US Judge Strikes Down ACA Preventive Care Mandate

    US Judge Strikes Down ACA Preventive Care Mandate
    Last updated Mar 31, 2023
    Image credit: AFP/Getty Images [via Forbes]


    • A federal judge in Texas on Thursday struck down an Affordable Care Act (ACA) mandate requiring health insurance plans to cover preventive care, including screenings for certain cancers and pre-exposure prophylaxis against HIV (PrEP), at no cost to patients.
    • US District Judge Reed O’Connor sided with Christian-owned businesses and six individuals in a follow-up to a Sept. 7 partial ruling that stated requiring companies to cover PrEP pills violated the Religious Freedom Restoration Act.
    • O’Connor ruled that enforcing the recommendations was “unlawful” and a violation of the Constitution’s Appointment Clause. The coverage requirements are driven by recommendations by the US Preventive Services Task Force, which is made up of volunteers.
    • This ruling applies to recommended medication, screenings, and other forms of health care, including free mammograms and screenings for colon, cervical, lung cancer, and Type 2 diabetes, among others.
    • Pres. Biden’s administration will likely appeal, as the administration and more than 20 Democratic-led states urged O’Connor against the ruling.
    • Employers' religious objections have been the subject of many other past challenges to the ACA, including cases related to contraception.


    Democratic narrative

    This is a terrible decision that has jeopardized the health of millions of Americans by eliminating coverage requirements for vital preventive care. Screenings for various cancers and other diseases have saved lives and allowed millions of middle- and low-income Americans to receive necessary services; now, those services will be inaccessible.

    Republican narrative

    This ruling is legitimate both in terms of enforcing freedom of religion and in terms of the statute being unconstitutional. First, the mandate was recommended by a task force not directly appointed by the president. Second, the plaintiffs believe some of these drugs, particularly the ones related to HIV, encourage a lifestyle they can’t be forced to endorse on religious grounds. O'Connor is right.

    Nerd narrative

    There’s a 42% chance that the US federal government will pass legislation by 2040 to provide universal healthcare for American citizens, according to the Metaculus prediction community.

    Articles on this story

    Sign up to our newsletter!