SUBSCRIBE TO OUR FREE NEWSLETTER
Daily news & progressive opinion—funded by the people, not the corporations—delivered straight to your inbox.
5
#000000
#FFFFFF
5
#000000
#FFFFFF
obamacare
'Nothing Short of Catastrophic': Federal Judge Strikes Down ACA Preventative Care Provision
"Another reason why we need Medicare for All—the milquetoast ACA is being dismantled before our eyes," said one critic.
Mar 30, 2023
A ruling handed down by a U.S. district judge on Thursday will threaten a range of lifesaving preventative healthcare services for more than 150 million people, legal experts and advocates said, as the decision challenged the legality of a federal task force that enforces coverage for the services.
Judge Reed O'Connor, a Bush appointee who sits on the U.S. District Court for the Northern District of Texas, ruled that insurance companies do not have to comply with preventative care recommendations made by the U.S. Preventive Services Task Force (USPSTF), which was established by a key provision in the Affordable Care Act (ACA), also known as Obamacare.
O'Connor ruled that the appointments of members of the task force violate the Appointments Clause in the U.S. Constitution and said that violation "invalidates its power to enforce anything against anyone nationwide," according toSlate journalist Mark Joseph Stern.
The USPSTF has issued recommendations for a wide range of preventative care services, including screenings for breast cancer, colorectal cancer, cervical cancer, and diabetes; interventions and tests for pregnant patients; anxiety screenings for children and adolescents; and pediatric vision tests.
Under the ACA, insurance companies are required to cover those services, but following O'Connor's ruling coverage will no longer be mandated.
The decision is "nothing short of catastrophic to the U.S. healthcare system," said Stern.
\u201cI anticipated this decision in September when O'Connor first telegraphed it. It is nothing short of catastrophic to the U.S. health care system. Millions of Americans, including many pregnant women, will have to forgo basic care if it is upheld.\nhttps://t.co/eVpemaBN5c\u201d— Mark Joseph Stern (@Mark Joseph Stern) 1680184452
The ruling stemmed from a lawsuit filed in 2020 by Christian employers who objected to paying for services such as contraceptives and preexposure prophylaxis (PrEP), to prevent HIV transmission.
In September, O'Connor ruled that coverage for PrEP violated the companies' religious freedom in a decision that one doctor who specializes in HIV treatment condemned as "disgusting and inhumane" and likely "driven solely by homophobia and transphobia."
\u201cA Bush-appointed judge blocks the ACA's coverage of preventative care, including cancer screenings and the HIV-prevention drug PrEP, as the Stephen Miller-backed plaintiffs claim it "encourage[s] homosexual behavior, prostitution [and] sexual promiscuity."https://t.co/IVTbOmOzCg\u201d— Emma Vigeland (@Emma Vigeland) 1680191769
The companies are being represented by Texas attorney Jonathan Mitchell, who helped develop the state's abortion ban that allows private citizens to sue anyone who "aids or abets" a person who obtains abortion care.
More than 150 million Americans who have private health insurance have coverage for preventative care under the ACA, as well as approximately 20 million Medicaid and 61 million Medicare recipients.
Last July, as O'Connor was considering the case, titled Braidwood Management Inc., vs. Xavier Becerra, national health organizations including the American Medical Association, the American Academy of Pediatrics, and the American College of Obstetricians and Gynecologists warned that a ruling in the plaintiffs' favor would "reverse important progress and make it harder for physicians to diagnose and treat diseases and medical conditions that, if caught early, are significantly more manageable."
"With an adverse ruling, patients would lose access to vital preventive healthcare services, such as screening for breast cancer, colorectal cancer, cervical cancer, heart disease, diabetes, preeclampsia, and hearing, as well as access to immunizations critical to maintaining a healthy population," the organizations wrote. "Our patients cannot afford to lose this critical access to preventive healthcare services."
The Biden administration is expected to appeal O'Connor's ruling, and since insurance coverage contracts typically run through the end of the year, coverage will likely not change for many before 2024.
If upheld, the ruling will deal "a devastating blow to American public health," said University of California law professor Jennifer Oliva.
\u201cA federal judge deals a devastating blow to American public health by enjoining the ACA preventative mandate nationally. Included among plaintiffs\u2019 claims was that it was against their religion for insurance plans to cover counseling for substance use disorder.\u201d— Jennifer Oliva (@Jennifer Oliva) 1680188419
Last year, a Morning Consult poll found that at least 2 in 5 Americans were not willing to pay out-of-pocket for preventative services currently covered by the ACA.
O'Connor previously ruled in 2018 that the ACA should be struck down in its entirety, but that ruling was overturned by the U.S. Supreme Court.
The judge's latest ruling offers "another reason why we need Medicare for All," said the Debt Collective. "The milquetoast ACA is being dismantled before our eyes. There is no reason not to fight for real solutions when the non-solutions stand no better chance."
Keep ReadingShow Less
Rejecting Right-Wing Attack, US Supreme Court Upholds Obamacare Subsidies
Experts had warned that a finding in favor of the plaintiffs would eviscerate the healthcare law
Jun 25, 2015
Handing a victory for President Barack Obama and the Affordable Care Act--as well as millions of people who gained more affordable healthcare under the law--the U.S. Supreme Court on Thursday ruled that individuals who get their health insurance through an exchange established by the federal government will continue to be eligible for tax subsidies.
