No-Cost Preventive Services Are Now in Jeopardy. Here’s What You Need to Know.

by | Apr 7, 2023 | Health

When a federal judge in Texas declared unconstitutional a popular part of the Affordable Care Act that ensures no-cost preventive care for certain services, such as screening exams for conditions such as diabetes, hepatitis, and certain cancers, it left a lot of people with a lot of questions.

On the face of it, the March 30 decision could affect ACA and job-based insurance plans nationwide and a host of medical services now free for patients.

What does this mean, really, for people with insurance? Policy and legal experts say there are some unanswered questions and a whole lot of nuances.

First, some background. The case, the latest legal challenge to the ACA, was brought by several individuals and an employer in Texas who argued the law’s requirement of free preventive care is unconstitutional, and also contended that requiring coverage of HIV prevention treatment can violate employers’ religious rights.

U.S. District Judge Reed O’Connor agreed with some of their arguments, declaring unconstitutional one way the recommended tests are chosen, and agreeing that requiring employers to offer preexposure prophylaxis treatment for HIV, known as PrEP, violates the Religious Freedom Restoration Act. But O’Connor disagreed on other points that could have eliminated no-pay coverage for such things as contraceptives and vaccines.

Despite the ruling, nothing much is likely to change for enrollees in the short term, as insurers and employers are expected to be reluctant or even unable to immediately begin charging copayments or deductibles for the affected preventive care.

But as the case makes its way through the court system — both the Department of Justice and the plaintiffs have filed notices that they would appeal — here are four things to keep in mind:

1. A Lot Remains Uncertain

Because of the ACA, most insured people currently get preventive care that includes screening te …

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