Crossroads Lab

Preventive health care will be free while challenge to Obamacare mandate proceeds

A man's hand holds a small blue pill next to a white prescription medication bottle. The bottle's lable says it contains the drug Truvada.
Truvada is one of the common drugs used to prevent HIV infection, Palm Springs, Calif., Thursday, February 21, 2019. A lawsuit filed by Tarrant County residents in 2020 is asking the courts to overturn a requirement that insurance companies cover the full cost of drugs like Truvada. Zoe Meyers/The Desert Sun

Health insurance companies will be required to continue paying for preventive services like screenings for cervical cancer and medication that prevents HIV infection, at least for now.

A lawsuit filed by North Texas residents in 2020 challenged a core provision of the Affordable Care Act, better known as Obamacare. The plaintiffs opposed the requirement that health insurers cover the full cost of preventive health care services, and said they opposed buying insurance plans that subsidized services like contraception, testing for sexually transmitted infections, and PrEP, the drug regimen that reduces the chance of an HIV infection.

In March, U.S. District Judge Reed O’Connor in Fort Worth sided with the plaintiffs, and ruled that part of the Affordable Care Act was unconstitutional. O’Connor’s ruling was nationwide and took effect immediately, meaning that insurance companies could legally have started charging co-payments from patients seeking routine health services.

The federal government appealed the case, and the Fifth Circuit Court of Appeals issued a stay to temporarily block the ruling from taking effect while the appeal proceeded. The court asked lawyers from both sides of the case to propose a compromise for the mandate until a final court decision is reached. On Monday, lawyers agreed to a deal.

The deal stipulates that, for now, O’Connor’s ruling will only apply to the plaintiffs in the case. The plaintiffs include multiple Tarrant County residents, a Tarrant County orthodontics office, and a company from the Houston area. The plaintiffs’ challenged the law initially because they were opposed on religious and moral grounds to health care services like birth control. The plaintiffs are “unwilling to purchase health insurance that subsidizes abortifacient contraception or PrEP drugs that encourage homosexual behavior and intravenous drug use,” according to the suit.

The Fifth Circuit Court of Appeals still has to approve the agreement. The court will likely rule on the case later this year.

The court case could have wide reaching effects if O’Connor’s original ruling is affirmed. When it was passed in 2010, the Affordable Care Act required insurance companies to pay the full cost of any health care considered to be “preventive.” O’Connor ruled the United States Preventive Service Task Force — one of the groups that determines what types of care are in fact preventive — didn’t have the authority to do so. His ruling did not invalidate the entire law, but rather focused on the health care recommendations the task force has made since 2010.

Ciara McCarthy
Fort Worth Star-Telegram
Ciara McCarthy covers health and wellness as part of the Star-Telegram’s Crossroads Lab. She came to Fort Worth after three years in Victoria, Texas, where she worked at the Victoria Advocate. Ciara is focused on equipping people and communities with information they need to make decisions about their lives and well-being. Please reach out with your questions about public health or the health care system. Email cmccarthy@star-telegram.com or call or text 817-203-4391.
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