The Affordable Care Act (ACA) requires private insurance plans to cover preventive services, receiving a Grade A or B rating by the United States Preventive Services Task Force (USPSTF) without cost sharing. Cervical cancer prevention is one such service. Family medicine provides more than half of all the cervical cancer screenings in the US. While the ACA has led to an increase in screening, half of the people assigned female at birth who develop cervical cancer have never been screened. In addition, 20 to 40% of screening-eligible people in the US do not participate in screening. Of those who do screen, and their screen is abnormal, only 34% attend their diagnostic colposcopy examination. Colposcopy with biopsy and endocervical curettage requires consequential copay for the examination and pathology, which increases financial toxicity. Beginning in 2027, policies similar to those in place for breast and colorectal cancer screening that require insurance plans to cover the entire diagnostic workup without cost sharing under the ACA preventive services provision, will be implemented for cervical cancer screening.
Young et al. (Sat,) studied this question.