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ACA preventive coverage mandate overview:
- Who: Reed O’Connor, a Texas federal judge, ruled the US government cannot enforce an Affordable Care Act provision that would have required insurance plans to provide a number of preventive treatments.
- Why: O’Connor ruled members of a task force created to determine what preventive treatments would be required were not lawfully appointed.
- Where: The case was heard in Texas federal court.
A federal judge in Texas has blocked the US government from being able to enforce a provision of the Affordable Care Act (ACA) that mandated insurers provide coverage for a large number of preventive treatments, including cancer and diabetes screenings.
The provision had been challenged by a group of two businesses and six individuals who argued the preventative care mandates were unconstitutional and violated the Religious Freedom Restoration Act (RFRA).
US District Judge Reed O’Connor sided with the group, ruling that members of a task force called the U.S. Preventive Services Task Force — created to determine preventive treatments insurance plans would need to provide — were unlawfully appointed.
“Individual Plaintiffs need not comply with the preventive care coverage recommendations … because the members of the Task Force have not been appointed in a manner consistent with Article II’s Appointments Clause,” O’Connor said, in his opinion and order.
Insurance plans will not be required to provide screenings for certain cancers, depression, and HIV, among other things
Insurance plans will now no longer be required to provide screenings for breast, cervical, lung, skin, and colorectal cancer, screenings for depression, diabetes, hepatitis, and child vision issues, and HIV screenings and treatment, reports Law360.
The provision would have also reportedly forced insurers to provide coverage for women who are pregnant and/or breastfeeding, along with care for their young children.
O’Connor, an appointee of former President George W. Bush, previously made headlines for rescinding the ACA in 2018 and ending Obama-era health insurance protections for gay and transgender individuals, reports Law360.
The federal judge also reportedly ruled in September that requiring a Christian-owned for profit to cover HIV prevention medication would be a violation of the RFRA.
In 2020, the Supreme Court held a phone hearing to discuss the constitutionality of the ACA, following challenges brought by the state of Texas and other Republican states.
Are you impacted by the decision to not require insurance plans to provide preventive treatments chosen by the task force? Let us know in the comments!
The plaintiffs are represented by Gene P. Hamilton of the America First Legal Foundation, H. Dustin Fillmore III and Charles W. Fillmore of The Fillmore Law Firm LLP, and Jonathan F. Mitchell of Mitchell Law PLLC.
The ACA preventive coverage mandate case is Braidwood Management Inc., et al. v. Xavier Becerra, et al., Case No. 4:20-cv-00283, in the U.S. District Court for the Northern District of Texas.
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