A court ruling to end the Affordable Care Act's guarantee of no-cost access to preventive medical care triggered opposition from major healthcare companies, trade associations, advocacy groups and Democratic officials.
Judge Reed O'Connor of the U.S. District Court for the Northern District of Texas issued an opinion Thursday invalidating this portion of the ACA, which allows patients to receive screenings for diseases such as cancer and HIV and other services recommended by the U.S. Preventive Services Task Force without cost-sharing. The plaintiffs in the case objected on religious grounds to their premiums going toward contraceptives and PrEP medicines that reduce the risk of HIV infections.
"All the preventative services are up for grabs, Laurie Sobel, associate director of women’s health policy at Kaiser Family Foundation said during a news briefing Thursday. O'Connor's ruling is effective nationwide, but President Joe Biden's administration is expected to appeal it and request a stay while the case continues its way through the courts, she said.
The American Hospital Association, Federation of American Hospitals and America's Essential Hospitals declined comment. Here are some of the statements issued in reaction to the court decision:
AHIP: “Every American deserves access to high-quality affordable coverage and healthcare, including affordable access to preventive care and services that help avoid illnesses and other health problems. As we review the decision and its potential impact with regard to the preventive services recommended by the United States Preventive Services Task Force, we want to be clear: Americans should have peace of mind there will be no immediate disruption in care or coverage. We fully expect that this matter will continue on appeal, and we await the federal government’s next steps in the litigation, as well as any guidance from relevant federal agencies.” - President and CEO Matt Eyles
Elevance Health: "This does not change benefits coverage for our members. We will continue to cover preventive benefits under the terms of our contracts for members."- Spokesperson
Kaiser Permanente:"We are carefully reviewing the decision of the federal district court in Texas. We expect this ruling will be appealed, and if so the case is likely to take some time to fully resolve in the courts. We do not expect any immediate effect on the care we provide our members. Kaiser Permanente will continue to provide these services at no cost to the members and patients in the areas we serve consistent with our approved benefit plans. We know these effective interventions prevent disease and save lives." - Statement
Blue Cross Blue Shield of Massachusetts: "While we are reviewing the details of the ruling out of Texas and awaiting anticipated further legal action by the federal government, we are deeply concerned that this decision will create consumer confusion about the coverage and cost of important preventive services including screenings for cancer, diabetes, HIV and depression, as well as preventive medications such as statins, immunizations and PreP (pre-exposure prophylaxis for HIV). BCBSMA members are encouraged to continue seeking preventive care. Coverage of these services at no cost share remains the same at this time." - News release
Association for Community Affiliated Plans: “This decision, if implemented, would erode access to an entire range of preventive health services—from cancer screening to HIV prevention to preeclampsia screening for expecting mothers. ... We call on the Justice Department to appeal this ruling such that this decision can be stayed to give the necessary acts of jurisprudential hygiene to occur. In the interim, our safety net health plans will continue to work to equitably improve the health of all their members—regardless of their sexual orientation or their gender identity.” - CEO Margaret Murray
American Medical Association: "The AMA is alarmed by today’s deeply flawed court ruling in Texas that jeopardizes access to preventive health services guaranteed under federal health reform. ... Denying access to proven preventive care flies in the face of good policy, and the societal costs of establishing barriers to preventive services are immeasurable. Physicians know the inevitable result when courts interfere with insurance coverage of effective, proven interventions. Patients will be subjected to needless illness and preventable deaths. We strongly urge employers and insurers to maintain this first-dollar coverage while legislative and judicial next steps are considered.” - President Dr. Jack Resneck Jr.
