoking, obesity, health insurance, and health incentives in the Affordable Care Act. . JAMA 310::143–44 [Google Scholar]
  42. Mann C. 42. . 2013.. Letter to State Medicaid Directors on Affordable Care Act Section 4106 (Preventive Services). Feb. 1, Cent. Medicaid CHIP Serv ., Dep. Health Hum. Serv., Baltimore, MD:. https://www.medicaid.gov/federal-policy-guidance/downloads/smd-13-002.pdf [Google Scholar]
  43. Mattke S. , Liu H. , Caloyeras JP. , Huang CY. , Van Busum KR. 43. , et al. 2013.. Workplace Wellness Programs Study: Final Report. Arlington, VA:: Rand Corp. https://aspe.hhs.gov/system/files/pdf/76661/rpt_wellness.pdf [Google Scholar]
  44. McAfee T. , Davis KC. , Alexander RI Jr.. , Pechacek TF. , Bunnell R. 44. . 2013.. Effect of the first federally funded US antismoking national media campaign. . Lancet 382::2003–11 [Google Scholar]
  45. Meit M. 45. . 2015.. The impacts of the Affordable Care Act on state and local health departments. Presented at Keeneland Conf., Sept. 22, Lexington, KY. http://www.aohc.net/aws/AOHC/asset_manager/get_file/136228?ver=57 [Google Scholar]
  46. Mettenbrink C. , Al-Tayyib A. , Eggert J. , Thrun M. 46. . 2015.. Assessing the changing landscape of sexual health clinical service after the implementation of the Affordable Care Act. . Sex. Transm. Dis. 42::725–30 [Google Scholar]
  47. 47. Natl. Women's Law Cent. 2016.. The Affordable Care Act birth control benefit: progress on implementation and continuing challenges. Rep., July 29 , Natl. Women's Law Cent., Washington, DC:. https://nwlc.org/wp-content/uploads/2016/07/The-ACAs-BC-Benefit-Report-1.pdf [Google Scholar]
  48. Navarro M. 48. . 2016.. U.S. will ban smoking in public housing nationwide. . New York Times Nov. 30. https://www.nytimes.com/2016/11/30/nyregion/us-will-ban-smoking-in-public-housing-nationwide.html [Google Scholar]
  49. Pace LE. , Dusetzina SB. , Keating NL. 49. . 2016.. Early impact of the Affordable Care Act on uptake of long-acting reversible contraceptive methods. . Med. Care 54::811–17 [Google Scholar]
  50. Pearson C. 50. . 2013.. Breast pumps now covered by insurance, but does it help?. Huffington Post Jan. 23. https://www.huffingtonpost.com/2013/01/08/breast-pumps-insurance-free_n_2432777.html [Google Scholar]
  51. Pollitz K. , Rae M. 51. . 2016.. Workplace wellness programs characteristics and requirements. Issue Brief, May, Kaiser Family Found., Menlo Park, CA:. http://files.kff.org/attachment/Issue-Brief-Workplace-Wellness-Programs-Characteristics-and-Requirements [Google Scholar]
  52. Rigby E. 52. . 2011.. How the National Prevention Council can overcome key challenges and improve Americans’ health. . Health Aff. 30::2149–56 [Google Scholar]
  53. Rojas Smith L. , Amico P. , Goode S. , Hoerger T. , Jacobs S. , Renaud J. 53. . 2016.. Evaluation of the Health Care Innovation Awards: Community Resource Planning, Prevention, and Monitoring. Second Annual Report. Research Triangle Park, NC:: RTI Int. https://downloads.cms.gov/files/cmmi/hcia-communityrppm-secondevalrpt.pdf [Google Scholar]
  54. 54. RTI Int. 2016.. State Innovation Models (SIM) Initiative Evaluation: Model Test Year Two Annual Report. Baltimore, MD:: Cent. Medicare Medicaid Serv. https://downloads.cms.gov/files/cmmi/sim-round1-secondannualrpt.pdf [Google Scholar]
  55. Sabik LM. , Adunlin G. 55. . 2017.. The ACA and cancer screening and diagnosis. . Cancer J. 23::151–62 [Google Scholar]
  56. Sama-Miller E. , Akers L. , Mraz-Esposito A. , Zukiewicz M. , Avellar S. 56. , et al. 2017.. Home Visiting Evidence of Effectiveness Review: Executive Summary. OPRE Rep . 2017–29. Washington, DC:: Adm. Child. Fam., US Dep. Health Human Serv. https://www.acf.hhs.gov/sites/default/files/opre/homvee_executive_summary_03162017_508.pdf [Google Scholar]
