Fort Worth orthodontist sues to end Obamacare’s requirement of free preventive care [Fort Worth Star-Telegram]

A Fort Worth orthodontist wants to end the requirement that health insurance pay for preventive health care like birth control, flu shots, and HIV prevention drugs.

The orthodontist, John Kelley, is one of eight North Texas residents who are suing federal officials over the Affordable Care Act, often known as Obamacare, and its requirement that health insurance plans pay for preventive health care in full, with no charge to patients.

Kelley’s attorneys either did not respond to emails and phone calls seeking comment or declined to be interviewed about the lawsuit

Kelly, who started Kelley Orthodontics, is challenging a key part of the Affordable Care Act known as the preventive services mandate. The mandate requires that any health care deemed preventative by federal officials be free to patients. So services like annual flu shots, mammograms, and colorectal cancer screenings must be free to patients who have private health insurance plans.

In their lawsuit, Kelley and his co-plaintiffs are seeking to end the preventive services mandate because they say insurance coverage of HIV prevention drugs, testing for sexually transmitted infections, and some types of birth control conflict with their religious beliefs. Kelley, a member of the Christ Chapel Bible Church in Fort Worth, is “a Christian, and he is therefore unwilling to purchase health insurance that subsidizes abortifacient contraception or PrEP drugs that encourage homosexual behavior and intravenous drug use,” according to the lawsuit, which was filed in 2020 in U.S. District Court in Fort Worth.

The suit incorrectly labels some types of birth control as comparable to abortions; the American College of Gynecologists says that no forms of FDA-approved birth control cause abortions, because abortions only occur after a pregnancy begins when a fertilized egg is implanted into the uterus. No forms of birth control can end a pregnancy that has already begun.

If Kelley and his co-plaintiffs succeed in their challenge, “it could wipe out the whole preventive services mandate” of the Affordable Care Act, said Allison Hoffman, a law professor at the University of Pennsylvania Law School.

In effect, that would allow insurance companies to charge patients co-pays for services that they are currently required to pay for in full.

But the suit could also have broader implications, Hoffman said.

“It’s using these kind of big constitutional provisions to try to say that the government didn’t have the authority to put these preventive preventive services requirements in place at all,” she said.

Opposition to HIV prevention drugs, STI testing

The ACA, which became law in 2010, is best known for for expanding Medicaid to millions of poor Americans throughout the U.S.

The law expanded access to preventive health care by requiring insurance companies to cover the cost of preventive care in full. In effect, the law requires that a service that could keep people healthy or prevent them from becoming sick be fully paid for by the insurance company, with no cost to the patient. This is why, if you have health insurance, your annual flu shot is free of charge, but if you break your arm and have to go to the emergency room, you might still have to pay money to get care.

The plaintiffs outline three specific types of preventive care they say conflicts with their religious beliefs in the suit: access to the HIV prevention drug known as pre-exposure prophylaxis, or PrEP, access to testing for sexually transmitted infections, and access to some types of emergency contraceptives.

PrEP is widely recognized as a game-changing drug in the fight to stop the AIDS epidemic, said DeeJay Johannessen, the CEO of the HELP Center in Tarrant County.

When taken daily as prescribed, PrEP can reduce the risk of getting HIV through sex by about 99%, according to the U.S. Centers for Disease Control and Prevention.

“Not only is it more cost effective, but it is more humane than after-the-fact intervention,” Johannessen said. “This is something that has allowed people to continue living their lives without fear.”

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