Federal Court Decision Threatens the ACA’s Preventive Services Benefit: State Options to Mitigate Harm to Consumers

Stakeholder Perspectives and Feedback on Health Equity in the 2023 Notice of Benefit and Payment Parameters


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By Sabrina Corlette and Justin Giovannelli

The same U.S. federal district judge that declared the Affordable Care Act (ACA) unconstitutional in Texas v. California has issued a ruling in a lawsuit, Braidwood Management Inc. v. Becerra (formerly known as Kelley v. Becerra), that strikes down a requirement that health plans cover and waive cost-sharing for many critical preventive services. Although the U.S. Department of Justice is likely to appeal the ruling, some legal experts believe the Braidwood Management plaintiffs may prevail in the higher courts, too.

The preventive services benefit is one of the more popular provisions of the ACA. The loss of this protection means that over 167 million people will need to pay out-of-pocket for dozens of critical preventive services. When confronted with hefty deductibles or coinsurance, people tend to delay or forego even essential preventive services, making them more susceptible to costly and serious illness.

If the ACA’s preventive services provision is gutted, only Congress can fully restore it. Still, there are steps that state policymakers can take to help many of their residents maintain this coverage. In a new Expert Perspective for the State Health & Value Strategies Program, CHIR’s Sabrina Corlette and Justin Giovannelli recap the legal issues in the case and outline options for states seeking to preserve consumers’ access to preventive services. You can read the full article here.

This entry was posted in Health reform, Implementing the Affordable Care Act and tagged essential health benefits, preventive services by CHIR Faculty. Bookmark the permalink.

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