Court keeps ACA preventive care mandate in place

A federal court kept the ACA preventive care mandate in place for now but raised questions about its constitutionality. 

The 5th U.S. Circuit Court of Appeals issued a decision in Braidwood Management v. Becerra on June 21. The judges called their decision a "mixed bag," and the case is likely to be litigated further. 

Braidwood Management, a Texas company, sued HHS in 2021. The company argued the requirement to cover preexposure prophylaxis, or PrEP, for HIV prevention violated the company's religious freedom. The appeals court ruled Braidwood Management cannot be compelled to pay for PrEP for its employees but reversed a lower court decision that prevented the federal government from enforcing requirements to cover preventive services. 

The ACA requires payers to cover more than 100 preventive health services with no copays. More than 100 million people use free preventive services each year. 

In March 2023, U.S. District Judge Reed O’Connor ruled that recommendations made by the U.S. Preventive services Task Force made after 2010 do not need to be complied with and blocked the federal government from enforcing its recommendations. HHS later struck a deal to preserve the mandate while the case was appealed. 

The appeals court agreed with Mr. O'Connor's ruling that because the members of the task force are not confirmed by the Senate, their authority to mandate coverage of services is unconstitutional. 

"We think it was error, however, for the district court to have also vacated all agency actions taken to enforce the preventive-care mandates and to universally enjoin the defendants from enforcing them," the judges wrote. 

The decision in the case will therefore apply only to Braidwood Management. The appeals court will send the issue of the authority of the task force back to a lower court to decide. 

Both the plaintiffs and the government are likely to be unhappy with the narrow ruling, legal experts told NBC News. 

The case is likely to make its way to the Supreme Court, NBC News reported. 

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