Viral Hepatitis and the Affordable Care Act

The implementation of the Affordable Care Act (ACA) provides multiple opportunities to prevent new viral hepatitis infections and diagnose and care for people with chronic viral hepatitis. The health care law helps people at risk of or living with viral hepatitis in several important ways:

• Providing access to insurance for uninsured Americans with pre-existing conditions. Under the ACA, people living with diagnosed chronic viral hepatitis who may have previously been unable to obtain health coverage can no longer be denied coverage and can now access needed prevention, care, and treatment services.
• Prohibiting insurance companies from dropping coverage when a customer gets sick or needs to use their insurance for care and treatment.
• Eliminating lifetime limits and regulating annual limits on insurance coverage. In the past, insurance companies could place lifetime or annual limits on the amount of insurance coverage a customer could use. Now, new plans can’t place yearly limits on what they spend for a customer’s coverage, or lifetime limits on essential health benefits for your care during the entire time you’re enrolled in a plan.
• Expanding Medicaid eligibility. Under the ACA, states have the option to expand Medicaid to generally include those with incomes at or below 138% of the Federal poverty line, including single adults without children who were previously not generally eligible for Medicaid. In states that have opted to expand Medicaid, viral hepatitis prevention, screening, and care services are more accessible to low-income individuals. (Find out if your state has expanded Medicaid coverage.)
• Making coverage more affordable. The ACA requires most Americans to have qualifying health insurance. To help people access the quality, affordable coverage they need, the ACA created Health Insurance Marketplaces in every state that help consumers compare different health plans and determine what savings they may qualify for. Also under the ACA, the federal government provides financial assistance for many low- and middle-income consumers who get health coverage through the Marketplace. This includes premium tax credits to lower the cost of their monthly premiums, as well as cost-sharing reductions that lower the amount individuals and families have to pay out-of-pocket each time they get medical services. (Find out if you qualify for savings.)
• Providing free preventive care. Under the ACA, all new health plans must cover certain preventive services—like shots and screening tests—without charging a deductible or co-pay. This includes important viral hepatitis services such as hepatitis A and B vaccination and hepatitis B and C testing. For more details, see this Table of Viral Hepatitis Preventive Services from the Centers for Disease Control and Prevention.
• Lower prescription drug costs for Medicare recipients. In the past, as many as one in four seniors went without a prescription every year because they couldn’t afford it. The ACA closes, over time, the Medicare prescription drug coverage (Part D) “donut hole,” giving Medicare enrollees the peace of mind that they will be better able to afford their medications and helping keep Medicare Part D affordable, sustainable, and working for seniors.
• Establishing consumer assistance programs to help consumers navigate the private health insurance system. Insurance benefits can vary widely across insurance plans so these consumer assistance programs can help people with chronic viral hepatitis to choose a plan that will provide the best coverage for needed services such as ongoing chronic disease management and treatment.
• Strengthening Community Health Centers and expanding the primary care workforce. The ACA included significant investments in community health centers, which provide primary and preventive care for millions of low-income people across the nation. These health centers are important partners in implementing the Viral Hepatitis Action Plan and expand the opportunities for integrating viral hepatitis prevention services, testing and diagnosis, and access to treatment for chronic viral hepatitis. Under the ACA, the federal government has also made the recruitment, training, and retention of primary care professionals a priority.

If you think you might be at risk, then take action! Three online tools help consumers understand and locate recommended hepatitis B and hepatitis C preventive and screening services.