Hospitals push for preservation of free preventive services

Hospital advocacy groups want to preserve a provision of the Affordable Care Act requiring health plans to cover some preventive services at no cost to patients.

Hospital advocacy groups have petitioned a federal appeals court to preserve a provision of the Affordable Care Act requiring health plans to cover some preventive services. (Image credit: ©vadim - stock.adobe.com)

The organizations filed a “friend-of-the-court” brief in response to a federal judge in Texas voiding the requirement nationwide as the legal battle continues. Many Americans take advantage of those screenings.

The American Hospital Association, Federation of American Hospitals, America’s Essential Hospitals, Catholic Health Association of the United States, and the Association of American Medical Colleges all came together for the court filing. President Biden's administration is appealing the decision.

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While the legal appeals continue, the hospital groups are urging the U.S. Court of Appeals for the 5th Circuit to reinstate the requirement to cover preventive services.

“A partial stay pending appeal is manifestly in the public interest,” the brief states. “Evidence-based preventive-care services free from political influence are essential to patient wellbeing and population health and lead to lower health care costs over the long term. Upending coverage of preventive-care services will increase the risk that acute illnesses or chronic diseases will not be timely detected or treated.

“Regardless of what this Court decides on the merits, reinstating the ACA’s preventive-care requirement down the road will not remedy the harms that Americans would suffer in the interim if a partial stay is not granted,” the brief states.

The hospital and healthcare organizations say that the court ruling could prevent people from getting screenings for cancer, heart disease, and mental health issues, among others.

On March 30, U.S. District Judge Reed O’Connor of the District Court for the Northern District of Texas struck down the Affordable Care Act provision covering preventive services. Several individuals and two businesses filed a challenge, arguing that covering medication to prevent HIV violated their religious beliefs. While the judge is based in Texas, his ruling is in effect nationwide.

In the court brief, the hospital groups argue that preventive services save lives and save money on healthcare costs.

“Preventive services requiring coverage without cost-sharing under the ACA benefit patients by enabling early detection, management, and treatment of chronic diseases and acute conditions, which can extend and improve patients’ lives,” the brief states. “The ACA’s covered preventive services also benefit the public as a whole by lowering costs for patients, providers, and insurers, leading to more affordable health care for all.”

About 100 million Americans with private insurance use those preventive services without having to spend their own money under the Affordable Care Act, the Kaiser Family Foundation projects.

O’Connor’s court ruling focuses on requirements driven by recommendations for coverage by the U.S. Preventive Services Task Force, an advisory panel which helps guide federal health policy. This week, the task force recommended that women begin screenings for breast cancer at the age of 40.

The hospital groups argue the requirement for preventive-care coverage ensures access to live-saving medications, including drugs that prevent HIV.

And the brief makes the point that many people won’t get screenings if they have to pay for them. Even for those with insurance, the out-of-pocket cost for a colonoscopy could be $1,000 or more if the patient’s deductible hasn’t been reached, the brief states.

“Access to preventive care without cost-sharing removed these barriers,” the brief states. “If they return, the risk that patients will skip necessary screenings because of cost is significant.”