Healthcare industry reacts to preventive care ruling

A court ruling to end the Affordable Care Act’s guarantee of no-cost access to preventive medical care triggered opposition from major healthcare 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, said 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 the ruling and request a stay while the case continues its way through the courts, she said.

Below are 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

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 Hospital Association: No comment.

Federation of American Hospitals: No comment.

America’s Essential Hospitals: No comment.

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 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

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: “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 Chair 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 Chair Frank Pallone (D-N.J.)

The National Association of Community Health Centers, the American Academy of Family Physicians and House Speaker Kevin McCarthy (R-Calif.) did not respond to requests for comment. The Health and Human Services Department, the Centers for Medicare and Medicaid Services, House Minority Leader Hakeem Jeffries (D-N.Y.) and Senate Minority Leader Mitch McConnell (R-Ky.) did not provide comments by press time.

Lauren Berryman contributed to this story.