Coverage of Preventive Services Without Cost Sharing in Jeopardy as Texas Court Strikes Down ACA Protection
Coverage of Preventive Services Without Cost Sharing in Jeopardy as Texas Court Strikes Down ACA Protection
By Justin Giovannelli and Rachel Schwab
The Affordable Care Act (ACA) requires nearly all private health plans to cover preventive care without cost sharing. This protection has benefited more than 150 million Americans, ensuring free access to over 100 critical items and services such as cancer screenings, contraception, and routine immunizations. At the end of March, a federal judge in Texas invalidated much of the preventive services protection—one of the ACA’s most popular provisions.
In a recent post for the Commonwealth Fund’s To the Point blog, CHIR experts break down the recent decision in Braidwood Management v. Becerra. The decision struck down, on constitutional grounds, the requirement to provide $0 coverage of a subset of preventive services recommended by an expert body appointed by a federal agency. Although the government has asked the judge to “stay” the decision, which may halt its immediate impact, the ruling threatens access to HIV prevention medicine, certain pregnancy-related care, and other crucial preventive services that save lives. Additional services may be added to this list as the litigation continues. Without a coverage requirement, payers may reimpose cost sharing, and could exploit the new flexibility to design plans that attract healthy consumers while discouraging enrollment by those with greater care needs. You can read the full blog post here.
