Future Coverage of Preventive Services without Cost Sharing Uncertain after Texas Judge's Ruling

DOWNERS GROVE, Illinois, Sept. 17 (TNSgov) -- The American Society for Gastrointestinal Endoscopy posted the following news:

A federal judge in Texas has ruled that members of the U.S. Preventive Services Task Force (USPSTF) are unconstitutionally appointed, putting in jeopardy patient access and affordability of preventive services currently recommended by the USPSTF, including colorectal cancer screening.

The decision is the outcome of a suit filed by six individuals and two businesses who challenge the legality of the preventive-care mandates under the Constitution and the Religious Freedom Restoration Act. According to court documents (https://storage.courtlistener.com/recap/gov.uscourts.txnd.330381/gov.uscourts.txnd.330381.92.0.pdf?source=email), the plaintiffs want the option to purchase health insurance that excludes or limits coverage of pre-exposure prophylaxis (PrEP) drugs to prevent HIV infection, contraception, the HPV vaccine, and screenings and behavioral counseling for STDs and drug use.

The Affordable Care Act requires most private health insurance to cover certain preventive care, including preventive services that receive an "A" or "B" rating from the USPSTF, without patient cost sharing. In his written opinion, District Judge Reed O'Connor stated that because members of the USPSTF are principal officers of the United States, constitutional methods for appointing them (nominated by the President and confirmed by the Senate) must be followed.

"Judge O'Connor's ruling creates uncertainty around the future availability of preventive services, including colorectal cancer screening, without patient cost sharing," said ASGE President Bret Petersen, MD, MASGE. "We know that consumers put off preventive care when they have to reach into their pocketbooks for colonoscopies, mammograms and other potentially life-saving care. It is therefore imperative that all preventive services recommended by the USPSTF remain available to consumers without cost-sharing requirements."

The Court will next hear from the Biden Administration attorneys (defendant) and plaintiffs on an appropriate remedy. However, the Judge has already warned that if the Administration attorneys argue that a remedy is to allow the Secretary of Health and Human Services to ratify the actions of the USPSTF, the defendants have already disclaimed that the Secretary has any authority over the USPSTF, and, without that authority, there can be no ratification.

The Administration is expected to appeal the ruling. Prior to consideration of the case, ASGE signed a joint statement on preserving access to preventive services.

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Original text here: https://www.asge.org/home/about-asge/newsroom/news-list/2022/09/16/future-coverage-of-preventive-services-without-cost-sharing-uncertain-after-texas-judge-s-ruling