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Supreme Court to Hear Case Threatening ACA’s No-Cost Preventive Care
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A pivotal case with important health and financial implications for millions of Americans is heading to the U.S. Supreme Court. In April, the justices will hear arguments in Kennedy v. Braidwood Management, a case challenging the constitutionality of the Affordable Care Act’s (ACA) requirement that insurers cover preventive care services without any out-of-pocket costs for patients. The outcome could reshape healthcare access across the nation, impacting everything from cancer screenings to vaccinations.
The Stakes: Access to Preventive Care in Jeopardy
At the heart of the matter is section 2713 of the ACA, a provision that has enabled hundreds of millions of Americans to obtain health insurance that covers a wide range of recommended preventive services. These services include not only contraceptives but also crucial interventions like the human papillomavirus (HPV) vaccine, pre-exposure prophylaxis (PrEP) for HIV prevention, and counseling for sexually transmitted diseases and substance use. The potential loss of these services could have devastating consequences for public health.
The Center for Value Based Insurance Design (V-BID) at the University of Michigan warns that if the Supreme Court deems the ACA’s no-cost preventive care provision unconstitutional, Americans may face the tough choice of paying for these services themselves or forgoing them altogether. This potential shift could have far-reaching consequences for public health, especially for vulnerable populations.
The V-BID center emphasizes the disproportionate impact this ruling could have on vulnerable populations. For low-income Americans, as well as Black, Latino, Asian American, Pacific Islander, and American Indian/Alaska Native communities, financial barriers to care are already significant.Eliminating no-cost preventive care could exacerbate existing health disparities and lead to a decline in overall health outcomes.
For journalists, the case of Kennedy v.Braidwood Management has the potential to cause millions of Americans to avoid preventive-care services, especially those who have financial barriers to care, such as low-income Americans, Black people, Latino people, Asian American people, and Pacific Islander and American Indian/Alaska Native populations.
Center for Value Based Insurance Design (V-BID) at the University of Michigan
The potential consequences extend beyond individual health. The V-BID center cautions that if Americans avoid preventive care due to cost, health outcomes will decline, and racial disparities will rise. This could reverse years of progress made in reducing health inequities.
The Legal Battle: Kennedy v. Braidwood Management
The Supreme Court officially announced on Feb. 24 that it would hear arguments in Kennedy v. Braidwood Management on April 21. The case was previously known as Braidwood Management versus Becerra, reflecting the change in the Secretary of Health and Human Services (HHS).
Adding another layer to the legal complexities, the Department of Justice (DOJ) filed a brief on Feb. 18, signaling its intention to defend the ACA requirement that insurers cover certain preventive services without cost-sharing. Alice Miranda Ollstein reported this progress for PoliticoPro.
The DOJ’s brief raises a critical legal question: Are members of the U.S. Preventive Services Task Force (USPSTF) validly appointed as “inferior officers,” or should they be considered principal officers requiring presidential appointment and Senate confirmation? The DOJ argues that Task Force members are indeed inferior officers as the Secretary of HHS retains ultimate authority over whether Task Force recommendations become legally binding on insurance issuers and group health plans.
The answer is straightforward: Task force members are inferior officers, because the Secretary of HHS — a quintessential principal officer — remains responsible for final decisions about whether Task Force recommendations will be legally binding on insurance issuers and group health plans.
Department of Justice Brief
The brief further emphasizes the secretary’s power to influence the Task Force’s work, noting that the Secretary can order studies, remove non-compliant members, delay or ignore recommendations, or even prevent them from being released. ollstein notes that if the arguments against the Task Force’s constitutionality prevail, preventive care coverage could remain, but the criteria for what qualifies as preventive care would become uncertain.
Why This Case Matters: Religious Objections and Preventive Services
Braidwood Management, a private company based in Katy, Texas, claims religious objections to Section 2713 of the ACA. This section is widely considered one of the law’s most popular provisions, providing essential healthcare access to millions.
The preventive services at risk extend beyond contraception. They include behavioral counseling, immunizations, and screenings for cancer, diabetes, and hypertension, according to the V-BID center. Section 2713 has demonstrably increased the use of preventive services, improved health outcomes, and reduced racial disparities in access to care for millions of Americans.
Attorneys general from 21 states and the District of columbia filed a friend-of-the-court brief on Feb. 25, echoing the importance of Section 2713. They highlighted that before the ACA, many insurers charged women higher rates and excluded numerous women’s health services from coverage.
The Scope of Impact: Millions Affected
Section 2713 of the ACA mandates that employers and nearly all private health plans (excluding those grandfathered under the ACA) cover more than 50 preventive services at no cost. This includes services with an “A” or “B” rating from the Preventive Services Task Force.
Preventive services are also recommended by the CDC’s Advisory Committee on Immunization Practices and the federal Health Resources and Services Management, which focuses on preventive care and screenings for women and children, according to a 2023 Health Affairs article.
