A federal judge for the U.S. District Court for the Northern District of Texas vacated nationally the Patient Protection and Affordable Care Act's (ACA's) preventive service insurance mandate for services recommended by the U.S Preventive Services Task Force. Section 2713 of the Patient Protection and Affordable Care Act has mandated 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.

In a ruling this week in Braidwood Management, Inc., et al. v. Xavier Becerra, et al. (formerly Kelley et al, v. Becerra, et al.) U.S. Judge Reed O'Connor enjoined requiring employers to provide coverage for these preventive health services, as well as for the HIV prevention drug PrEP.  The court, however, dismissed Braidwood Management Inc.’s contraceptive mandate claim.

Judge O’Connor ruled last September that because the members of the U.S. Preventive Services Task Force are not Senate confirmed, the task force is not constitutionally permitted to wield such authority to determine coverages subject to the ACA's mandate. But in his September ruling, O’Connor requested supplemental briefings from the parties as to whether the government should be entirely blocked from requiring health plans to cover services identified by the task force, or whether his decision should apply solely to the plaintiff, Braidwood. Despite amicus briefs from organizations like the American Cancer Society and the American Medical Association, he is imposing his injunction broadly.

As we wrote earlier here and here, Section 2713 of the ACA mandates 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 recommended by the USPSTF include many offered by diagnostic imaging suppliers, like breast and lung cancer screenings that have received a rating of ‘A’ or ‘B’ from that task force. 

We can expect the government to appeal. The impact of this decision could be catastrophic to the efforts to detect cancer early for millions of patients unless employers and health plans decide voluntarily to continue offering such preventive health services without out-of-pocket costs.