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Some Employers Unsure if They Will Cover Preventive Care

Analysis  |  By Jay Asser  
   May 12, 2023

Employers may follow a ruling by a federal judge that struck down preventive care services in the Affordable Care Act (ACA).

More than a quarter of employers either don't know if they will continue covering preventive care services or expect to be more selective, according to a survey by the National Alliance of Healthcare Purchaser Coalitions.

The organization polled 29 employers representing approximately 1.5 million employees from April to May 2023 to better understand employer attitudes towards health benefits and their plans following the end of the public health emergency (May 11).

Employers were asked about their feelings on preventive care in light of a federal district court judge in Texas invalidating enforcement of preventive care mandates under the ACA.

While 72% of respondents said they expect to continue providing coverage for all preventive services, 22% said they do not know how they will approach coverage for preventive care and 6% stated they plan to be more selective.

Furthermore, only 14% of employers are planning to fully cover over-the-counter COVID-19 tests, with 33% saying they will not cover them. Going forward, 71% said COVID treatment will be covered similar to non-COVID services and 24% will fully cover.

Three in four (76%) respondents said that keeping up-to-date on current COVID guidelines is central to their immunization strategies, while 81% agreed that the urgency for vaccinations is high.

When it comes to vaccine information, 81% of respondents believe that employers are a trusted source, compared to 62% for health plans.

"The pandemic has reinforced the critical role of immunizations in workforce health strategy but it also raised newfound concerns, confusion and misinformation," Michael Thompson, National Alliance president and CEO, said in a press release. "With the end of the public health emergency, employers expect to double down on education and employee engagement to encourage vaccinations across the board."

It will likely be some time before the dust settles on the litigation process on preventive care under the ACA, but in the meantime it could mean many lose coverage.

Jay Asser is the contributing editor for strategy at HealthLeaders. 


The National Alliance of Healthcare Purchaser Coalitions surveyed 29 employers on their approach and thinking on health benefits with the public health emergency now over.

Though 72% of employers said they expect to continue covering preventive services, 22% revealed they do not know whether they will provide coverage and 6% said they'll be more selective.

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