Without assistance, PrEP can cost thousands of dollars per year. Likewise, pre-exposure prophylaxis (PrEP) for HIV prevention was recommended by the USPSTF in 2019, and private insurance providers will no longer be required to cover it without costs. With lower screening rates, many of these cancers will probably be detected at a more progressed stage, leading to increases in the morbidity of colon cancer. While the ruling only impacts screenings for adults aged 45-49 years, colorectal cancer incidence is increasing in younger populations, and an estimated 7,500 men and women will be diagnosed in this age group in 2023, according to GlobalData. In a 2018 study published in Value in Health by Bhandari and Li, which compared the prevalence of colorectal cancer screenings between 20 in the Medical Expansion Panel Survey, the elimination of cost-sharing under the ACA positively increased colorectal cancer screening by 9% and 7% among men and women with private health coverage, respectively. Since the inception of the ACA, changes in cancer screening among privately insured individuals show an overall increase in colorectal cancer screening tests. Additionally, this could lead to various epidemiological shifts such as certain cancers including colorectal cancer being diagnosed at a more severe stage or increases in the incidence of infectious diseases like HIV. However, if the ruling stands, millions of people may have to pay more for preventive services, and some may even lose access to certain services. The ruling only applies to services recommended by the US Preventive Services Taskforce (USPSTF) after 23 March 2010, when the ACA was enacted. On 30 March 2023, a US District Court judge issued a final judgment ruling that struck down a portion of the Affordable Care Act’s (ACA’s) requirement for most private insurance plans to cover many preventive services. While this new ruling only impacts screenings for adults aged 45-49 years, colorectal cancer is on the rise in younger populations.
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