While many reports cite an estimate of 150 million Americans benefiting from no-cost
ACA’s Preventive Care Mandate on the Supreme Court Docket: A Looming Healthcare Crisis?
will the Supreme court’s decision in Kennedy v. Braidwood Management dismantle a cornerstone of the Affordable Care Act, leaving millions without access to vital preventive services?
Interviewer (World-Today-News.com): Dr. Anya Sharma, a leading healthcare policy expert and professor at Harvard University’s School of Public Health, welcome to World Today News. The Supreme Court is poised to hear a case that could dramatically alter access to preventive care under the Affordable Care Act. Can you explain the meaning of Kennedy v. Braidwood management for our readers?
Dr. Sharma: Thank you for having me. The Kennedy v. Braidwood management case represents a important threat to a crucial aspect of the Affordable Care Act – the mandate for no-cost preventive services. This provision,Section 2713,has ensured access to a wide range of essential preventative services,from cancer screenings and vaccinations to crucial health counseling for millions of Americans. A ruling against this mandate would fundamentally reshape the American healthcare landscape,perhaps jeopardizing the health and well-being of millions. The core issue is the legal challenge to the authority of the U.S.Preventive Services Task Force (USPSTF) to determine which services qualify for this no-cost coverage.
Interviewer: Many people aren’t entirely clear on what preventive care actually encompasses. Could you elaborate on the services potentially affected by this Supreme Court decision?
Dr. Sharma: Absolutely. Preventive care under the ACA extends well beyond simply annual check-ups. We’re talking about a broad range of services deemed essential to preventing illness and promoting health. This includes:
Immunizations: Vaccinations against diseases like influenza, measles, HPV, and more.
Cancer Screenings: Mammograms, colonoscopies, pap smears – crucial tools for early detection and treatment.
Chronic Disease Management: Regular checkups and management plans for conditions like diabetes and hypertension.
Behavioral Counseling: Services focused on mental health, substance use disorders, and other concerning behaviors.
Preventive medications: such as PrEP for HIV prevention.
These are just some examples. The potential loss of no-cost access to these vitally vital services would disproportionately impact vulnerable populations and significantly impact public health outcomes.
Interviewer: You mentioned the disproportionate impact on vulnerable populations. Could you unpack that further?
Dr.Sharma: The elimination of no-cost preventive care would exacerbate existing healthcare disparities. Low-income individuals, as well as racial and ethnic minority groups (including black, Latino, Asian American, Pacific Islander, and American Indian/alaska Native communities), already face significant financial barriers to accessing healthcare. For these communities, the added cost of preventive services could mean forgoing these services entirely, leading to poorer health outcomes and wider health equity gaps. This isn’t just about affordability; it’s about access to care, and the potential for even greater health inequities. This risk is highlighted in reports from organizations like the Center for Value Based Insurance Design (V-BID) who have done crucial work on the financial barrier analysis relating to health access.
Interviewer: The DOJ has defended the ACA mandate. What is the central legal argument in this case?
Dr. Sharma: the central question before the Court revolves around the appointment of members of the USPSTF. The DOJ argues that these members are considered “inferior officers,” meaning their appointment process doesn’t require Senate confirmation.However, the opposing argument challenges this classification, arguing they should be considered “principal officers” needing presidential appointment and Senate approval. The constitutionality of the USPSTF’s authority to determine covered preventative services is fundamentally at stake. The outcome will significantly affect the way we regulate healthcare at a national and state level.If the court rules against the USPSTF’s authority, we could see significant uncertainty around which services are covered under the preventive care mandate, potentially impacting the availability and access to a multitude of health services.
Interviewer: What are the long-term implications of a ruling against the ACA’s no-cost preventive care mandate?
Dr. Sharma: The long-term consequences of losing this mandate are severe. We could see a rise in preventable diseases,increased healthcare costs down the line due to delayed treatments of more serious conditions,and a regression in addressing health inequities. The potential impact on public health could be profound and long-lasting. This isn’t just about the immediate cost of services; it’s about preventing future, more expensive health problems. The cumulative effect of millions of people forgoing preventive care will likely impose a substantial burden on the healthcare system as a whole. It’s a critical area, and one that needs to be thoroughly evaluated.
Interviewer: What is your overall perspective on the potential outcome of this case, and what message would you like to leave our readers?
Dr. Sharma: The Kennedy v. Braidwood Management* case is of paramount importance to the future of American healthcare. The potential ramifications far outweigh the immediate legal dispute. We need to pay close attention to this case and advocate for policies that ensure access to affordable,quality preventive care for all Americans. This is essential not only for individuals’ well-being but for the preservation of a truly equitable and robust public health system overall.We need to engage in the conversation to safeguard access to critical preventative care and strive towards equitable health opportunities. I urge readers to share their thoughts on this very important issue, and to contact their legislators to let their opinions be known.