Emphasis on Prevention Under the Affordable Care Act (ACA)

Key provisions of the Affordable Care Act (ACA) were written to address the problem that too many of us don’t get the care we need to prevent serious illnesses. Heart disease is the leading cause of death in the U.S.,1 but it doesn’t have to be. We can lessen our risk for heart disease and many other conditions.

While annual U.S. healthcare spending is estimated at $3.6 trillion, less than 3% goes toward prevention and public health.2

Embracing prevention

To help shift the emphasis of our healthcare to prevention, the ACA calls for the creation of the Prevention and Public Health Fund to invest in proven prevention and public health programs to help Americans lose weight, stop smoking, and adopt other healthy living habits needed to win the battle against heart disease.

It also calls for making preventive services, such as screenings, vaccinations, and counseling, more accessible and affordable by eliminating deductibles, copays, and coinsurance for employer-sponsored health plans or individual health insurance policies created after September 23, 2010, including preventive services specifically for children and those who are pregnant. Keep in mind, however, that some plans may charge for out-of-network providers and office visits.

You’ll make the most of your coverage if you work with your doctor to develop a wellness plan that includes the appropriate preventive services based on age, gender, and risk factors. Call your plan administrator if you have questions about what is and isn’t covered under your plan. You can also contact your state insurance department if you need more information.

Preventive services available under the ACA

The following preventive services may be available to you depending on your plan (view comprehensive list):

  • Blood pressure, diabetes, and cholesterol tests
  • Many cancer screenings, including mammograms and colonoscopies
  • Counseling on such topics as quitting smoking, losing weight, eating healthfully, treating depression, and reducing alcohol use
  • Routine vaccinations against diseases such as measles, polio, or meningitis
  • Flu, pneumonia, and COVID-19 shots
  • Counseling, screening, and vaccines to ensure healthy pregnancies
  • Regular well-baby and well-child visits from birth to age 21

The ACA also includes incentives for primary care physicians and improving access to care for underserved communities by renovating existing community health centers, building new ones, and expanding their services.

Helpful prevention guides

Below is a list of helpful resources for more information about what you can do to improve your health and reduce your risk of developing heart disease and other health issues:

Habits are hard to change, but the reward for good prevention practices is great for you and your family if it can help you stay healthy and live a longer, happier life.