SUPREME COURT TO DECIDE PREVENTATIVE CARE MANDATE CONSTITUTIONALITY
The Supreme Court is scheduled to hear arguments in a case that will decide whether insurance companies will continue to be required to cover preventative healthcare services.
Under the Affordable Care Act (ACA), health insurers must cover 100% of preventative care and screening examinations approved by the United States Preventative Health Task Force (USPHTF). Examples of approved preventive services include:
- Cancer screenings
- Tobacco cessation interventions
- Vaccinations
- Blood pressure screenings
- Developmental screenings
- Routine immunizations
The impact of the ACA preventative care mandate has resulted in broad support from healthcare organizations and providers. Research has demonstrated that it has improved access to healthcare, reduced healthcare spending, and saved lives.
Brentwood Management, a Texas employer, joined by a coalition of religious organizations in filing a lawsuit arguing that the preventative healthcare mandate incorporated within the Affordable Care Act violates their religious freedoms under the Religious Freedom Restoration Act. The plaintiffs in the lawsuit argue the act violates their constitutional rights on 2 principles.
The first argument is that the United States Preventative Health Task Force is not politically appointed and, therefore, does not reflect the will of the American people. The plaintiffs argue that the Task Force should be a politically appointed agency, not selected by clinical experts.
The second argument is that the mandate’s provisions violate employers’ religious freedoms. The ACA preventative care mandate includes a provision that medications that prevent HIV infection, referred to as PREP, must be covered under that mandate. The plaintiffs argue that the mandate to cover HIV preventative medication encourages homosexuality and, therefore, violates the employers’ religious liberty.
The Fifth Circuit Court of Appeals initially heard the case and ruled in Favor of the plaintiffs, determining that the preventative care mandate was unconstitutional. The United States Supreme Court will decide on the case, which could significantly impact healthcare delivery in the country.
If the Supreme Court upholds the Fifth Circuit decision, health insurers would no longer be required to cover preventative care services. This would result in a significant cost shifting for preventative care services onto the patient, likely resulting in decreased health screenings and preventative care.
Arguments in the case are anticipated to occur this spring with a ruling in July.
Courtemanche, C., Marton, J., Ukert, B., Yelowitz, A., & Zapata, D. (2018). Effects of the affordable care act on health behaviors after three years (No. w24511). National Bureau of Economic Research.
Kaiser Family Foundation. (2015). Preventive services covered by private health plans under the Affordable Care Act.
Sommers, B. D., Maylone, B., Blendon, R. J., Orav, E. J., & Epstein, A. M. (2017). Three-year impacts of the Affordable Care Act: improved medical care and health among low-income adults. Health Affairs, 36(6), 1119-1128.
