The Affordable Care Act mandates that all health insurance policies include certain preventive services without the burden of cost-sharing requirements, creating consistency in a kind of care shown to improve health.

That requirement, however, could go away through the rule-making process with a stroke of President Trump’s pen, adding uncertainty where it is not welcome or needed. Maine lawmakers took a step toward eliminating that uncertainty by passing with bipartisan support L.D. 1476, which would put the ACA preventive mandate in state law. Gov. Paul LePage vetoed the measure last week, and this week it goes back to the Legislature, which should override the veto and help ensure that Mainers have the tools to stay healthy.

L.D. 1476, from Rep. Joyce McCreight, D-Harpswell, follows on the heels of a law passed last year that put in state statute the ACA’s requirement of no-copay birth control. It would require all health insurance policies to include without cost-sharing requirements all preventive services given an A or B rating by the U.S. Preventive Services Task Force, a longstanding, independent panel of national experts in prevention and medicine that makes evidence-based recommendations.

Included in the task force’s recommendations are services that cover Mainers from birth to old age, and which can identify health problems well before they get too difficult – and costly – to treat.

Immunizations and screenings for infants, children and adolescents are included, as are screenings for pregnant women. Breast-feeding services and supplies make the grade, as do Pap tests and screenings for sexually transmitted infections and the BRCA gene mutation, which are linked to the risk of cervical and breast cancer.

Blood pressure and diabetes screenings are also included in the bill, as well as preventive medications for older adults such as aspirin and statins.


Prevention and early detection can make all the difference. Detecting cancer in its early stages, for instance, increases greatly the five-year survival rate for colorectal, cervical and breast cancer. Finding and removing pre-cancerous polyps can literally mean the difference between life and death.

It is clear that when more people have access to these services, more people use them, and more people have their health problems diagnosed before they are too far along.

Gov. LePage, in his veto message, said the uncertainty surrounding the ACA at the federal level makes it unwise to put anything related to it into law at this point.

The ACA, he said, has been a disaster, and he won’t sign any law that puts its features in play here.

But the preventive care aspects of the ACA have been a success by any measure, and legislators can make sure they don’t disappear from Maine at a moment’s notice. The evidence is clear – preventive care makes a difference in people’s lives, and all Mainers should have access to it.

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