Biden appeals Texas ruling tossing range of preventive care coverage under ACA

The Biden administration appealed a federal Texas judge's ruling that struck down an ACA provision that requires insurance companies to provide coverage for preventive services such as certain cancer screenings and HIV prevention drugs, CNBC reported March 31.

U.S. District Judge Reed O'Connor said in his March 30 ruling that preventive care recommendations made by the U.S. Preventive Services Task Force do not need to be complied with and blocked the federal government from enforcing its recommendations. 

"Preventive care is an essential part of health care: it saves lives, saves families money, and improves our nation's health," an HHS spokesperson said, according to the report. "Actions that strip away this decade-old protection are backwards and wrong." 

The case will go before the 5th Circuit Court of Appeals. 

The new ruling only applies to task force recommendations made by the panel on or after March 23, 2010 (when the ACA became law), such as statins, lung and skin cancer screenings, and preexposure prophylaxis, or PrEP, an HIV prevention drug. STI screenings and cancer screenings such as mammograms and cervical screenings would still be included for preventive coverage.

It's likely that most insurers will still cover preventive services, but they may raise cost-sharing for members for certain services, according to the Kaiser Family Foundation. An increase in costs will not happen immediately because of current contracts, but that could change in the next calendar year. For PrEP specifically, there could be substantial cost-sharing. Generic PrEP costs around $360 a year, while branded prescriptions can reach upward of $20,000 annually.

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