Patients May Carry Costs After Judge Strikes Down ACA’s Free Preventive Care Provision

Stat: Texas Judge Strikes Obamacare Provisions On Preventive Care
A federal judge Thursday reversed a major Obamacare provision requiring plans to cover preventive care ranging from cancer and chronic disease screenings to pregnancy care and certain drugs. The ruling could deal a massive blow to President Joe Biden’s moonshot goal of slashing cancer rates through early screenings. It also leaves the door open for insurers to refuse coverage of statins, drugs preventing HIV transmission known as PrEP, and a vast range of health screenings recommended by federal officials. It could also eventually threaten the Biden administration’s efforts to lower maternal and infant mortality rates and bolster reproductive rights in the wake of Roe’s overturn. (Owermohle, 3/30)

NBC News: Judge Strikes Down Obamacare Provisions Requiring Insurers Cover Some Preventive Care Services
In the decision, U.S. District Judge Reed O'Connor mentioned his previous ruling on the structure of the U.S. Preventive Services Task Force, which was created under Obamacare and helps determine preventive services coverage, saying it violates the appointments clause of the Constitution and therefore its related preventive care mandates are unlawful. (Shabad, 3/30)

Politico: Texas Judge Strikes Down Free HIV Drugs, Cancer Screenings Under Obamacare 
The employers and individuals had standing to sue, Judge O’Connor wrote, because “compulsory coverage for those services violates their religious beliefs by making them complicit in facilitating homosexual behavior, drug use, and sexual activity outside of marriage between one man and one woman.” The employers argued that recommendations made by the U.S. Preventive Services Task Force can’t be enforced because its members are private medical experts who advise the government, not government employees. (Ollstein, 3/30)

KHN: Judge’s Decision Would Make Some No-Cost Cancer Screenings A Thing Of The Past
It is almost certain to be appealed, possibly by both sides: the conservative groups that brought the case and had hoped the decision would be broader, and the Biden administration, which supports the ACA. ... Now, the Department of Justice must decide whether to seek an emergency order putting the ruling on hold during the appeal process. (Appleby and Andrews, 3/30)

Reaction to the ruling —

Reuters: U.S. Judge Blocks Obamacare Coverage Mandate For Some Cancer Screenings, PrEP 
Major medical groups criticized the decision. American Medical Association President Jack Resneck called it "deeply flawed" and said that patients "will be subjected to needless illness and preventable deaths" as a result. Lisa Lacasse, president of the American Cancer Society Cancer Action Network, said the ruling could have "huge implications" and make it more difficult to catch treatable cancers early. "We cannot emphasize enough how important screenings are for early detection of cancer," she said. (Pierson, 3/30)

Modern Healthcare: Healthcare Industry Reacts To Preventive Care Ruling
The American Hospital Association, Federation of American Hospitals and America's Essential Hospitals declined comment. Here are some of the statements issued in reaction to the court decision. (Turner, 3/30)

When will your coverage change? —

Axios: Don't Expect Big Changes To Insurance, Yet
Thursday's federal court ruling against the Affordable Care Act's preventive services requirement won't bring a seismic shift to employer-sponsored health care. But experts say it could well add new costs for the approximately 100 million privately insured people who use such services. The big picture: The ruling immediately removes a legal requirement of no-cost coverage for certain skin and lung cancer screenings, statins for heart disease, medications that prevent HIV and other services recommended by the U.S. Preventive Services Task Force, Axios' Adriel Bettelheim writes. (Reed, 3/31)

The New York Times: Federal Judge Strikes Down Obamacare Requirement For Free Preventive Care 
The ruling, which is in the form of a nationwide injunction, takes effect immediately, said Lawrence O. Gostin, an expert on health policy at Georgetown University who has followed the case. It will affect a long list of preventive care services, he said, including services like screenings for heart disease, pap smears and tobacco cessation services. “It might be that tomorrow, a woman might wake up and find that her mammogram is not covered,” Mr. Gostin said, adding, “I think we forget what it was like before the Affordable Care Act, where we had to pay and it was unaffordable for basic primary health care services.” (Stolberg and Abelson, 3/30)

AP: Judge’s Ruling Undercuts US Health Law’s Preventive Care 
Experts cautioned that insurers are unlikely to stop any coverage immediately. The Biden administration was expected to appeal and seek a stay of the ruling. “This is not the potential fatal blow 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 health policy at the Kaiser Family Foundation. (Weber, 3/30)

The Washington Post: Texas Judge Invalidates ACA Promise Of Free Preventive Health Services 
Insurers don’t typically revise their plans’ offerings in the middle of a calendar year, an effort that would be logistically complex. Still, some experts said nothing would preclude an insurer from doing so. And some predicted that, in coming years, insurers might keep covering preventive benefits but impose co-pays or deductibles. (Goldstein, 3/30)

San Francisco Chronicle: Federal Judge's Ruling Against Affordable Care Act Won't Affect Californians, State Commissioner Says
A federal judge's ruling Thursday against the Affordable Care Act’s requirement that insurers cover preventive health screenings for cancer, mental illness and other conditions won't affect most Californians because state law mandates that coverage for state-regulated insurers, said Insurance Commissioner Ricardo Lara. (Egelko, 3/30)

Also —

KHN: KHN's 'What the Health?': A Judicial Body Blow To The ACA
Opponents of the Affordable Care Act may have stopped trying to overturn the entire law in court, but they have not stopped challenging pieces of it — and they have found an ally in Fort Worth, Texas: U.S. District Judge Reed O’Connor. In 2018, O’Connor held that the entire ACA was unconstitutional — a ruling eventually overturned by the Supreme Court. Now the judge has found that part of the law’s requirement for insurers to cover preventive care without copays violates a federal religious freedom law. (3/30)