The "ALEC-fueled" case, King v. Burwell, dealt with whether the Affordable Care Act provides subsidies to everyone in the country who qualifies for them on the basis of income level, regardless of whether they get their insurance through a state-run exchange or an exchange run by the federal government. Basing their argument on just four words buried in the massive legislation, the plaintiffs claimed that subsidies were supposed to be only for those purchasing health care through state-run health exchanges--not the federal one.
Experts warned that a finding in favor of the plaintiffs would eviscerate the healthcare law.
Affirming the decision of the Fourth Circuit, the justices voted 6-3 to uphold the subsidies. Chief Justice John Roberts, as well as Justices Anthony Kennedy, Ruth Bader Ginsburg, Stephen Breyer, Sonia Sotomayor, and Elena Kagan were in the majority.
Here's how SCOTUS Blogdescribed "the core of the dispute:"
[T]o ensure that everyone can afford the health insurance that they are now required to buy, the ACA also provides for subsidies for people who buy their health insurance through an exchange. But one provision of the ACA indicates that subsidies are only available if you purchase your health insurance on an exchange "established by the State." The plaintiffs in this case argue that subsidies are therefore not available if you are one of the roughly seven million people who buy their health insurance on an exchange established by the federal government, because the federal government is not a "State." Defending the subsidies, the federal government argues that, if you look at the entire ACA and its history, it is clear that the subsidies are available to everyone who purchases insurance on an exchange, no matter who created it - including because the plaintiffs' reading could mean the end not just of the subsidies, but the entire health-insurance system created by the ACA.
About 6.4 million people are receiving subsidies in more than 30 states where the marketplace is run by the federal government. In a piece published Thursday, the New York Times asked one simple--but critical--question: "Have the subsidies succeeded?"
"By many measures, the answer is yes," wrote Times journalists Margot Sanger-Katz and Robert Pear. "More than seven million people are enrolled in the federal health insurance marketplaces, and a majority of them--87 percent--receive subsidies in the form of tax credits to help pay their premiums, the government says. Without subsidies, many would be unable to buy insurance."
They continued: "The subsidies also appear to have drawn substantial numbers of younger, healthier Americans into the new insurance markets, stabilizing premiums, even for people who pay the full cost themselves."
Of course, they add, "The effectiveness of the subsidies is separate from the question of whether they are legal."
Speculating on the potential impact of a ruling for the plaintiffs--against the ACA subsidies--Sanger-Katz and Pear wrote:
The effects would be felt around the country, but disproportionately in the South. More than three million people are receiving subsidies in four states that use the federal exchange: Florida, Georgia, North Carolina and Texas. In Florida alone, 1.3 million people -- more than 8 percent of the population under 65 -- receive subsidies to buy insurance.
However, some have maintained all along that King v. Burwell merely underscored the need for a single-payer system.
"Because of the ACA's administrative complexity and flaws--largely reflecting its accommodation to the private health insurance industry and other corporate, profit-oriented interests in U.S. health care--it is particularly vulnerable to the kind of legal challenge we saw today," said Physicians for a National Health Program president Robert Zarr.
"In contrast," he continued, "a single-payer system--an improved Medicare for All--would achieve truly universal care, affordability, and effective cost control. It would put the interests of our patients--and our nation's health--first."
And while he praised the Supreme Court ruling for not throwing millions off health insurance, Sen. Bernie Sanders (I-Vt.) added: "What the United States should do is join every other major nation and recognize that health care is a right of citizenship. A Medicare-for-all, single-payer system would provide better care at less cost for more Americans."
Keep ReadingShow Less
The Mind-Boggling Libertarian Legal Game Plan to Repeal Obamacare
Jul 23, 2014
Dave Weigel explains something that I had not fully understood before --- the Obamacare repeal legal game plan:
At least 4 million people, who signed up for Obamacare in states that chose not to set up exchanges (or in the case of Oregon, tried and failed to set up their own), are currently panicking about the threat of erased subsidies and higher payments. Why do I attribute this to libertarians? Like I wrote in 2013, and like Alec MacGillis has been writing, the Halbig case's chief advocate was Michael Cannon, a Cato Institute scholar who had previously campaigned to stop states from setting up their own exchanges.
Cannon's goal, stated bluntly and frequently, was that Obamacare had to be brought down by any means necessary. States that did not set up exchanges were in a better position to sue the government. Fewer people in the exchanges meant higher overall costs. To insurers, the "death spiral" was an apocalypse scenario; to Cannon, it meant freedom.
"A victory for the Halbig plaintiffs would not increase anyone's premiums," he wrote Monday.* "What it would do is prevent the IRS from shifting the burden of those premiums from enrollees to taxpayers. Premiums for federal-Exchange enrollees would not rise, but those enrollees would face the full cost of their 'ObamaCare' plans."
This is the Leninism I'm referring to in my headline. Cannon's no socialist--quite the opposite!--but he saw a solution to the Republican crisis of watching people grow used to new entitlements. Rip the entitlement away, weaken the system, and a painful short term would give Congress no choice but to undo the law. Take away some of the beams, and what do you know? The roof collapses.
An what "undoing" the law means in this context is removing the requirements for pre-existing conditions and the basic package of coverage --- which means that people affected will go uncovered or pay an unaffordable price for an inadequate policy. You know, like it used to be. Which in their minds was a great system apparently.
Remember, this is how they really feel about this:
Teaparty: Just Let Uninsured People Die (CNN GOP debate, Ron Paul)https://24ahead.com/s/tea-parties (Super special note for Ron Paul fans below) Teapartiers shout out "yeah!" when Wolf Blitzer ...
Keep ReadingShow Less
Most Popular