Insurers Still Must Cover Preventive Care for Now, Court Says

A federal appeals court has temporarily restored the Affordable Care Act requirement that health insurers fully pay for certain preventive services. 

The order was issued Monday by the U.S. Court of Appeals for the 5th Circuit in New Orleans, The New York Times reported. The move puts on hold a judge's decision in March that it was unlawful on religious grounds to require that insurers pay for contraception or preventive HIV treatments. That March decision potentially would have lifted ACA requirements for insurers to fully cover many preventive treatments, including for cancer and depression screenings, many heart medications, and prenatal services, according to a summary by the Kaiser Family Foundation, a health policy think tank. 

As many as 150 million Americans could be affected by the ruling if the appeal attempt by the U.S. Justice Department is unsuccessful, according to the Times. Removing the ACA requirement for insurers to pay for preventive services would apply to people who have private health insurance policies such as through their employer or purchased through the Marketplaces like HealthCare.gov.

It's unclear if any insurers had already changed their coverage of preventive services since the ruling earlier this year.

The lawsuit was one of more than 2,000 that have been filed targeting the ACA since it was passed into law in 2010. This latest legal battle was initiated by a Christian employer who challenged the requirement that its private health insurance cover HIV preventive treatments called PrEP that can reduce the chance of getting HIV from injection drug use or from sex.

"The requirement for health plans to cover preventive services without cost sharing has been demonstrated to save lives," the government said in its court filings, The Hill reported. "Its elimination would do the opposite."

Sources:

The New York Times: "Appeals Court Pauses Ruling That Threatened Free Preventive Health Care."

KFF: "Explaining Litigation Challenging the ACA's Preventive Services Requirements: Braidwood Management Inc. v. Becerra."

The Hill: "Appeals court temporarily pauses Texas ruling that overturned ObamaCare requirement."

WebMD Health News © 2023 

Cite this: Insurers Still Must Cover Preventive Care for Now, Court Says - Medscape - May 16, 2023.