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Latest Republican Attack on the ACA Targets Lifesaving Preventive Care That 150 Million Americans Rely On

Yesterday, U.S. District Judge Reed O’Connor struck down a major provision of the Affordable Care Act (ACA) that requires no cost coverage of lifesaving preventive health care services. Braidwood Management v. Becerra is the latest effort by ACA opponents and Republicans to use the courts to dismantle American health care. News coverage and reactions from lawmakers make clear that ending guaranteed free preventive care will disrupt health care for millions of patients, blocking access to lifesaving care. 

Elected Officials

Majority Leader Senator Chuck Schumer: “Yet again, a Republican activist judge has issued a ruling based on MAGA ideology and not the law, that would decimate our healthcare system and is opposed by a vast majority of Americans… Whether it is attacking laws like this, taking away a woman’s right to choose or trying to gut Medicaid, Republicans must stop their non-stop onslaught on Americans’ health care.” [Senator Chuck Shumer, 3/30/23]

Former Speaker of the House Nancy Pelosi: “Today, a GOP-appointed federal judge ruled to eliminate free, life-saving preventative health care – like cancer screenings and immunizations – guaranteed by the ACA. Every day, MAGA Republicans prove that they will stop at nothing to rip away health care from America’s families.” [@SpeakerPelosi, 3/30/23]

Majority Whip Senator Dick Durbin: “A district judge in Texas just issued an extreme ruling blocking free insurance coverage for preventive health care. Under threat? Cancer screenings, mental health checks, colonoscopies, mammograms… the list goes on. It’s Republicans’ latest ploy to strip away health care.” [@SenatorDurbin, 3/30/23]

Vice Chair of Conference Senator Elizabeth Warren: “This decision will prevent millions from receiving free preventive health services—from cancer screenings to medication preventing HIV. The ruling, issued by a single, Republican-appointed judge, threatens access to life-saving services & will cost lives.” [@SenWarren, 3/31/23]

President Pro Tempore Senator Patty Murray: “This is a downright dangerous decision. More than a decade after we passed the ACA, Republican interests are still working around-the-clock to roll back critical protections for patients.” [The Washington Post, 3/30/23]

Chairman of the Committee on Finance Senator Ron Wyden: “The only thing this ruling [Braidwood v. Becerra] will achieve is making Americans sicker. Shameful.” [@RonWyden, 3/30/23]

Ranking Member of Energy and Commerce Committee Representative Frank Pallone: “This decision striking down the ACA’s preventive services coverage requirement imperils access to lifesaving care including mammograms, lung cancer and skin cancer screenings, screenings for pregnant women and newborns, and PrEP.” [@FrankPallone, 3/30/23]

Ranking Member of Ways and Means Committee Representative Richard Neal: “Over the last 13 years, Americans have come to rely on the ACA’s life- and cost-saving care while Republicans attempt to make people sicker and poorer every chance they get. Yet again, a judicial activist, despite a failed track record, is redefining health care law and taking our country backward. While courts across the country have reaffirmed the ACA time and time again, this decision is based not on legal merit but rather steeped in partisan warfare on Americans’ access to care.” [Rep. Richard Neal, 3/30/23]

Ranking Member on Health Subcommittee Representative Anna Eshoo: “This ruling is another example of the Republican 13-year war against the Affordable Care Act that puts politics ahead of the lives of children, pregnant women, and adults. Fortunately for many of my constituents, California law requires individual insurance to cover preventive care. Insurers have the money to continue to cover these lifesaving services at no cost. I call on insurance companies to continue to do so, despite what one judge in Texas says.” [Rep. Anna Eshoo, 3/30/23]

Headlines

Axios: Obamacare Ruling Gives Democrats New Political Ammo. “It’s unclear how insurers would respond should the decision be upheld by higher courts, but even the threat of new patient costs for some cancer screenings, statins for heart disease or HIV prevention drugs presents an opportunity to rail on Republican extremism… All of this takes place against a backdrop of sustained messaging from Democrats and the White House about Republican attempts to cut Medicare, Medicaid and Social Security, even though the GOP hasn’t formally proposed any such cuts this Congress.The ruling puts Democrats in a familiar and comfortable position and will likely force Republicans to once again answer for a politically unpopular court decision.” [Axios, 3/31/23]

