Key TakeawaysA judge in Texas has invalidated no cost coverage of preventive health services under the Affordable Care Act.The Justice Department is expected to appeal the decision and ask for a stay on its implementation while the case goes through the courts.About 100 million people use various preventive services each year in the United States. Screenings such as imaging tests for lung cancer, which is one of the covered services, is credited with saving lives.

Key Takeaways

A judge in Texas has invalidated no cost coverage of preventive health services under the Affordable Care Act.The Justice Department is expected to appeal the decision and ask for a stay on its implementation while the case goes through the courts.About 100 million people use various preventive services each year in the United States. Screenings such as imaging tests for lung cancer, which is one of the covered services, is credited with saving lives.

A federal judge in Texas has overturned a very popular part of the Affordable Care Act (ACA): free coverage ofmany preventive healthcare services.

The U.S. Department of Justice is likely to ask for a hold on the judge’s ruling while the case is appealed, which would keep coverage of services in place as the case winds its way through the courts. For now, though, there’s a great deal of confusion among patients, and concern among doctors, who worry patients will stop getting needed preventive services.

“A critical section of the Affordable Care Act required insurers and health plans to cover dozens of preventive health services with no cost to patients…for the early detection of potentially fatal medical conditions, including cancer, hypertension, diabetes, and sexually-transmitted infections,” Resneck said. “Invalidating this provision jeopardizes tools physicians use every day to improve the health of our patients.”

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It’s not just coverage through federally-funded marketplace plans, like Obamacare, that are at stake. Most private health plans do not require any payment—including copays or deductibles—for preventive servicesbecauseof the ACA requirement. Without that requirement, things may change for nearly everyone.

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Experts don’t think there will be an immediate effect of the ruling because the Justice Department will step in for now.

“It’s [likely] that the administration will immediately appeal this…and will be asking for a stay,” saidLaurie Sobel,associate director for Women’s Health Policy at the Kaiser Family Foundation. “We’ll have to see how the litigation plays out to see when anything could take effect.”

It’s also unlikely that insurers will end coverage of preventive services or start charging copays anytime soon, because most insurance contracts are annual ones and run through the end of December 2023,Natalie Davis,CEO of bipartisan health insurance advocacy group United States of Care, told Verywell.

That means that many insurance firms can’t change provisions for insurance beneficiaries yet. It also buys time for several protective measures to possibly happen:

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Don’t Cancel Medical Appointments

There’s likely to be news in the next few days about any effects of the ruling. In the meantime, if you’re scheduled for a health exam, don’t cancel.

“I would advise people to contact their insurer directly and clarify with them about the cost,” Leana Wen, MD, an emergency physician and a professor of health policy and management at George Washington University, told Verywell. “The company should state that preventive services are still covered. Call first and confirm, then ask for this information in writing if you want to be extra certain. The key is not to delay; so many people have postponed cancer screenings and other routine checkups due to COVID-19, and they should not put off care that could detect problems early.”

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What This Means For You

1 SourceVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Kaiser Family Foundation.Q&A: implications of the ruling on the ACA’s preventive services requirement.

1 Source

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Kaiser Family Foundation.Q&A: implications of the ruling on the ACA’s preventive services requirement.

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

Kaiser Family Foundation.Q&A: implications of the ruling on the ACA’s preventive services requirement.

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