The Affordable Care Act (ACA) was dealt a major blow after a federal judge ruled that employers don’t have to cover certain preventive services.
Specifically, U.S. District Judge Reed O'Connor of Texas' Northern District Court ruled that private insurers do not have to cover preexposure prophylaxis (PrEP) drugs, which prevent HIV, and birth control. The lawsuit hinged on religious grounds arguments that insurers shouldn't have to cover HIV drugs or birth control, but the ruling could extend to other preventive services as well, including screenings for cancer and diabetes. The suit was brought by Christian business owners who argued they shouldn’t have to cover PReP-related expenses.
“The question is whether the government has a compelling interest in requiring all private insurers to cover PrEP drugs in every one of their insurance policies,” the ruling noted.
One of the most critical provisions of the Affordable Care Act was its no-cost preventive services, meaning insurance providers have had to cover many preventive services, including birth control, for free to beneficiaries.
O’Connor previously ruled last year that PReP was a step too far for private insurers to cover, but his latest ruling goes even further, targeting services the Preventive Services Task Force most highly recommends for preventive care.
It is likely the lawsuit will be appealed by the Biden administration. The ACA has been the target of numerous lawsuits since it was implemented by the Obama administration. Its adoption has led to a significant reduction in the uninsured rate, and the law has mostly held up through these challenges, including a Supreme Court challenge.
However, O’Connor is well known when it comes to ACA challenges. After Republicans successfully challenged and overturned the individual mandate provision of the healthcare law, O’Connor ruled that the move effectively made the rest of the ACA null and void. The ACA has been upheld as the law of the land.
Amy joined TriMed Media as a Senior Writer for HealthExec after covering home care for three years. When not writing about all things healthcare, she fulfills her lifelong dream of becoming a pirate by sailing in regattas and enjoying rum. Fun fact: she sailed 333 miles across Lake Michigan in the Chicago Yacht Club "Race to Mackinac."