Our Story and More

District Judge Rules Against the Affordable Care Act Again

You may have read that District Judge Reed O’Connor issued another ruling in March which concluded that the Affordable Care Act (ACA) requirement that most preventive services be covered without patient cost-sharing is unconstitutional. This is the same judge who in 2018 ruled the entire ACA unconstitutional which was subsequently overturned by the Supreme Court. With ACA-compliant coverage, many preventive services are covered by the plan premium. As a result, services like regular physical exams or screenings like mammograms, colonoscopies, and others are covered without respect to meeting the deductible and the patient has no copayment or coinsurance. This emphasis on preventive services is intended to encourage prevention and hopefully diagnose serious medical conditions early on.

Fortunately, most major insurance companies have decided to disregard this ruling as it winds its way through the courts. We applaud that decision for its common sense and decency. Almost everyone except those on Medicare are covered through ACA-compliant plans so it would be extremely disruptive to substantially change the benefit design for millions of Americans and to implement those changes to comply with this ruling.

The ruling appears to be based on a technical challenge about how members of the U.S. Preventive Services Task Force are appointed. This is the task force that recommends which preventive services should be covered by the premium itself. However, according to news reports, the opposition stems from a conservative activist’s opposition to a drug prescribed to prevent HIV infection.

We will keep our comments brief so as not to waste any more of our readers’ time. The Supreme Court first upheld the Affordable Care Act in 2012 so it seems Judge O’Connor’s ruling has little potential for success. We truly hope he finds some other life’s passion than opposing the Affordable Care Act. Although we normally applaud most efforts to reduce the cost of healthcare which is so burdensome to so many, this change would simply shift costs by lowering premiums and increasing out-of-pocket expenses at great administrative expense to the entire system. The priority should be to improve the ACA and our troubled healthcare system.