A judge cancels the provision of preventive services from Obamacare

A The Texas federal judge who previously ruled to dismantle the Affordable Care Act on Thursday struck down a narrower but key piece of the national health law that requires most insurers to cover preventative services that include cancer screenings. , diabetes and mental health.

Other free services, including HIV tests, are also impacted by U.S. District Judge Reed O’Connor’s decision that opponents say will jeopardize preventive care for millions of Americans.

Experts have warned that insurers are unlikely to stop all cover immediately. The Biden administration was to appeal and seek a stay of the decision.

“It’s not the potential deathblow to the ACA like previous court cases, but it would limit a very popular benefit that tens of millions of people use,” said Larry Levitt, executive vice president for policy at health at the Kaiser Family Foundation.

The ruling comes more than four years after O’Connor, a candidate for former President George W. Bush, ruled that all health care law, also known as “Obamacare,” was unconstitutional. The United States Supreme Court overturned that decision.

This time, O’Conner blocked only the requirement that most insurers cover a range of preventative care — including screenings for several types of cancer — siding with plaintiffs, including a Texas conservative activist and a Christian dentist who opposed mandatory coverage of contraception and HIV. preventive treatment for religious reasons.

Coverage requirements are determined by the recommendations of the volunteer US Preventive Services Task Force. O’Connor ruled the application of the recommendations was “unlawful” and a violation of the Constitution’s appointment clause, which sets out how government officials can be appointed.

Dr. Michael Barry, chair of the federal task force, said in a statement following the ruling that low-income people have been able to get the services they need as care has expanded over the past decade due to the law.

“Fundamentally, people across the country deserve the opportunity to receive these important preventative services that have been proven to help them live longer, healthier lives,” Barry said.

White House press secretary Karine Jean-Pierre said the Justice Department and the Department of Health and Human Services are reviewing the decision, but called the case ‘yet another attack’ against the health care law which has been in place for 13 years and has survived. multiple legal challenges.

The Biden administration previously told the court that the outcome of the case “could create extraordinary upheaval in the public health system of the United States.” More than 20 states, mostly controlled by Democrats, had urged O’Connor against a sweeping decision that would remove the preventive care coverage requirement entirely.

The ruling applies to recommendations made by the task force after March 2010, when the Affordable Care Act was signed into law. Some of the nation’s largest medical groups have spoken out against the lawsuit, warning that insurers could in future impose cost-sharing on patients for screenings that are now fully covered.

Levitt said if O’Connor’s decision stands, insurers will likely consider changes to coverage beginning in the next calendar year because existing contracts are already in effect.

While the decision impacts a wide range of preventive care, it does not eliminate coverage for all preventive screenings. For example, experts said the ruling would not void coverage for preventive health services for women that were approved outside the task force.

Some cancer screenings approved before 2010 would also not be affected, including cervical and colorectal cancer screenings, said Alina Salganicoff, senior vice president and director of women’s health policy at the foundation. Kaiser. But she said lung and skin cancer screenings, which were approved more recently, could be affected.

In September, O’Connor ruled that mandatory coverage of HIV prevention treatment known as PrEP, which is a pill taken daily to prevent infection, violated the plaintiffs’ religious beliefs. The ruling also undermined the broader system that determines which preventive medications are covered in the United States, ruling that a federal task force that recommends preventive treatment coverage is unconstitutional.

Employers’ religious objections have been a sticking point in past challenges to former President Barack Obama’s health care law, including on contraception.

The lawsuit is part of conservative attempts to roll back the Affordable Care Act — or eliminate it entirely — since it was signed into law in 2010. The lawyer who filed the lawsuit was an architect of the Affordable Care Act. Texas abortion that was the nation. strictest before the Supreme Court overturned Roe v. Wade in June and authorizes states to prohibit the procedure.


Associated Press reporters Amanda Seitz and Seung Min Kim in Washington contributed to this report.

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