- A Texas federal judge on Thursday tossed a mandate under the Affordable Care Act requiring health plans to fully cover certain preventative medical services like cancer, HIV and diabetes screenings.
- Judge Reed O’Connor in U.S. District Court for Northern Texas ruled that the task force of expert panels that recommend covered care violated the Constitution because its members are not appointed by the president or confirmed by the Senate.
- The plaintiffs also argued that the ACA mandate requiring them to include coverage of preventative drugs like PrEP, which prevents HIV, violated their religious beliefs under the Religious Freedom Restoration Act.
Thursday’s ruling, which goes into effect immediately, was met with pushback and criticism from medical organizations.
“Providing insurance coverage for screenings and interventions that prevent disease saves lives — period,” American Medical Association President Jack Resneck said in a statement.
“Invalidating this provision jeopardizes tools physicians use every day to improve the health of our patients,” he said.
However, insurance groups emphasized that there would be no immediate loss of coverage.
“As we review the decision and its potential impact with regard to the preventive services recommended by the United States Preventive Services Task Force, we want to be clear: Americans should have peace of mind there will be no immediate disruption in care or coverage,” said Matt Eyles, president and CEO of health insurance lobby AHIP in a statement. “We fully expect that this matter will continue on appeal, and we await the federal government’s next steps in the litigation.”
O’Connor, who was appointed by former President George W. Bush, has issued previous rulings regarding the ACA, including a 2018 ruling where he said that the entire ACA was unconstitutional. The Supreme Court later overruled him in 2021 in a 7-2 decision.
In September O’Connor ruled against the preventative care mandate and asked the parties to submit briefs on how to proceed in terms of relief.
The vacated ACA mandate required health plans to fully cover hundreds of preventive services under recommendations made by three agencies: the U.S. Preventive Services Task Force, the Health Resources and Services Administration and the Advisory Committee on Immunization Practices.