FORT WORTH, TX – Late last night, a coalition of America’s leading medical professional organizations representing hundreds of thousands of physicians and health care professionals, led by the American Medical Association (AMA) and represented by Democracy Forward, submitted a friend of the court brief urging the U.S. District Court for the Northern District of Texas not to eviscerate the Affordable Care Act’s (ACA) requirement that insurance plans cover recommended preventive care services without patient cost. As the brief explains, the research on preventive services is clear: no-cost preventive care – ranging from colonoscopies to mammograms – saves lives, saves money, improves health outcomes, and enables healthier lifestyles. The brief was filed in Braidwood Management v. Becerra.
Other groups joining the AMA in submitting the brief are the American College of Obstetricians and Gynecologists, the Society for Maternal-Fetal Medicine, the American Academy of Pediatrics, the American Medical Women’s Association, the American Academy of Family Physicians, National Medical Association, and the Infectious Diseases Society of America.
The coalition warns that gutting the ACA’s preventive care requirements will lead many of their patients, including many of the most vulnerable Americans, to turn down necessary services because of the very financial barriers the ACA seeks to remove. The brief also cites studies showing that the ACA reduced racial disparities in the utilization of the required services, and that “those who experience the greatest financial barriers to care appear to benefit the most from cost-sharing elimination.” Studies have found that the ACA’s enactment increased the rate of cancer screenings, increased the use of general wellness services, and improved utilization and health outcomes among populations that have been subjected to discrimination.
Because of the ACA, approximately 76 million individuals gained access to preventive care without cost-sharing and approximately 233 million individuals are currently enrolled in health plans that must cover preventive services without cost-sharing.
“There’s no two ways about it: gutting the ACA’s preventive care requirement would jeopardize the wellbeing of millions,” said Skye Perryman, President and CEO of Democracy Forward. “We urge the court to protect these requirements that have been in place under the law for ten years. The court should not leave doctors and other healthcare professionals in an untenable situation, struggling to encourage their patients to accept medically indicated services that will save lives while patients face a loss of coverage and are required to navigate a confusing insurance situation.”
Background on the case
The Affordable Care Act has been challenged in court by special interests a number of times since its enactment in 2010. The challenge in Braidwood Management v. Becerra was brought by several businesses and individuals that asked the court to rule that the ACA’s requirement that insurance plans cover at no out-of-pocket cost certain preventive services recommended by expert committees and a federal government agency is unconstitutional. They also asked the court to rule that the requirement to cover pre-exposure prophylaxis (PrEP), medication for HIV prevention, violates their religious rights.
On September 7, 2022, Judge Reed O’Connor ruled, among other things, that it was unconstitutional to require the vast majority of the country’s health plans to cover no-cost preventive services based on the United States Preventive Services Task Force’s recommendations. That Task Force is the entity responsible for making recommendations on health screenings and testing for myriad conditions and diseases. Judge O’Connor subsequently called for supplemental briefing on the terms and scope of an appropriate remedy; the coalition’s brief supports the government’s position on that issue.