A federal district court in Texas overturned part of the Affordable Care Act (ACA) that requires group health plans and insurers to cover certain preventive healthcare services recommended by the United States Preventive Services Taskforce (USPSTF), with no cost sharing (i.e., no out-of-pocket costs).
In Braidwood Management, Inc. v. Becerra, Judge Reed O’Connor of the U.S. District Court for the Northern District of Texas held that the USPSTF recommendations were not authorized because task force members were not constitutionally appointed. Judge O’Connor is the same judge who previously struck down the entire ACA before it was eventually upheld by the U.S. Supreme Court.
Note, other ACA preventive care mandates that were not recommended by the USPSTF remain in effect. The court specified that two other federal groups — the Health Resources and Services Administration (HRSA) and the Advisory Committee on Immunization Practices (ACIP) — may require group health plans and insurers to cover certain preventive products and services with no cost sharing because they were created by the Health and Human Services (HHS) Secretary, a presidential appointee. HRSA covers a range of women’s healthcare (including contraceptives), while ACIP covers routine vaccinations.
HHS (via the Department of Justice) has already appealed the decision and is expected to ask for a stay on the ruling pending appeal, so changes to group health plans and insurance contracts would not be immediate. It is unclear when the appeals court will rule on this case and whether it will eventually be appealed and decided by the U.S. Supreme Court.
| Title | File Type | File Size |
|---|---|---|
| Insider April 2023 | .2 MB |
