One of the most staunch and stubborn opponents of the Affordable Care Act has finally struck down one of the most important and beneficial aspects of the law. On Thursday, Texas District Judge Reed O’Connor ruled that insurance companies are no longer required to offer free cancer screenings, HIV screenings, diabetes tests and a number of preventive care options.
It’s a blow to the ACA, often colloquially referred to as Obamacare. Under the law, the U.S. Preventive Services Task Force issued a long list of services insurance companies are obligated to cover everything from breast, cervix, colorectal, and from ovarian cancer screenings to HIV testing for teens and adults. There are also diabetes screenings, vision screenings in children, the use of statins to prevent cardiovascular disease, STI screenings, drugs to reduce the risk of breast cancer – basically a long list of services to help keep people healthy and away from costly hospital visits.
Contraceptive requirements are also covered by the preventive services provisions, although the judge ignored arguments about forcing insurance to offer birth control and other reproductive health care options, at least for now. The Biden administration still has time to appeal, which could take the case to the Supreme Court.
The case revolves around two businesses whose owners argue that the preventive care mandate violates their religious rights. In his decision on Braidwood Management c. Xavier BecerraO’Connor wrote that the entire Preventive Services Task Force is unconstitutional because it violates provisions of the Constitution Appointment clausemeaning that officials must be elected by Congress.
O’Connor had previously struck down provisions of the ACA that HIV pre-exposure prophylaxis, AKA PrEP pills cannot be covered by Obamacare. The law laughs were quick to point out that this would probably lead to the complete elimination of the preventive services clause. The judge was first elected under President George W. Bush in 2007, but has since become the leading opponent of the health care law in court, routinely trying to strike down parties or even the whole lawalthough the United States Supreme Court upheld the general structure of the landmark 2010 bill.
There is a good reason this provision exists. Health care and insurance costs have has prevented many people from seeking preventative treatment, which goes a long way in saving people from life-threatening illnesses and even higher costs down the road. Not to mention that the end of the provision is a huge blow to women seeking pregnancy care. Liz Sepper, a health law expert at the University of Texas at Austin, wrote that all reproductive health care is “at stake.”
The American Medical Association and a host of other health care organizations have regularly told in court it must leave the ACA’s zero-cost preventive care provisions intact. The organizations have argued that easy access to preventive care has saved lives and that its repeal would leave even more people confused about navigating the quagmire that is the US insurance industry. AMAs amicus brief late last year mentioned that physicians “will see many of their patients, including some of the most vulnerable, denied medically indicated services because of financial barriers that Congress has sought to remove.”
According to a January 2022 report of the Assistant Secretary for Planning and Evaluation, more than 150 million people with private insurance are eligible for free preventive services under Obamacare. This also includes people on Medicare and Medicaid. Some individual states still have laws in the books that allow greater access to preventive services, although the vast majority, most states in Central and South America, do not.
It is likely that tThe case will be appealed and the decision may be put on hold while the appeal is argued.