Justice Department seeks pause of Texas judge's ACA preventive care ruling

The Justice Department will seek an injunction to halt a Texas federal judge's ruling that struck down an ACA provision requiring insurance companies to provide coverage for preventive services, CNN reported April 11. 

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. The Biden administration appealed the ruling to the 5th Circuit Court of Appeals.

The Justice Department has not yet filed the motion requesting the stay and it is unclear whether it will first ask Mr. O'Connor — the typical route — or send the request to the appellate court, according to the report. 

Mr. O'Connor's 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, drugs, which prevent HIV infection. STI screenings and cancer screenings such as mammograms and cervical screenings would still be included for preventive coverage.

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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