By Brendan Pierson
(Reuters) – A mandate that U.S. health insurers cover preventative care like cancer screenings and HIV drugs at no extra cost to patients could stay in place while the Biden administration appeals an order by the Biden. court quashing it, following an agreement in principle announced on Friday.
The administration’s settlement with the conservative businesses and individuals who filed a lawsuit challenging the mandate is not yet final, according to a filing with the 5th U.S. Circuit Court of Appeals.
The agreement would preserve the nationwide mandate while appeals unfold, but allow the employer contesting the mandate, Texas-based Braidwood Management, to stop covering HIV pre-exposure prophylaxis (PrEP) and other preventive services without co-payment for its employees for now.
The company, which operates an alternative health center, would be immune from any retroactive application if the warrant were reinstated on appeal.
The Preventive Care Mandate, part of the Affordable Care Act (ACA), often referred to as Obamacare, covers services recommended by a federal task force.
Braidwood and the other plaintiffs sued specifically for HIV PrEP, which they said violated their religious beliefs by encouraging homosexuality and drug use.
In March, U.S. District Judge Reed O’Connor in Fort Worth, Texas, blocked the federal government from enforcing the warrant for a much broader range of services, finding the task force’s role under the ‘ACA violated the US Constitution.
If the task force’s recommendations automatically trigger coverage, he said, then it has enough power to have its members nominated by the president and confirmed by the US Senate.
The decision does not apply to services recommended by the task force before the ACA was enacted in 2010, including breast cancer screening.
More than 150 million people were eligible for free preventive care as of 2020 under the ACA, according to data from the US Department of Health and Human Services.
If O’Connor’s decision is not overturned on appeal, insurers will be able to charge patients co-payments and deductibles for these services in new insurance plans, most of which will begin next year.
The Biden administration has said O’Connor’s decision threatens public health. Major U.S. medical associations also weighed in against the decision.
O’Connor came to national attention in 2018 when he overturned the entire ACA, a decision that was later overturned.
(Reporting by Brendan Pierson in New York, editing by Alexia Garamfalvi and Bill Berkrot)