Will ACA preventive care coverage be protected? Court seeking compromise

On Friday, it was announced that a tentative agreement has been reached after a federal appeals court ordered both sides to reach a compromise on whether to lift the freeze on preventive health services under Obamacare.

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

The Biden administration is near a deal to preserve preventive care coverage for HIV prevention, cancer screenings and some other types of preventive care, in a tentative agreement announced on Friday. However, the agreement between the administration and conservative businesses and individuals that sued to challenge the mandate in the Braidwood Management v. Becerra case is not yet final, according to a filing with the 5th U.S. Circuit Court of Appeals in New Orleans.

At issue is a March ruling by a federal judge in Texas who ruled that some of the preventive care requirements under the ACA are unconstitutional. The decision jeopardized cost-free coverage for millions of Americans.

Last Tuesday, the court heard oral arguments over a Biden administration request that it pause the earlier decision during a lengthy appeals process. 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.

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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 Judge Reed O’Connor’s ruling in the U.S. District Court for the Northern District of Texas case is not frozen for the appeal. It is not clear that insurers would drop the no-cost coverage of the services in response to O’Connor’s ruling, said Attorney Jonathan Mitchell.

However, lawyers for the Biden administration stressed that they are not seeking to block enforcement protecting the plaintiffs in the case from requirements to provide preventive care, but they do want a stay that would keep the Texas judge’s ruling from applying nationwide while the appeals play out.

On Wednesday, federal appeals court judges told attorneys on both sides in the ACA preventive services case playing out in appeals court that they needed to report by Friday 5 p.m. on the possibility of a temporary compromise on the case.