The measure within the Affordable Care Act (ACA) that requires insurance companies to cover certain preventive care services with no cost-sharing has been restored for the time being after the two parties in the case over its legality struck a deal.
The Fifth Circuit Court of Appeals ordered the two parties to reach an agreement last week when discussing a potential stay of a lower court’s order that blocked the ACA preventive care provision on the basis that it violated a religious freedom law.
The March order from U.S. District Judge Reed O’Connor affected more than 100 preventive services like PrEP for HIV, as well as cancer screenings, prenatal services and mental health care.
O’Connor also ruled to invalidate the entire task force in charge recommending preventive services to be covered as its expert members are not appointed by the president or confirmed by the Senate, but its recommendations are still binding.
The plaintiffs in the case — who objected to covering PrEP as they argued it encouraged homosexual behavior that conflicted with their religious beliefs — acknowledged in court documents filed on Monday that the order vacating the ACA’s provision did not protect them from potential penalties if the initial decision is ultimately overturned.
One of the plaintiffs, Braidwood Management Inc., stated it was “unwilling to change” its current self-insured plan to exclude preventive care services required by the ACA until a final ruling has been made.
Plaintiffs argued last week that a stay of the lower court’s decision was unnecessary as insurers were unlikely to alter their coverage as long as the initial decision might be overturned. The majority of U.S. insurers had said as much following O’Connor’s decision.
Judges on the appeals court, however, took issue with having to predict how insurers might act.
As part of the agreement, the federal government agreed to not pursue penalties or enforcement action against the plaintiffs during the course of the appeal process if they find insurers who offer plans that exclude coverage for the preventive services required by the ACA.
