Status of freeze on ACA free preventive care ruling? An appeals court hears arguments

On Tuesday, an appeals court weighed lifting freeze on Affordable Care Act's preventive health services mandate nationwide in a case most likely headed to the Supreme Court.

U.S. Court of Appeals for the Fifth Circuit. Photo: Mike Scarcella/ALM

A judicial ruling that would nullify a mandate requiring certain preventive services under the Affordable Care Act continues to wind its way through the federal court system. On Tuesday, the 5th U.S. Circuit Court of Appeals in New Orleans heard oral arguments over a Biden administration request that it pause the earlier decision. The ruling from U.S. District Judge Reed O’Connor is on hold under an administrative stay while the appeals court considers whether it should be frozen long-term while the appeal of the case plays out. A ruling could come as soon as this week, say legal experts.

In the Tuesday hearing, a Justice Department attorney argued that if O’Connor’s ruling were allowed to take full effect, it would cause “enormous harms” to the 150 million people whose insurance plans may be affected if their insurers end the no-cost coverage of the services in question.

“These preventive services are meant to be gotten early so that you detect … cancer and prevent heart attacks and strokes and … all of these things,” attorney Alisa Klein said. “The reason Congress said, ‘you’ve got to cover all these services without cost sharing’ is to get people to get them in a timely fashion so they don’t get the disease at a point where their survival rates are much lower.”

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The lawyer for the businesses and individuals challenging the ACA mandate argued that the administration is overplaying the harms that would occur if O’Connor’s ruling is not frozen for the appeal. Attorney Jonathan Mitchell said it is not clear that insurers would drop the no-cost coverage of the services in response to O’Connor’s ruling.

Multiple judges on the panel wondered whether the Justice Department and the plaintiffs could come to some agreement for how the court could issue an order that narrows the scope of O’Connor’s ruling so it would focus on how the mandates were affecting the individuals and business that brought the lawsuit.

“It would help us with whatever we may do on this, if we have the understanding that both of you have of this case — more than we can, in our exposure to it – of what is the best thing to do, if we are going to stay anything,” Circuit Judge Leslie Southwick said. “To have your collective agreement as to what that is would be very helpful — or your collective near-agreement.”