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Federal judge slaps down Obamacare preventive health mandates

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WASHINGTON – A federal judge in Texas blocked enforcement Thursday of preventative health care mandates included in the Affordable Care Act, setting up the latest legal brawl over Obamacare and threatening to curb free access to HIV-prevention pills, screenings for cancer and other services.  

U.S. District Judge Reed O’Connor ruled that preventative requirements set by a federal taskforce violated the law because the members of the panel had not been appointed by the president and confirmed the Senate. More than 150 million benefit from the coverage, according to government estimates.

The decision will almost certainly be appealed and may eventually wind its way to the Supreme Court.      

The decision Thursday was not a surprise: O’Connor ruled against the preventative mandates on the merits last fall but until now had left the practical result of his decision unresolved. O’Connor has repeatedly found violations in the Affordable Care Act, including a decision in 2018 that the law’s coverage mandate was unconstitutional. That ruling was overturned by the Supreme Court in 2021.

What did Judge Reed O’Connor rule in the latest Obamacare case? 

  • The U.S. District Court imposed a nationwide prohibition on the requirement that insurers cover certain preventative services. Those mandates were challenged by Texas businesses who said the requirements violated their religious beliefs. 
  • O’Connor, who was nominated by former President George W. Bush, said that the Preventive Services Task Force that created those recommendation was not appointed legally so its recommendations were invalid. Those recommendations led to no-cost access to screenings for breast cancer, cervical cancer and diabetes, among other things.   
  • The Biden administration is likely to appeal the decision and O’Connor’s ruling may be placed on hold while that appeals process unfolds. The Justice Department did not immediately respond to questions about a possible appeal. 

What is the preventative care at issue in the case? 

The business owners who filed the suit had objected, on religious grounds, to coverage of contraception as well as screenings for sexually transmitted diseases. But the Preventive Services Task Force has included many other procedures and treatments in the list of preventive care that insurers must cover at no additional cost, including screenings for diabetes and cancer. 

Another major issue in the case was a debate over drugs that prevent the transmission of HIV, known as PrEP drugs. PrEP, short for pre-exposure prophylaxis, is a drug that reduces the likelihood of HIV infection during exposure.

Gay, bisexual and other men who have sex with men, as well as transgender women who have sex with men are among the groups at highest risk for HIV infection, according to the U.S. Department of Health & Human Services. Black and Hispanic Americans are disproportionately affected by the virus.

Contributing: Cady Stanton

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