A federal judge in Texas struck down a crucial Affordable Care Act (ACA) policy Thursday that mandated that private health insurers fully cover preventive care services at no cost to patients.
The ruling applies nationwide and took effect immediately thereby affecting dozens of possibly lifesaving preventive health care services that include screenings for cancer, diabetes and mental health.
Free preventive care has been deemed by health experts as one of Obamacare’s most transformative policies because it essentially removed the financial barrier for the necessary care of tens of millions of Americans.
In 2023, Florida is once again leading the nation in enrollment for health insurance through the ACA.
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A record 3.2 million Floridians signed up for health insurance plans for 2023 offered through the federal marketplaces, according to data released Wednesday by the Centers for Medicare & Medicaid Services.
This figure is roughly 500,000 more than last year and nearly a million more than Texas which is the next highest state.
The new court ruling has already brought the ACA back into the political fray, with the Biden administration planning to appeal it.
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“This is not the potential fatal blow to the ACA like previous court cases, but it would limit a very popular benefit that tens of millions of people use,” said Larry Levitt, executive vice president for health policy at the Kaiser Family Foundation.
The decision comes more than four years after U.S. District Judge Reed O’Connor, a nominee of former President George W. Bush, ruled that the entire health care law also known as “Obamacare” was unconstitutional. The U.S. Supreme Court overturned that ruling.
Although most people will not see their benefits change from one day to the next, here's what consumers need to know about how ruling and how could it can affect them.
What health benefits are at stake due to the ruling?
By striking down this crucial ACA policy, the ruling states that insurers no longer have to provide free coverage for any care the United States Preventive Services Task Force has recommended since 2010.
Although the ruling impacts a broad spectrum of preventive care, it does not wipe out coverage for all preventive screenings. For instance, experts said the decision would not overturn coverage for preventive women’s health services that were approved outside the task force.
Some cancer screenings approved before 2010 would also not be affected, including screenings for cervical and colorectal cancer, said Alina Salganicoff, senior vice president and director for women’s health policy at the Kaiser foundation. But she said screenings for lung and skin cancer, which were more recently approved, could be affected.
The ruling would, however, affect a recommendation for PrEP, a daily pill that is highly effective at preventing the transmission of H.I.V.
Who is affected by the ruling?
The ruling could potentially affect not just people with Obamacare, but all Americans with private health coverage.
This means that approximately 150 million people will be affected, most of whom get their health benefits through their work.
The ruling, however, does not appear to affect people with public insurance such as Medicare or Medicaid.
Will the ruling immediately change my health insurance plan?
Health insurers could legally begin to apply co-payments and deductibles to the newer types of preventive health care, but health policy experts and insurance plans said they do not expect many consumers to feel any immediate changes to their benefits.
Why is this?
Typically, health plans have policies that last a full year, and it is rare for insurers to change benefits in the middle of a contract.
