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Back in March, a U.S. District Court struck down the Affordable Care Act’s (ACA) preventative care coverage requirements. The ruling stated that items or services with A or B ratings by the U.S. Preventative Services Task Force (USPSTF) violated the U.S. Constitution. The District court granted an injunction against the enforcement of those requirements. The Biden administration also appealed the court’s decision.
On May 15, 2023, the 5th Circuit Court of Appeals put the enforcement of the court’s ruling on hold, pending a decision on the merits of the care. It is unclear if the District Court’s ruling will be reversed or upheld by the 5th Circuit. A decision on the merits of the case is expected by the end of 2023.
Non-grandfathered health plans and issuers should continue to cover the full range of preventative care services required by the ACA, without cost sharing. This includes items and services that have an A or B recommendation by the USPSTF. Download the bulletin for more details.