ACA preventive care rule remains, for now

The government can keep enforcing requirements under the Affordable Care Act that health insurance plans cover preventative care — such as HIV prevention, some types of cancer screenings and other illnesses — while a legal battle over the mandates plays out, under a court agreement approved Tuesday.

The pact approved by the 5th U.S. Circuit Court of Appeals preserves — at least for now — cost-free preventive care coverage for millions of Americans under the Affordable Care Act.

That coverage was thrown into question by a March ruling from a federal judge in Texas, who said some of the preventive care requirements under former President Barack Obama’s 13-year-old health care law are unconstitutional.

The ruling by U.S. District Judge Reed O’Connor had nationwide effects. The Biden administration had argued last week at the appeals court that the ruling should be stayed while appeals are pursued.

The agreement was filed with the court Monday. In it, the plaintiffs in the case, including a Christian dentist who opposes coverage for contraception and HIV prevention on religious grounds, agreed to a broad stay nationwide.

In return, during the appeal process, the handful of plaintiffs would be allowed to provide insurance plans that don’t include the preventive care. If O’Connor’s ruling was reversed, they would have to provide the coverage, but they would not be penalized for having dumped the coverage during appeals.

O’Connor’s March ruling deals with requirements for coverage driven by recommendations by the U.S. Preventive Services Task Force. The judge ruled that because the task force is made up of volunteers, enforcing its recommendations violates the Constitution’s Appointment Clause, which lays out how government officials can be appointed.

Not all preventive care was threatened by O’Connor’s ruling. An analysis by the nonprofit Kaiser Family Foundation found that some screenings, including mammography and cervical cancer screening, would still be covered without out-of-pocket costs because the task force recommended them before the health care law was enacted in March 2010.

The ruling by U.S. District Judge Reed O’Connor had nationwide effects.