Appeals court does not block US mandate to cover cancer screenings, HIV
drugs
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[June 22, 2024]
By Brendan Pierson
(Reuters) -A U.S. appeals court on Friday refused to block a federal
mandate requiring health insurers to cover preventive care services like
cancer screenings and HIV-preventing medication at no extra cost to
patients, but ruled against the government on a key legal issue that
leaves the mandate's future in doubt.
A unanimous panel of the 5th U.S. Circuit Court of Appeals agreed with a
group of Christian businesses suing to challenge the mandate that
claimed that the way services were chosen for coverage violates the U.S.
Constitution.
However, the panel found that U.S. District Judge Reed O'Connor in Fort
Worth, Texas had gone too far by blocking the mandate nationwide in
March 2023, and instead blocked its enforcement only against the
businesses that brought the lawsuit. O'Connor's ruling had been on hold
while the appeals court considered the case.
Major U.S. medical groups have said that eliminating the preventive care
mandate would put patients at risk and increase healthcare costs.
The panel also ordered O'Connor to reconsider his decision to uphold
mandatory coverage of certain vaccines and childhood screening services,
which the businesses had also challenged. The panel said O'Connor had
not considered some relevant legal issues, though it did not weigh in on
how he should decide.
While the 5th Circuit's ruling allows the government to continue
enforcing the mandate, it could provide support for other employers or
insurers wishing to challenge it.
The plaintiffs were represented by conservative group America First
Legal. Gene Hamilton, the group's executive director, in a statement
called Friday's decision "a victory for the Constitution, the rule of
law, and every American who does not want unelected bureaucrats making
decisions about their healthcare coverage."
The U.S. Department of Health and Human Services (HHS) did not
immediately respond to a request for comment.
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Sample laboratory equipment is displayed at the University of
Pennsylvania, Perelman School of Medicine and Abramson Cancer Center
in Philadelphia, Pennsylvania January 15, 2016. REUTERS/Mark Makela/File
photo
In their 2020 lawsuit, the
businesses objected to covering pre-exposure prophylaxis (PrEP) for
HIV on religious grounds, but also argued that the entire mandate
violated the U.S. Constitution by having an HHS-appointed task force
choose what treatments must be covered. A task force with that much
power must be appointed by the president and confirmed by the
Senate, they said.
Both O'Connor and the 5th Circuit agreed with that argument, and the
5th Circuit rejected the government's claim that HHS Secretary
Xavier Becerra could fix the problem retroactively by "ratifying"
the task force's decisions.
Two members of the panel, Circuit Judges Don Willett and Cory
Wilson, were appointed by Republican former President Donald Trump.
The third, Circuit Judge Irma Carrillo Ramirez, was appointed by
President Joe Biden, a Democrat.
The preventive care mandate is part of the 2010 Affordable Care Act,
often called Obamacare because it was championed by then-President
Barack Obama. O'Connor drew widespread attention in 2019 by ruling
that the entire act was unconstitutional, which was later
overturned.
His ruling on the preventive care mandate did not apply to
preventive services the task force recommended before the ACA was
enacted, including breast cancer screening.
(Reporting By Brendan Pierson in New York, Editing by Alexia
Garamfalvi and Cynthia Osterman)
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