Advertisement

Federal judge strikes down preventative coverage requirements, setting up latest Obamacare battle

WASHINGTON – A federal judge in Texas blocked enforcement Thursday of no-cost preventative health care mandates included in the Affordable Care Act, setting up the latest legal brawl over Obamacare and threatening to curb access to HIV-prevention pills, screenings for cancer and other services.

U.S. District Judge Reed O'Connor ruled that preventative requirements set by a federal task force violated the law because the members of the panel had not been appointed by the president and confirmed by the Senate. More than 150 million people benefit from the coverage generally, according to government estimates.

"Providing insurance coverage for screenings and interventions that prevent disease saves lives – period," said Jack Resneck, president of the American Medical Association. "Invalidating this provision jeopardizes tools physicians use every day to improve the health of our patients.

The decision will almost certainly be appealed and may eventually wind its way to the Supreme Court. Experts predicted insurers are unlikely to drop coverage for the services if the decision is upheld, but they may require patients to pay for them.   

What did O'Connor rule in the latest Obamacare case?

  • The U.S. District Court imposed a nationwide prohibition on the requirement that insurers cover certain preventative services. Those mandates were challenged by Texas businesses who said the requirements violated their religious beliefs.

  • O'Connor, who was nominated by former President George W. Bush, said that the Preventive Services Task Force that created those recommendations was not appointed legally so its recommendations were invalid. Those recommendations led to no-cost access to screenings for breast cancer, cervical cancer,  and diabetes, among other things.

  • The Biden administration is likely to appeal the decision and O'Connor's ruling may be placed on hold while that appeals process unfolds. A Justice Department spokesperson said officials are reviewing the decision.

  • The decision Thursday was not a surprise: O'Connor ruled against the preventative mandates on the merits last fall but until now had left the practical result – or the remedy – of his decision unresolved. O'Connor has repeatedly found violations in the Affordable Care Act, including a decision in 2018 that the law's coverage mandate was unconstitutional. That ruling was overturned by the Supreme Court in 2021.

The Affordable Care Act may be headed to the Supreme Court.
The Affordable Care Act may be headed to the Supreme Court.

What is the preventative care at issue in the case?

The business owners who filed the suit had objected, on religious grounds, to coverage of contraception as well as screenings for sexually transmitted diseases. But the Preventive Services Task Force has included many other procedures and treatments in the list of preventive care that insurers must cover at no additional cost, including screenings for diabetes and certain types of cancer.

Another major issue in the case was a debate over drugs that prevent the transmission of HIV, known as PrEP drugs. PrEP, short for preexposure prophylaxis, is a drug that reduces the likelihood of HIV infection during exposure.

Gay, bisexual and other men who have sex with men, as well as transgender women who have sex with men, are among the groups at the highest risk for HIV infection, according to the U.S. Department of Health & Human Services. Black and Hispanic Americans are disproportionately affected by the virus.

The drew a swift reaction from several medical groups and the White House.

"This case gets between patients and their doctors," White House press secretary Karine Jean-Pierre said. "It's yet another attack on the ability of Americans to make their own healthcare choices."

Contributing: Maureen Groppe, Cady Stanton 

This article originally appeared on USA TODAY: Federal judge in Texas slaps down Obamacare preventive health mandates