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| 1 minute read

Are zero dollar "out-of-pocket" preventive health care services in jeopardy in Federal court?

If it is not already on your radar, keep your eyes on a case pending in the U.S. District Court for the Northern District of Texas. The case of Kelley v. Becerra is yet another dispute over provisions in the Patient Protection and Affordable Care Act (ACA). The plaintiffs in this class action lawsuit challenge the ACA Section 2713 mandate that group health plans and health insurers cover a long list of preventive health services like cancer screenings, immunizations and contraceptives without out-of-pocket, co-insurance and deductible costs to patients.  The ACA's list of preventive services include those offered by diagnostic imaging suppliers like breast and lung cancer screenings that have received a rating of ‘A’ or ‘B’ from the United States Preventive Services Task Force. Zero dollar out-of-pocket cost preventive services are also pegged to the recommendations of the Advisory Committee on Immunization Practices and the Health Resources and Services Administration, an agency within the Department of Health and Human Services.

In anticipation of an imminent ruling by the Federal judge in this case, the American Medical Association and multiple other medical societies, including the American College of Radiology, have issued a statement expressing their extreme concern about a potentially adverse ruling. They believe a ruling to strike down the Section 2713 mandate would "significantly jeopardize the coverage of preventive health care services for millions of Americans with private health insurance and reverse positive trends in patient health achieved by the early detection and treatment of diseases and other medical conditions."

Regardless of the ruling, expect this case to ultimately be heard by the justices of the Supreme Court of the United States.

Our patients cannot afford to lose this critical access to preventive health care services. Rolling back this access would reverse important progress and make it harder for physicians to diagnose and treat diseases and medical conditions that, if caught early, are significantly more manageable.


health care & life sciences, aca, preventive services