Federal judge strikes down some ACA preventive care requirements

    Authored by Bukaty Companies on April 4, 2023

    Since the 2010 passage of the Affordable Care Act (ACA), non-grandfathered health plans and health insurers have been required to provide most preventive care services with no cost sharing. Last Thursday a Texas federal judge ruled that employers cannot be required to provide specific preventive services.

    At the heart of the judge’s ruling is the U. S. Preventive Services Task Force (PSTF), a voluntary body of non-federal experts who recommend many of the preventive services to be covered by the ACA preventive mandate. The judge claimed the PSTF was not appropriately established under the constitution and, as such, the group’s compulsory preventive coverage requirements, particularly those that conflict with the Religious Freedom Restoration Act, cannot be required. Other long-established preventive care ACA mandates, such as well-women visits, mammograms and preventive services for children, remain in effect.

    At aim in the case is the PSTF’s inclusion of FDA-approved contraceptive methods, including certain drugs used to induce abortions and drugs used by those who are at high risk of HIV.

    The Department of Justice this past Friday filed an appeal with the U.S. Court of Appeals for the Fifth Circuit. For now, health insurer representatives Bukaty Companies represents are unofficially stating they are unlikely to stop any coverage immediately. Updates will be released as more is learned.

    For additional information, contact your Bukaty benefits consultant at 913.345.0440.