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Insurers say free preventive care will continue while lawsuit is appealed

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April 20, 2023
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The majority of health insurers in the country do not anticipate ending free preventive services while a lawsuit challenging ObamaCare’s requirement plays out in court, according to a joint letter industry groups sent to Democratic lawmakers.

A federal judge in Texas impose a nationwide injunction last month on a popular ObamaCare requirement that health insurance must cover preventive services for free is at risk of ending, sending shockwaves through the health system.

The letter was a response by some of the industry’s largest trade groups to Democrats on key House and Senate health committees, who requested information from a dozen major health insurance companies and trade groups on whether they plan to continue covering certain preventive services until all the appeals are concluded, including review by the Supreme Court.

“The overwhelming majority [of our members] do not anticipate making changes to no-cost share preventive services, and do not expect disruptions in coverage of preventive care, while the case proceeds through the courts,” according to the letter signed groups as America’s Health Insurance Plans, the Blue Cross Blue Shield Association and the American Benefits Council.

The groups noted that preventive care is popular and effective, and that the decision from a federal judge in Texas last month is likely just the start of a lengthy legal process.

“Our associations have long supported preventive care and continue to do so,” they wrote. “By responding together, we wish to make clear our strong support for continued access to preventive health care for millions of Americans who rely on it. “

The response and the initial inquiry from lawmakers shows the concern over the future of free preventive services.

The decision from U.S. District Judge Reed O’Connor — who previously held that the entire Affordable Care Act was unconstitutional — jeopardizes access to treatment for the approximately 150 million Americans who use free preventive services annually, and it leaves the door open for insurers to impose deductibles and copays for potentially life-saving screening tests.

The ACA requires insurers to cover, without cost-sharing, more than 100 preventive health services recommended by the U.S Preventive Services Task Force. A lawsuit challenged that requirement, and led to a nationwide injunction from O’Connor ending it as well as invalidating the entire task force.

The lawsuit was led by Jonathan Mitchell, the architect of Texas’s six-week abortion law that offers a $10,000 bounty to private citizens who successfully sue abortion providers.

Attorneys for the Department of Health and Human Services appealed to the Fifth Circuit Court of Appeals. The Justice Department has asked for O’Connor’s decision to be paused as the appeal proceeds.

If the ruling stands, it won’t impact every single preventive screening, as some recommendations predate the ACA. So breast cancer and colon cancer screenings won’t be impacted, but newer recommendations on skin cancer and lung cancer would be.

There are currently 15 states with laws on the books requiring individual market insurers to cover, without cost sharing, the same categories of preventive services required by the ACA.

But there are limits to what states can do. States can regulate private insurance, but self-insured employer plans, which cover most people with private insurance, can’t be touched by state regulations.

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