Medical groups sound off on ruling over preventive service coverage

Medical advocacy groups are criticizing a recent federal court ruling regarding challenges to the Affordable Care Act's (ACA) zero-cost coverage of preventive services mandate that could impact cancer screening.

The Fifth Circuit Court of Appeals on June 21 issued its ruling on Braidwood Management, Inc. et al. v. Xavier Becerra et al., stating that recommendations made by the U.S. Preventive Services Task Force (USPSTF) are unconstitutional, since they violate the Appointments Clause. However, the Fifth Circuit did not agree with the District Court Northern District of Texas’ decision in 2023 to apply the outcome nationwide, stating that this ruling should only apply to the parties in the case.

“The Fifth Circuit’s decision endangers access to vital, evidence-based services relied upon by 150 million Americans, including life-saving mammography screenings, our most effective tool for early breast cancer detection,” said Susan G. Komen President and CEO Paula Schneider in a statement.

The ruling challenges the portion of the ACA that provides preventive health services at no cost, such as mammography for breast cancer screening or CT scans for lung cancer screening. Plaintiffs in the case wanted the option to purchase health insurance that excludes or limits coverage of PrEP drugs, contraception, the HPV vaccine, and the screenings and behavioral counseling for STDs and drug use, citing a “mixture of religious and economic reasons.”

Advocacy groups say this ruling could have a ripple effect by impacting such services for millions of Americans.

“We cannot allow this ruling to reverse the significant strides we’ve made in saving lives through early detection and access to affordable health care. Lives depend on maintaining this progress," Schneider stated.

For the first time in the organization’s history, in 2023 Komen filed an amicus curiae (friend of the court) brief due to the potential impact on people who may need access to affordable breast cancer risk reduction and early detection.

“Komen is hopeful the U.S. Supreme Court will agree to hear an appeal to the Fifth Circuit’s ruling and overturn it so that anyone who requires preventive services can access them at no cost, improving outcomes for all Americans,” said Molly Guthrie, Komen's vice president of policy and advocacy. “This decision is too important to get wrong, and Komen is committed to doing everything it can to maintain affordable and accessible care for all.”

Several organizations on June 21 also came out with their own joint statement on the ruling. The organizations include the American Lung Association, AcademyHealth, the American Heart Association, Campaign for Tobacco-Free Kids, Families USA, GO2 for Lung Cancer, LUNGevity Foundation, Parents Against Vaping E-cigarettes, Public Citizen, Public Health Law Center, and Truth Initiative.

While the ruling is limited to the parties involved in Braidwood v. Becerra, the organizations stated that this could open the door for similar future legal challenges.

“Everyone must have easy access to essential and lifesaving preventive care," the organizations said in a joint statement. "As a result of the Affordable Care Act, an estimated 58 million women and 37 million children have access to preventive care in the form of well visits and prenatal care. And millions of people have access to USPSTF-recommended services including lung cancer screening, smoking cessation interventions, statins for cardiovascular disease, PrEP to prevent HIV, cervical cancer screening, colorectal cancer screening, depression screening in adults and children, and more."

The groups stated they will “continue to vigorously defend access to cost-free preventive care as this case continues to move through the legal system.”

USPSTF chair Wanda Nicholson, MD, in a statement to AuntMinnie.com, reasserted that the task force's recommendations are based solely on evidence from published studies rather than on any insurance-related considerations.

"Fundamentally, people across the country deserve the opportunity to receive these important preventive services that have been proven to help them live longer and healthier lives," Nicholson said.

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