Federal Court Blocks Many ACA Preventive Services Requirements

A federal judge in Texas has handed down a ruling that could eventually keep clients from getting the insurance coverage they expected for cancer screenings and other health screenings.

Judge Reed O’Connor, a judge in the U.S. District Court for the Northern District of Texas, on Thursday held that the federal government cannot enforce any Affordable Care Act preventive care requirements based on the work of the U.S. Preventive Services Task Force.

O’Connor blocked the U.S. Department of Health and Human Services and other agencies from enforcing a coverage mandate for HIV preventive medication partly because he believes the mandate violates the religious rights of business owners and executives who object to the mandate, and partly because the ACA delegates authority to the preventive services task force in a way that violates Article II of the U.S. Constitution.

Members of the task force have not been appointed in a fashion that gives them the ability to set federal policy, according to O’Connor.

O’Connor handed down the ruling in Braidwood Management v. Xavier Becerra et al. (Case No. 4:20-cv-00283).

The ACA Preventive Services Requirements

The ACA requires all major medical coverage providers, including self-insured employer plans, to cover a package of preventive services without imposing deductibles, co-payments or other cost-sharing requirements on the patients.

The package includes measles vaccinations and other vaccinations, mammograms and other cancer screenings, and screenings for conditions such as diabetes.

The U.S. Preventive Services Task Force shares responsibility for developing the preventive services package with the federal Health Resources and Services Administration and the federal Advisory Committee on Immunization Practices.

The Impact

Opponents could seek and get an injunction preventing the O’Connor ruling from taking effect immediately, and HHS will appeal the ruling.

Health Insurers’ Reaction

Matt Eyles, president of America’s Health Insurance Plans, said in a statement in response to the decision that there should be no immediate disruption to care or coverage as a result of the O’Connor ruling.

“Every American deserves access to high-quality affordable coverage and health care, including affordable access to preventive care and services that help avoid illnesses and other health problems,” Eyles said. “We fully expect that this matter will continue on appeal, and we await the federal government’s next steps in the litigation, as well as any guidance from relevant federal agencies.”