As the health care reform law expands access to preventive services at the doctor’s office, a new analysis finds that many with disabilities who rely on Medicaid might be left out.

Under the Affordable Care Act, most private insurers and plans offered through Medicare and the Medicaid expansion program will be required to cover an array of preventive services ranging from cancer to heart disease screenings. That mandate, however, was not extended to adults who already receive health benefits through state Medicaid programs.

Now a review of Medicaid policies across the country suggests that most state programs do not offer coverage for all of the preventive services currently recommended by the U.S. Preventive Services Task Force.

“The Affordable Care Act guarantees millions of low-income Americans access to mammograms, colonoscopies and other lifesaving preventive services, but that assurance does not extend to people who currently have Medicaid coverage,” said Chris Hansen, president of the American Cancer Society Cancer Action Network, which helped fund the study published in the July issue of the journal Health Affairs.

For the analysis, researchers at The George Washington University School of Public Health and Health Services reviewed Medicaid programs from each state and the District of Columbia from June through November 2012. They then contacted state officials, as needed, to clarify any missing information about coverage.

Access to preventive services varied widely, the study found. Nearly all state Medicaid programs explicitly covered screening mammograms and 36 covered pap smears. Less than half of state programs, however, covered cholesterol or obesity screenings.

Meanwhile, in a dozen states, Medicaid did not cover well-adult exams meaning that beneficiaries were only able to see a doctor once they had a health concern, according to the analysis.

Compounding the issue, the report authors said, is that Medicaid policies in many states included confusing language making it unclear precisely what services would be paid for.

“Preventive services save lives by detecting diseases before they can progress,” said Sara Wilensky of The George Washington University who is the report’s lead author. “Why should some Medicaid beneficiaries be left out when it comes to coverage for this kind of care?”

As of 2009, people with disabilities accounted for 15 percent of Medicaid beneficiaries nationwide, the report indicated.

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