A federal judge in Texas struck down a crucial Affordable Care Act (ACA) policy Thursday that required private health insurers to fully cover preventive care services at no cost to patients.
The decision applies nationwide and is effective immediately, affecting dozens of potentially life-saving preventive health services that include cancer, diabetes and mental health screenings.
Free preventive care is considered by health experts to be one of Obamacare’s most transformative policies, as it essentially removed the financial barrier to needed care for tens of millions of Americans.
In 2023, Florida again leads the nation in health insurance enrollment through the ACA.
A record 3.2 million Floridians signed up for 2023 health insurance plans offered through the federal marketplaces, according to data released Wednesday by the Centers for Medicare & Medicaid Services.
That figure is roughly 500,000 more than last year and nearly a million more than Texas, the next highest state.
The new court ruling has already thrown the ACA back into the political fray, with the Biden administration planning to appeal it.
“This is not the potential fatal blow to the ACA that previous lawsuits have been, 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 US Supreme Court overturned that decision.
While most people won’t see their benefits change from one day to the next, here’s what consumers should know about how it works and how it could affect them.
What health benefits are at stake due to the decision?
By eliminating this crucial ACA policy, the ruling states that insurers no longer have to provide free coverage for any care recommended by the United States Preventive Services Task Force in 2010.
Although the decision affects a wide range of preventive care, it does not eliminate coverage for all preventive examinations. For example, experts said the decision would not roll back coverage for preventive health services for women that are approved outside the task force.
Some cancer screenings approved before 2010 also would not be affected, including cervical and colorectal cancer screenings, said Alina Salganikoff, senior vice president and director of women’s health policy at the Kaiser Foundation. But she said lung and skin cancer screenings that were recently approved could be affected.
However, the decision would affect the recommendation for PrEP, a daily pill that is very effective at preventing the transmission of HIV
Who is affected by the decision?
The decision could potentially affect not only people with Obamacare, but all Americans with private health coverage.
This means that approximately 150 million people will be affected, most of whom receive their health benefits through their work.
However, the decision does not appear to affect people with public insurance such as Medicare or Medicaid.
Will the decision immediately change my health insurance plan?
Health insurers could legally begin applying copayments and deductibles to newer types of preventive health care, but health policy and insurance plan experts said they don’t expect many consumers to feel immediate changes to their benefits.
Why is that?
Health plans typically have policies that last a full year, and it’s rare for insurers to change benefits mid-term.