  57. Satcher D. , Higginbotham EJ. 57. . 2008.. The public health approach to eliminating disparities in health. . Am. J. Public Health 98::S8–11 [Google Scholar]
  58. Schmidt H. , Voight K. , Wikler D. 58. . 2010.. Carrots, sticks, and health care reform—problems with wellness incentives. . N. Engl. J. Med. 362::e3 [Google Scholar]
  59. Shartzer A. , Long SK. , Anderson N. 59. . 2015.. Access to care and affordability have improved following Affordable Care Act implementation; problems remain. . Health Aff. 35::161–68 [Google Scholar]
  60. Simon K. , Soni A. , Cawley J. 60. . 2016.. The impact of health insurance on preventive care and health behaviors: evidence from the 2014 ACA Medicaid expansions. NBER Work. Pap. 22265 [Google Scholar]
  61. Skopec L. , Sommers BD. 61. . 2013.. Seventy-one million additional Americans are receiving preventive services coverage without cost-sharing under the Affordable Care Act. Issue Brief, March 18 , Assist. Secr. Plan. Eval., Washington, DC:. https://aspe.hhs.gov/system/files/pdf/76626/ib_prevention.pdf [Google Scholar]
  62. Skopec L. , Waidmann TA. , Sung J. , Dean O. 62. . 2016.. Access to health care improved during early ACA marketplace implementation. Brief, Jan., AARP Public Policy Inst., Washington, DC:. http://www.aarp.org/content/dam/aarp/ppi/2015/access-to-health-care-improved-during-early-aca-%20marketplace-implementation.PDF [Google Scholar]
  63. Sobel L. , Salganicoff A. , Kurani N. , Wiens J. 63. . 2015.. Coverage of Contraceptive Services: A Review of Health Insurance Plans in Five States. Menlo Park, CA:: Henry J. Kaiser Family Found. http://files.kff.org/attachment/report-coverage-of-contraceptive-services-a-review-of-health-insurance-plans-in-five-states [Google Scholar]
  64. Sommers BD. , Blendon RJ. , Orav EJ. , Epstein AM. 64. . 2016.. Changes in utilization and health among low-income adults after Medicaid expansion or expanded private insurance. . JAMA Intern. Med. 176::1501–9 [Google Scholar]
  65. Sonfield A. , Tapales A. , Jones RK. , Finer LB. 65. . 2015.. Impact of the federal contraceptive coverage guarantee on out-of-pocket payments for contraceptives: 2014 update. . Contraception 91::44–48 [Google Scholar]
  66. 66. US FDA (Food Drug Adm.). 2017.. Menu labeling requirements. Updated Sept. 29, US FDA, Silver Spring, MD:. https://www.fda.gov/Food/GuidanceRegulation/GuidanceDocumentsRegulatoryInformation/LabelingNutrition/ucm515020.htm [Google Scholar]
  67. Vu M. , White A. , Kelley VP. , Hopper JK. , Liu C. 67. . 2016.. Hospital and health plan partnerships: the Affordable Care Act's impact on promoting health and wellness. . Am. Health Drug Benefits 9::269–78 [Google Scholar]
  68. Wallace J. , Sommers BD. 68. . 2015.. Effect of dependent coverage expansion of the Affordable Care Act on health and access to care for young adults. . JAMA Pediatr. 169::495–96 [Google Scholar]
  69. Welch HG. 69. . 2015.. Less Medicine, More Health: 7 Assumptions That Drive Too Much Medical Care. Boston:: Beacon [Google Scholar]
  70. Williams ED. , Redhead CS. 70. . 2010.. Public Health, Workforce, Quality, and Related Provisions in the Patient Protection and Affordable Care Act (PPACA). CRS Rep. Congr . Washington, DC:: Congr. Res. Serv., Libr. Congr. https://www.aamc.org/download/130996/data/ph.pdf.pdf [Google Scholar]
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Promoting Prevention Under the Affordable Care Act
Annual Review of Public Health 39, 507 (2018); https://doi.org/10.1146/annurev-publhealth-040617-013534
/content/journals/10.1146/annurev-publhealth-040617-013534
/content/journals/10.1146/annurev-publhealth-040617-013534
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