American Academy of Family Physicians: “We are alarmed that the court’s decision will create insurmountable barriers to screenings, counseling and preventive medications that improve individual patient and population health, including pre-exposure prophylaxis (PrEP) medications for the prevention of HIV. ... While we are relieved that the court upheld the contraceptive coverage mandate and coverage requirements for immunizations and preventive services recommended by the Advisory Committee on Immunization Practices and the Health Resources and Services Administration, the AAFP urgently calls on lawmakers, insurers and health plan sponsors to ensure that patients can continue to access high-value, essential preventive services without cost-sharing.” - President Dr. Tochi Iroku-Malize
American College of Obstetricians and Gynecologists: "Allowing personal or political bias to interfere with the practice of medicine will cause harm to our patients. No-copay coverage of critical preventive care like HIV prevention is intended to increase access in order to keep people healthier. ...We should be working toward increased access to and utilization of all preventive care recommended by the U.S. Preventive Services Task Force. Instead, we find ourselves once again defending healthcare from outside interference and responding to attempts to dismantle our current preventive care system. Today’s decision will leave more people without access to preventive care and will grow health inequities among those who will now find themselves underinsured.” - News release
Human Rights Campaign: “This court ruling is a slap in the face to every person receiving healthcare subject to the Affordable Care Act—a law that was crafted to ensure any American could have access to quality, affordable medical care. Today, that full scope of care was stripped away. It’s important to note that insurance companies can continue to offer these services without any interruption in care—we call on them to do so." - President Kelley Robinson
HIV+Hepatitis Policy Institute: "It is imperative that these critical preventive services must continue for the health of our nation. We expect that the U.S. government will quickly act to stay this decision so that preventive services can continue nationwide, and appeal it. ... The decision to single out PrEP is based on a deep discrimination against people who can benefit from it and would greatly impede our efforts to reduce HIV cases. ... While the appeals process moves forward, we call on health insurers to act on their own and continue to cover these preventive services without cost-sharing for the benefit of their enrollees." - Executive Director Carl Schmid
White House: "This case is yet another attack on the Affordable Care Act, which has been the law of the land for 13 years now. ... Because of the ACA, you see 150 million Americans have access to preventative care like cancer and heart disease screenings. Sixty percent of people use a preventive care service under the ACA every year. ... Preventive care saves lives, it saves families money, and protects and improves our health. ... Efforts to undermine this requirement are wrong, and they take us backwards, not forwards. So the administration will continue to fight to improve healthcare and make it more affordable for working families, even in the face of these attacks." - Press Secretary Karine Jean-Pierre
Health and Human Services Department: "Preventive care is an essential part of healthcare: it saves lives, saves families money and improves our nation’s health. Because of the Affordable Care Act’s preventive services requirement, 150 million Americans have access to crucial, free preventive care like cancer and heart disease screenings. Actions that strip away this decade-old protection are backwards and wrong. HHS is currently reviewing the decision and consulting with the Department of Justice on next steps in the litigation. We will do everything we can to protect and defend Americans’ rights to the healthcare they need and deserve." - Acting Assistant Secretary for the Public Affairs Kamara Jones
Senate Democrats: "This ruling is not only misguided, it is outright dangerous and could cost lives. Whether it is attacking laws like this, taking away a woman’s right to choose or trying to gut Medicaid, Republicans must stop their non-stop onslaught on Americans’ healthcare. I call for an immediate appeal and stay of this injunction, as well as call on insurers to publicly commit they will retain free preventive care.” - Majority Leader Chuck Schumer (D-N.Y.)
House Democrats: "Today, an extreme, right-wing judge in Texas struck down a key provision of the Affordable Care Act that requires insurance companies to cover lifesaving preventative care for free, such as mammograms, diabetes screenings and medication for heart disease. If upheld, this decision would massively disrupt our health care system, reduce access to care and raise costs for working families. Extreme MAGA Republicans have repeatedly failed in their decades-long effort to repeal the ACA. Once again, they’re forum shopping for activist judges who are willing to gut healthcare coverage for millions of Americans. House Democrats will continue to protect and strengthen the Affordable Care Act and combat extreme MAGA Republican attempts to roll back coverage and increase costs. We will never stop fighting to preserve the right to high-quality, affordable healthcare." - Minority Leader Hakeem Jeffries (D-N.Y.)
"This decision is based not on legal merit but rather steeped in partisan warfare on Americans’ access to care. For women, this means losing coverage of mammograms, postpartum mental health services, including breastfeeding support, and general preventative care needs." - Ways and Means Committee ranking member Richard Neal (D-Mass.)
“The Department of Justice should immediately move to appeal this reckless decision and have it stayed so that Americans do not lose access to care. I am also calling on all healthcare insurers to commit to continuing to cover all preventive services without cost-sharing while this case is litigated and until final disposition of the lawsuit. There is no excuse to eliminate consumer protections because of a meritless decision that I expect will rightfully be overturned on appeal. I will be following up with insurers for their commitments in writing." - Energy and Commerce Committee ranking member Frank Pallone (D-N.J.)
The National Association of Community Health Centers and House Speaker Kevin McCarthy (R-Calif.) did not respond to requests for comment. The Centers for Medicare and Medicaid Services and Senate Minority Leader Mitch McConnell (R-Ky.) did not provide comments.
Lauren Berryman contributed to this story.
Correction: A previous version of this story incorrectly named Rep. Richard Neal (D-Mass.) as chair of the House Ways and Means Committee and Rep. Frank Pallone (D-N.J.) as chair of the House Energy and Commerce Committee. The lawmakers are the ranking minority members of those panels.
