Biden administration appeals Texas court decision striking down free Obamacare coverage of preventive care

Members of the media ask questions to U.S. President Joe Biden as he walks to the Marine One helicopter to depart for travel to Mississippi to view tornado damage, from the White House in Washington, U.S., March 31, 2023. 

Jonathan Ernst | Reuters

The Biden administration on Friday appealed a Texas federal judge’s decision to strike down free Obamacare coverage of preventive health-care services ranging from screenings for certain cancers and diabetes to HIV prevention drugs.

U.S. Judge Reed O’Connor of the U.S. Northern District Court of Texas on Thursday struck down an Obamacare mandate requiring most private insurance plans to cover certain types of health care recommended an independent panel of experts called the Preventive Services Task Force.

“Preventive care is an essential part of health care: it saves lives, saves families money, and improves our nation’s health,” said Kamara Jones, a Health and Human Services spokesperson, on Thursday evening after the judge’s ruling. “Actions that strip away this decade-old protection are backwards and wrong.” 

The case will now go to U.S. Fifth Circuit Court of Appeals. A majority of the judges on that court were appointed by Republican presidents.

HHS estimates that 150 million Americans benefited from the free screenings, counseling, medications and other forms of health care that prevent disease under the Obamacare requirements.

The judge’s ruling has created confusion about which preventive services are still covered and which are not due to the way the court order was written. But Lawrence Gostin, an expert on health law at Georgetown University, said the ruling clearly puts free coverage of the vast majority of preventive services listed below at risk.

Here is a list of the preventive health services that the judge’s ruling likely applies to

Gostin said most private insurance plans will probably continue to cover these services but charge copays and deductibles. Working class Americans will get hit the hardest and might forgo essential health care because they can’t afford the cost, Gostin said.

O’Connor ruled that Obamacare cannot mandate free coverage of health care recommended by the Preventive Services Task Force because the organization’s members were appointed in an illegal manner. O’Connor tried to strike down Obamacare in its entirety in 2018, but the Supreme Court overruled him.

Two business owners and several individuals sued the U.S. in March 2020 over the preventive health services mandate, arguing that buying insurance that covers drugs that prevent HIV infection violates their Christian religious beliefs.

The plaintiffs claimed in their suit that the mandate to cover HIV prevention drugs “forces religious employers to provide coverage for drugs that facilitate and encourage homosexual behavior, prostitution, sexual promiscuity, and intravenous drug use.”

They also argued the Preventive Services Task Force was appointed in an unconstitutional manner and therefore its recommendations cannot serve as the basis of an Obamacare mandate.

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