Appeals Court Continues Freeze on Lower Court’s Ruling Striking Down Affordable Care Act Provision

By Consumers for Quality Care, on June 21, 2023

The U.S. Court of Appeals for the Fifth Circuit in New Orleans has maintained its partial “stay,” or freeze, on a lower-court ruling that struck down nationwide the free, preventive health care services mandated by the Affordable Care Act (ACA), according to Axios.

Under the ACA, insurers must cover preventative health services recommended by the U.S. Preventative Services Task Force. Last month, however, a federal trial court judge deemed the task force’s recommendations invalid, calling the process by which its members are appointed unconstitutional.

The judge’s ruling, had it taken effect, would have jeopardized preventative services for more than 150 million consumers nationwide. Thankfully, the 5th Circuit Court of Appeals stayed the judge’s ruling almost immediately and then on Tuesday maintained that stay after an agreement was reached between the litigants. The stay allows the trial judge’s ruling to take effect for consumers whose healthcare is provided by the plaintiffs while still protecting preventative services for consumers nationwide, at least until all appeals regarding the stay are finally resolved by the 5th Circuit likely later this year.

Late last month, against the backdrop of this high-stakes legal wrangling, a new study was released by Peterson-KFF finding that health care consumers – up to 10 million of them – would face higher out-of-pocket costs if the preventive care mandate were to be struck down.

The researchers concluded, “If the Fifth Circuit Court stay is lifted and the district court’s decision is affirmed by a higher court, insurers would be allowed to introduce cost-sharing for any of the affected preventive services and drugs or exclude coverage altogether, though the latter appears to be the less likely scenario.”

A previous Peterson-KFF study found that 60 percent of consumers with private insurance use some preventive care afforded to them through the ACA, a finding that shows how important these provisions are for millions of consumers.  

CQC spoke out against the original ruling back in March, applauding the Fifth Circuit’s ruling and expressing optimism that the preventive services provision of the Affordable Care Act will remain. CQC will continue working to ensure consumers have access to affordable, quality care, including preventive health care.