Court Ruling Preserves Zero-Cost Preventive Coverage

An agreement approved by the 5th U.S. Circuit Court of Appeals preserves free preventative care services for millions of Americans, at least for now, after a Texas judge previously ruled the coverage is unconstitutional.

On June 13, the 5th U.S. Circuit Court of Appeals signed a stipulated order requiring health insurance plans to continue to pay for preventative services like colon cancer screening and HIV prevention under the Affordable Care Act (ACA).

The order preserves these services for millions of Americans while a legal battle over whether the ACA's requirements are unconstitutional continues.

The battle involves the case of Braidwood Management v. Becerra, in which the plaintiffs argued that paying for health plans requiring coverage of services they object to is causing financial and religious harm. They also claimed that members of the U.S. Preventive Services Task Force (USPSTF) — who recommend preventative services to government agencies — are in violation of the Appointment Clause.

On March 30, Judge Reed O'Connor at the U.S. District Court in the Northern District of Texas ruled that because members of the U.S. Preventive Services Task Force (USPSTF) are not appointed in a manner consistent with the Appointment Clause, some of the ACA requirements for preventative care services are unconstitutional. Therefore, the plaintiffs would not have to comply with USPSTF recommendations made after 2010.

The judge's decision also meant that health insurance companies would no longer have to pay for specific preventive care services utilized by millions of Americans.

However, the June 13 Appeals Court ruling preserved these services, at least for now.

According to the stipulated order, while the legal battle ensues, health insurance plans must continue to provide zero-cost coverage for these services. However, the plaintiffs will not have to pay for specific preventative care services during the appeals process. In addition, they will not have to pay penalties if the courts reverse the Texas Judge's decision.