A federal judge鈥檚 ruling last month to eliminate free coverage for many basic preventive care services and medications under the Affordable Care Act has health care providers nationwide concerned about its potential implications for patients.
In South Florida, Stephen Fallon, chief executive officer of Latinos Salud, a health care provider with four clinics in Miami鈭扗ade and Broward counties, told 港澳天下彩that he鈥檚 especially worried that it could mean insurers may drop the HIV prevention drug known as PrEP, a pill taken daily to prevent infection. South Florida has among the nation鈥檚 highest rates of new HIV cases.
"If somebody gets used to being on PrEP and then they stop, their risk of acquiring HIV can actually be higher than if they never started PrEP in the first place," he said. "They carry that feeling of self鈭抋ssurance that they may not have had before. So retaining patients on PrEP is vitally important."
Latinos Salud caters its services to gay Latino men, people who have HIV and people who identify as transgender.
According to Fallon, even before the federal judge鈥檚 decision, insurers didn鈥檛 always follow the coverage requirement. He said some engaged in 鈥渃ost鈭� sharing,鈥� a move pushing some expenses to patients who often don't know how to contest the charges.
He said his clinics will 鈥渄o what it takes to keep people at risk for an HIV infection on the medicine.鈥�
Fallon fears the judge鈥檚 ruling, if it remains in place, would hurt the nation鈥檚 health care system.
鈥淭he impact 鈥� could essentially create a caste system of health insurance plans, with some employers choosing insurance plans that would deny their employees access to the very free preventive or screening services that help lower overall medical costs and taxes for all of us," Fallon told WLRN.
Experts cautioned that insurers are unlikely to stop any coverage immediately. The Justice Department said this week it will file an appeal and seek a stay of the ruling of Texas鈭抌ased U.S. District Judge Reed O' Connor.
鈥淭his is not the potential fatal blow to the ACA like previous court cases, but it would limit a very popular benefit that tens of millions of people use,鈥� said Larry Levitt, executive vice president for health policy at the Kaiser Family Foundation.
The decision comes more than four years after O'Connor, a nominee of former President George W. Bush, also known as 鈥淥bamacare" was unconstitutional. The U.S. Supreme Court overturned that ruling.
This time O'Conner blocked only the requirement that most insurers cover a range of preventive care 鈥� including screenings for multiple types of cancer 鈥� siding with plaintiffs who include a conservative activist in Texas and a Christian dentist who opposed mandatory coverage for contraception and an HIV prevention treatment on religious grounds.
The requirements for coverage are driven by recommendations by the U.S. Preventive Services Task Force, which is made up of volunteers. O'Connor ruled that enforcing the recommendations was 鈥渦nlawful" and a violation of the Constitution's Appointment Clause, which lays out how government officials can be appointed.
Dr. Michael Barry, chairman of the federal task force, said in a statement following last month's ruling that people with low incomes have been able to get services they need as care has expanded over the past decade because of the law.
鈥淔undamentally, 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,鈥� Barry said.
White House Press Secretary Karine Jean-Pierre said the Department of Justice and the Department of Health and Human Services has called the case 鈥測et another attack鈥� on the health care law that has been in place for 13 years and survived multiple legal challenges.
The Biden administration previously told the court that the outcome of the case 鈥渃ould create extraordinary upheaval in the United States鈥� public health system.鈥� More than 20 states, mostly controlled by Democrats, had urged O鈥機onnor against a sweeping ruling that would do away with the preventive care coverage requirement entirely.
The Texas lawsuit in federal court is among the attempts by conservatives to chip away at the Affordable Care Act 鈥� or wipe it out entirely 鈥� since it was signed into law in 2010.
