ACA preventive care mandate to stay in place after appeals court ruling

The U.S. 5th Circuit Court of Appeals ruled Friday that a Christian-owned business can’t be compelled to cover preventive medications as is required under the Affordable Care Act. However, the court also determined a Texas judge carried out an “abuse of discretion” in his prior ruling by blocking federal agencies from enforcing the rule universally.

The decision in Braidwood Management v. Becerra affirmed a lower court’s ruling that the secretary of the Department of Health and Human Services could not force Braidwood Management to abide by a preventive care mandate in the ACA. The court rejected another ruling, however, and remanded another one back to the lower courts.

At issue is a provision in the ACA that requires private health insurers and companies to cover preventive services and drugs like HIV preventive drugs, known as PrEP. The provision also requires coverage of cancer screenings, vaccines, STD screenings, gestational health screenings and birth control.

Braidwood contended that this requirement violated the company’s religious freedom and beliefs.

Judge Reed O’Connor of U.S. District Court for the Northern District of Texas, struck down the provision in September 2022. The appeals court said in the last week’s ruling that it believed blocking the federal government from enforcing this mandate across the board was an “error” and “an abuse of discretion.”

However, the appeals court also determined other arguments had yet to be fully decided and should be subject to further review in the lower courts.

One issue left to be decided is whether the U.S. Preventive Task Force that decides which services must be covered under the ACA is constitutionally sound.

The ACA specifies four main categories of preventive care for all adults as well as for women and children in particular:

1. Services with an A or B rating in the current recommendations of the U.S. Preventive Services Task Force.
2. Immunizations recommended by the Advisory Committee on Immunization Practices.
3. Preventive care and screenings for infants, children, and adolescents in comprehensive guidelines supported by the Health Resources and Services Administration.
4. Preventive care and screenings for women’s health specified in the HRSA guidelines.