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Federal appeals court stays nationwide injunction on some ACA preventive care

Author

Maureen Gammon and
Benjamin Lupin
May 26, 2023

On May 15, 2023, the Fifth Circuit Court of Appeals issued a temporary administrative stay (a “freeze”) in the case involving part of the Affordable Care Act (ACA) that requires group health plans and insurers to cover certain preventive healthcare services with a United States Preventive Services Taskforce (USPSTF) recommendation grade of either A or B, with no cost sharing.

As background, in Braidwood Management, Inc. v. Becerra, a federal district court in Texas granted the plaintiff’s request for a nationwide injunction by blocking the enforcement of the ACA’s requirement to cover the USPSTF recommendations with no cost sharing.[1]

The government appealed that ruling to the Fifth Circuit and asked for a stay of the injunction. The Fifth Circuit has now ordered that the ACA mandate remain in effect (for everyone except the few health plans challenging the requirement) until it issues a final decision in the case, expected later this year. This means that, at least for now, group health plans and insurers must continue to cover USPSTF recommendations with an A or B rating.

Footnote

  1. See “Federal court issues nationwide injunction on some ACA preventive care,” Insider, April 2023 Return to article

Authors

Maureen Gammon

Senior Director, RIC Health and Benefits Technical Services

Benjamin Lupin

Senior Regulatory Advisor, Health and Benefits

SOLUTION

Health and Benefits