Appeals Court Pauses Ruling That Threatened Free Preventive Health Care

Appeals Court Pauses Ruling That Threatened Free Preventive Health Care

A federal appeals court on Monday temporarily blocked a lower court decision overturning the Affordable Care Act’s requirement that all health plans provide full coverage for certain preventive health services.

The move by the US Circuit Court of Appeals for the Fifth Circuit in New Orleans will freeze a March decision that had jeopardized insurance coverage for recommended services such as depression screening for teens and drugs that prevent HIV transmission. The Justice Department had appealed the decision, and the Court of Appeals stay remains in place while the appeals process is ongoing.

The ruling earlier this spring overturned one of the Affordable Care Act’s most popular requirements by removing financial hurdles for a number of preventive services. It took effect immediately nationwide and had the potential to affect approximately 150 million Americans who had signed up for private health insurance either through employer-sponsored plans or through the Obamacare marketplaces.

While the case is still under review, full coverage of prevention benefits is required by law.

Earlier this year, Judge Reed O’Connor of the Federal District Court for the Northern District of Texas ruled that insurers are not required to cover any of the benefits recommended by the United States Preventive Services Task Force since 2010. His reasoning: The task force is not appointed by Congress and therefore does not have the constitutional authority to decide what services a health insurer must provide.

This ruling built on previous ones: in 2018, Justice O’Connor had ruled that the ACA was unconstitutional (although the Supreme Court later overturned that decision). Last September, he ruled that the ACA’s order requiring employers to pay for a daily HIV-prevention pill called PrEP violated a company’s freedom of religion.

For the time being, employers are still obliged to cover preventive services free of charge. But the Fifth Circuit is conservative-leaning, and the case could eventually end up in the Supreme Court and present another challenge to the Obamacare health care law.