Advocacy Group’s Representative: Lawsuit Has Potential to Disrupt Preventive Services
April 21, the U.S. Supreme Court is expected to hear arguments in the Kennedy v. Braidwood Management Inc. (formerly Braidwood Management Inc. v. Becerra) court case challenging the Affordable Care Act’s (ACA) no-cost preventive services requirement. The lawsuit will determine whether 151 million people will continue to have access to preventive healthcare services with no out-of-pocket costs.
It must be noted that the ACA does not spell out the preventive services that must be covered. It relies on federal experts in HHS—the United States Preventive Services Task Force (USPSTF or the “Task Force”), the Health Resources and Services Administration (HRSA), and the Advisory Committee on Immunization Practices (ACIP), Andrew Twinamatsiko, Zachary Baron, and Sheela Ranganathan, wrote in an article entitled “Fate of ACA Preventive Services Uncertain Before Supreme Court.”
“The ACA requires virtually all insurers to provide cost-free coverage of various preventive services, including screenings for lung cancer, mammograms, cholesterol medication, vaccinations, tobacco cessation, and many other services,” the authors underscored.
The decision by the Supreme Court to take up the case followed several rulings by lower courts challenging the authority of the Task Force. Adam Liptak explained for The New York Times that some Texas residents and two small Christian-affiliated businesses that provide health insurance to employees sued to contest how the Task Force had been appointed, saying it violated the Constitution. “The plaintiffs objected to the Task Force’s decision to cover medication preventing H.I.V. infection in some at-risk people.”
Healthcare Innovation’s Mark Hagland reported on January 2 that the legal dispute hinges on whether the Task Force members are “principal officers” or “inferior officers.” “The distinction matters,” Hagland explained, “because the plaintiffs’ legal argument is based on their contention that the Task Force members are “principal officers” whose appointments should have been confirmed by the U.S. Senate.”
Ahead of oral arguments, Healthcare Innovation spoke with Lisa Hunter, senior director of federal policy and advocacy for United States of Care, a healthcare policy think tank. In February, USofCare sent an amicus brief with 47 health advocacy groups urging SCOTUS to protect free preventive healthcare services.
Hunter explained that before the preventive services mandate, preventive services were something that you had to pay for, which meant that there was an economic barrier for many people to access them.
“The stakes in this case could not be higher,” Hunter emphasized, “Half of people in the United States are currently benefiting from this, no cost, preventive services mandate.” “There are people who have been brought up in the healthcare system who don't even know what it's like not to have access to these services.”
“Anything but a clear preservation of this mandate from the Supreme Court could have a really adverse effect on not just people and their ability to seek care but also injects a lot of confusion and uncertainty in the market.”
“A system that does not prioritize preventive services can be really costly down the line....There are a lot of economic and public health reasons why you would want to preserve the full slate of USPSTF preventive services,” Hunter answered the question of how insurers would respond if SCOTUS ruled in favor of the plaintiffs.
“Our hope would be that we get a clear ruling from the Supreme Court that adheres to a clear protection of the preventive services mandate in full.... Anything short of a clear ruling on this can be catastrophic for people, the market, and stakeholders.”
“We want to see people have access to affordable healthcare across the country,” Hunter shared. “We know that this is a very common-sense policy to provide preventive services at no cost.”
“This case,” Hunter cautioned, “has the potential to disrupt access to healthcare services that really hone in on prevention, on helping people reach their optimal health, all the things that we want to see.”
“All of these places that are at the front lines providing preventive services and catching diseases, illnesses, and ailments early, those are the places that are likely going to see less people coming through when there's a copay cost associated with visits.”
USofCare is anticipating a decision by the Supreme Court in June or July.
