ACA preventive services requirement goes before the Supreme Court
The U.S. Supreme Court is expected to hear arguments next week in a case that case challenging the Affordable Care Act’s no-cost preventive services requirement. The lawsuit will determine whether 151 million people will continue to have access to preventive health care services with no out-of-pocket costs.
Kennedy vs., Braidwood Management Inc. (formerly Braidwood Management Inc. v. Becerra) centers on whether an employer can be compelled to cover preventive medications as required under the ACA.
If the court rules in favor of Braidwood, the conservative Texas employers who filed the case, tens of millions of people who get their health insurance from their employer or through the ACA marketplace would be impacted by the removal of a preventive services requirement. Removing this requirement would erode the coverage of tens of millions of people whose insurers currently cover the full cost of everything from vaccines to birth control.
In June, the U.S. 5th Circuit Court of Appeals ruled that a Braidwood can’t be forced to cover preventive medications as is required under the ACA. However, the court also determined a Texas judge carried out an “abuse of discretion” in his prior ruling by blocking federal agencies from enforcing the rule universally.
The decision in Braidwood Management v. Becerra affirmed a lower court’s ruling that the secretary of the Department of Health and Human Services could not force Braidwood Management to abide by a preventive care mandate in the ACA. The court rejected another ruling, however, and remanded another one back to the lower courts. The mandate remained in place while the case continued to work its way to the Supreme Court.
Preventive services at issue
At issue is a provision in the ACA that requires private health insurers and companies to cover preventive services and drugs like HIV preventive drugs, known as PrEP. The provision also requires coverage of cancer screenings, vaccines, STD screenings, gestational health screenings and birth control.
Braidwood contended that this requirement violated the company’s religious freedom and beliefs.
Judge Reed O’Connor of the U.S. District Court for the Northern District of Texas, struck down the provision in September 2022. The appeals court said in last week’s ruling that it believed blocking the federal government from enforcing this mandate across the board was an “error” and “an abuse of discretion.”
However, the appeals court also determined other arguments had yet to be fully decided and should be subject to further review in the lower courts.
One issue left to be decided is whether the U.S. Preventive Task Force that decides which services must be covered under the ACA is constitutionally sound.
The ACA specifies four main categories of preventive care for all adults as well as for women and children in particular:
- Services with an A or B rating in the current recommendations of the U.S. Preventive Services Task Force.
- Immunizations recommended by the Advisory Committee on Immunization Practices.
- Preventive care and screenings for infants, children, and adolescents in comprehensive guidelines supported by the Health Resources and Services Administration.
- Preventive care and screenings for women’s health specified in the HRSA guidelines.
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