Experts say a Supreme Court case set for Monday puts that free care guarantee at risk.
ObamaCare requires insurers to cover, without cost-sharing, more than 100 preventive health services recommended by an outside panel of experts called the U.S. Preventive Services Task Force (USPSTF).
The requirement extends coverage of evidence-based preventive services such as cancer screening, tobacco cessation, contraception and immunizations, without cost-sharing, to more than 150 million people each year.
Without the requirement, health plans and employers can pick and choose which preventive services they cover. Cost-sharing will likely deter patients — particularly those of limited means — from scheduling those procedures.
“We know that if costs are reintroduced, people just don't seek care,” said Eric Waskowicz, senior state policy manager at the advocacy group United States of Care. “And so I think we all have an interest in keeping no cost preventive care in place.”
The Supreme Court is expected to rule on the case in June.
“The minute that provision gets struck down … we will be back at the mercy of the insurance companies. They'll still get the same premium from you, but they'll offer less services,” said Leslie Dach, executive chair of the Democratic-aligned group Protect Our Care.
The lawsuit began in 2022 when a group of conservative Texas employers and individuals challenged the coverage requirement, arguing the task force’s members are not appointed by the president or confirmed by the Senate, yet its recommendations are binding.
Initially, a district court judge agreed with the plaintiffs and invalidated the entire task force. Last year, the 5th U.S. Circuit Court of Appeals sided with the employers but limited the decision to just the eight Texas companies involved in the case, rather than nationwide.
The Biden administration appealed. Then, in a surprising move, the Trump administration earlier this year said it will continue to defend the law.
But some legal experts said the arguments being presented by the Justice Department indicate a desire to give Health and Human Services (HHS) Secretary Robert F. Kennedy Jr. substantial control over an independent government task force.
The administration argues the HHS secretary has the ultimate say over both the recommendations and the individual members of the panel, meaning he can dismiss members or block recommendations he does not agree with.
Even if the court upholds the task force’s constitutionality, “the question will then be, will HHS follow the science and uphold the USPSTF recommendations, or will it take a different course? And that, obviously, is something that everyone will be watching very carefully,” said Andrew Pincus, a partner at Mayer Brown LLP.
Pincus filed a brief on behalf of the American Public Health Association, which argued that invalidating the mandate could increase the cost of preventive care and the cost of health care overall, as patients would delay treatment for preventable diseases and emergencies.
