Appeals Court Blocks Ruling that Jeopardized Preventive Care Coverage

?The 5th U.S. Circuit Court of Appeals on May 15 temporarily blocked a March district court ruling that jeopardized cost-sharing required by the Affordable Care Act (ACA) for preventive care, including cancer screenings and PrEP, an HIV-prevention drug. We’ve gathered articles on the news from SHRM Online and other media outlets.

Administrative Stay

The 5th Circuit granted an administrative stay while it reviews the case. The U.S. Department of Justice had appealed the March decision. For now, no-cost coverage for preventive services is required.

(Axios)

District Court Ruling

Religious objector businesses wanting to provide health insurance to workers and exclude coverage of preventive care such as PrEP persuaded the district court that the ACA mandate to cover PrEP costs violated the Religious Freedom Restoration Act. The plaintiffs also persuaded a court that members of the U.S. Preventive Services Task Force were unconstitutionally appointed and that the plaintiffs didn’t have to follow the task force’s preventive care coverage recommendations, which includes guidance on some cancer screenings.

(SHRM Online)

Limits to District Court’s Decision

The district court ruling applied only to task force recommendations made by the panel on or after March 23, 2010, such as on statins, lung and skin cancer screenings and PrEP. Under its ruling, sexually transmitted infection screenings and cancer screenings such as mammograms and cervical screenings still were included for preventive coverage.

(Becker’s Payer Issues)

Public Health Groups Oppose District Court Decision

Public health groups warn of serious consequences if the lower-court ruling is upheld—citing research showing that even small costs deter many people from seeking preventive care, leading to sicker patients and more costly treatments. The groups welcomed the 5th Circuit stay.

(Politico)

District Court Decision Might Deter Treatment

Some have expressed concern that patients hearing about the district court decision might be deterred from seeking out services for fear of being hit with a medical bill.

 (Politico)