A federal appeals court in New Orleans has issued a ruling regarding certain federal health insurance requirements, specifically related to no-cost coverage for preventive care. The ruling, made by the 5th U.S. Circuit Court of Appeals, applies narrowly to eight employers who objected to providing coverage for preventive services such as HIV prep and certain cancer screenings.
The court's decision does not extend nationwide and does not impact the coverage of preventive services for most insurers. However, the ruling found that the coverage requirement for HIV prevention was adopted unconstitutionally due to procedural issues related to the body responsible for the recommendations.
The requirements in question were established under the Affordable Care Act, commonly known as Obamacare, and faced challenges based on religious and procedural grounds. Last year, a U.S. District Judge in Texas ruled that these requirements violated the Constitution.
While the ruling may affect the coverage of certain preventive services, including HIV preventatives, it does not eliminate all coverage options. Employers may choose to implement copays or deductibles to maintain access to these services, albeit not free of charge.
Some preventive care services, such as mammography and cervical cancer screening, will continue to be covered without out-of-pocket costs as they were recommended before the enactment of the health care law in 2010.
However, the court's decision leaves some issues unresolved, including the constitutionality of coverage requirements based on recommendations from other entities. The case will be sent back to a lower court for further review of these unresolved issues.
The U.S. Department of Health and Human Services has not yet provided a response to the recent court ruling.
