Sunscreen Coverage as Preventive Care Under the Affordable Care Act: A Low-Cost Way to Reduce the Prevalence of the Most Common Cancer.

Skin cancer is the most commonly diagnosed malignancy in the United States, costing more than $8.1 billion annually in treatment-related expenses, yet with ultraviolet exposure considered the most significant risk factor for skin cancer development, cutaneous malignancy is also highly preventable. The Affordable Care Act (ACA) is committed to covering demonstrably effective preventive health care measures without patient cost sharing. To prevent skin cancer, the American Academy of Dermatology recommends applying sunscreen, donning sun-protective clothing, seeking shade, and avoiding midday sun. Additionally, The US Preventive Services Task Force recommends behavioral counseling for skin cancer prevention, including application of broad-spectrum sunscreen, from ages six months to 24 years of age. Despite these evidence-based recommendations and widespread precedent for ACA coverage of certain over-the-counter medications, dermatologic products such as sunscreen are notably excluded. Herein, we address an under-recognized insurance coverage gap for patients by outlining the evidence that sunscreen, as a primary prevention, dually reduces skin cancer incidence and healthcare costs, highlighting the critical need to address barriers to sunscreen utilization. As such, we advocate for amendment of current ACA coverage to include the cost of sunscreen as an evidence-based strategy to decrease the incidence of UV-induced cutaneous disease and associated treatment expenses.