District court finds Affordable Care Act preventative healthcare provision unconstitutional

The United States District Court for the Northern District of Texas on March 30, 2023, issued a ruling in Braidwood Management v. Becerra striking down a provision of the Affordable Care Act (ACA) that requires private health insurance plans to cover preventative healthcare services without patient cost-sharing. 

Braidwood Management sued the U.S. Department of Health and Human Services (HHS) Secretary Xavier Becerra arguing that the ACA’s preventative services coverage mandates are unconstitutional because they violate the appointments clause of the U.S. Constitution by giving the U.S. Preventative Services Task Force (USPSTF) authority to make rules regarding coverage. The company further argued that the ACA’s requirements violate the Religious Freedom and Restoration Act (RFRA) by requiring the company to cover preventative services and medications that prevent HIV and other sexually transmitted diseases. 

Judge Reed O’Connor on September 7, 2022, issued the first ruling in Braidwood Management v. Becerra and held that ACA’s requirement that the company covers preventative services and medications that prevent sexually transmitted diseases violates the RFRA. Judge O’Connor later issued a March 2023 order vacating any federal agency action that has occurred since ACA’s passage to implement USPSTF-recommended preventative services published after March 23, 2010.

HHS appealed the case to the United States Court of Appeals for the Fifth Circuit on March 31, 2023. Becerra argued in a statement, “Efforts to strip away access to preventive health care are harmful and unacceptable.”

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