December 19, 2022 – Healthcare providers reacted harshly to a U.S. District Court judge’s decision in September that shakes the foundation of one of the most popular aspects of the Affordable Care Act (aka Obamacare), that is, the responsibility of non-grandfathered group or individual market health plans to make available about a hundred preventive services to members with zero co-pay.
“If today’s ruling stands, it will jeopardize health outcomes by creating financial barriers to screenings, counseling and preventive medications that improve our patients’ health,” tweeted Sterling Ransone Jr., MD, FAAFP, then-president of the American Academy of Family Physicians.
Among the zero-co-pay services threatened are blood pressure screenings, cancer screening, cholesterol screening, screening for sexually transmitted infections and fall-prevention exercise interventions for some adults over 65. They are among the so-called “essential health benefits” associated with plans available through the Health Insurance Marketplace.
Issued by U.S. District Judge Reed O’Connor in Texas on Sept. 7, the decision in Braidwood Management v. Becerra (formerly Kelley v. Becerra) struck down the requirement for zero-co-pay coverage for certain preventive health recommendations issued by the U.S. Preventive Services Task Force. The reason? The USPSTF members are not properly appointed under the U.S. Constitution’s Appointments Clause, the judge ruled.
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