The Washington Post: Texas Judge Invalidates ACA Promise Of Free Preventive Health Services. “With the mandate gone, at least for now, it will be up to insurers and employers to choose whether to continue the coverage of various forms of preventive care or to save money by charging patients part of their cost… “It’s going to exacerbate all the leading causes of death in this country,” said Georges C. Benjamin, executive director of the American Public Health Association. “In a nation that has enormous health inequities, it is going to disadvantage communities of color…” Critics of the ruling predicted that while the Biden administration seeks to overturn O’Connor’s decision on appeal, the plaintiffs were likely to try to broaden it to cover contraception and other services that are spared for now.” [The Washington Post, 3/30/23]

The New York Times: Judge Strikes Down Critical ACA Preventive Care Mandate. “The decision, by Judge Reed O’Connor of the Federal District Court for the Northern District of Texas, applies nationwide. If it stands, it could have far-reaching implications for millions of Americans, bringing the United States back to the days before the 2010 health law known as Obamacare, when insurers were free to decide which preventive services they would cover. The ruling, which is in the form of a nationwide injunction, takes effect immediately, said Lawrence O. Gostin, an expert on health policy at Georgetown University who has followed the case.” [The New York Times, 3/30/23]

Stat: Key Provision in the ACA Overturned by District Judge. “It [The Braidwood v. Becerra ruling] also leaves the door open for insurers to refuse coverage of statins, drugs preventing HIV transmission known as PrEP, and a vast range of health screenings recommended by federal officials. It could also eventually threaten the Biden administration’s efforts to lower maternal and infant mortality rates and bolster reproductive rights in the wake of Roe’s overturn. The lawsuit was brought by Braidwood Management, which represents a handful of Christian-owned businesses in Texas who argued they should not be required to cover birth control and PreP.” [Stat, 3/30/23]

Reuters: U.S. Judge Blocks Obamacare Coverage Mandate For Some Cancer Screenings, PrEP. “More than 150 million people were eligible for preventive care free of charge as of 2020 under the ACA, according to data from the U.S. Department of Health and Human Services. If O’Connor’s ruling is not paused or overturned on appeal, insurers will be able to charge patients copays and deductibles for such services in new insurance plans… Major medical groups criticized the decision… Lisa Lacasse, president of the American Cancer Society Cancer Action Network, said the ruling could have ‘huge implications’ and make it more difficult to catch treatable cancers early. ‘We cannot emphasize enough how important screenings are for early detection of cancer,’ she said…” [Reuters, 3/30/23]

Yale Daily News: Researchers Predict Rapid Increase in HIV Infections Due Directly to Braidwood Ruling. “In a recent study led by the Yale School of Public Health, researchers found that the Sept. 2022 Texas ruling in Braidwood Management v. Becerra could potentially result in more than 2,000 predictable cases of human immunodeficiency virus in the U.S. in the coming year. In the study, the researchers tried to estimate how many new HIV infections would result from the outcome of this court ruling, focusing on men who have sex with men… In addition, the researchers estimated that coverage would drop from 28 percent to 10 percent after the Braidwood Management v. Becerra decision… However, according to Paltiel, this number is almost certainly an underestimate.” [Yale Daily News, 3/31/23]

Bloomberg Law: ACA Preventive Care Mandate Limited by Texas Judge. “A federal judge blocked on Thursday an Obamacare requirement for health plans to pay in full for certain preventive health-care services, including PrEP drugs for HIV. Judge Reed O’Connor of the US District Court for the Northern District of Texas vacated actions taken by the US Health and Human Services Department to implement or enforce certain Affordable Care Act preventive services coverage requirements.” [Bloomberg Law, 3/30/23]