Judge’s ruling undercuts US health law’s preventive care

I've been told this process might be complicated because of all the paperwork and deadlines that will come with it. But there are certain organizations that are working extremely hard to make sure that anyone applicable gets that Medicaid coverage since March of 2020. When the COVID-19 relief package passed Medicaid enrollment has skyrocketed to *** record 90 million people and since then, no one has been kicked off. Having folks be able to have this level of continuous coverage under Medicaid has been *** blessing. Now, about 15 million people could be dropped from Medicaid when the continuous enrollment requirement ends this spring, seven million of whom could still be eligible but may fall the cracks according to the US Department of Health and Human Services to put it simply COVID-19 Emergency orders banned states from kicking people off Medicaid starting in 2020. But this spring that ends and the responsibility of red determination and dis enrollment is put in the hands of states. It worries me *** lot and I hope that that really is *** worst case scenario. I would be paying out of pocket money that I probably don't have to spend on medical bills as *** Medicaid recipient. People like Seth Watkins say they know how important this coverage is to receiving life saving treatment and medication. I wouldn't be able to afford my medications like all of my medications for my diabetes and my psychiatric medications and my HIV medications. And he worries about everyone who is at risk of losing coverage. I'm afraid for people that have no coverage or I'm afraid for people from like other countries like refugees and people that speak other languages that don't know how to interpret the Red Determination process. Gretchen mcguinness is the senior VP of health care systems and accountable care for Colorado access. The last non profit health plan in the state of Colorado. One of the things that's helpful in this process is that it's not happening all at once. And so we're talking about *** 14 month wave of this. The first thing to understand is that your red determination date is based on your enrollment time period. That's when the state conducts *** review of your eligibility requirements. So you won't get information until two months before your red determination date. So I think there will be some anxiety for folks who think they may be losing coverage but their red determination date may not be until November 2nd. She says anyone on Medicaid needs to make sure their address is up to date because red determination packets are sent through us mail keeping that updated is of the utmost importance and update it every time it changes as often as the state can or states can. Nationally, they're going to try to validate *** member's eligibility without them doing anything. So she says there will be *** portion of people that sail through approval because they provided income verification through *** job application or other means. She also points out that states are partnering collaboratively with health care exchanges to provide other options. That is *** service. Available in every state that helps people shop for and enroll in affordable medical insurance. That can be another avenue for coverage for folks who are are likely going to continue to be on that end of earning too much to qualify for Medicaid with 90 million Americans and snail mail involved. This isn't going to be *** simple process. Experts say they stress that no matter where you are in the country, there are people and case managers that can help you navigate it Jesse Cohen Scrips News, Denver,

A federal judge in Texas who previously ruled to dismantle the Affordable Care Act struck down a narrower but key part of the nation's health law Thursday that requires most insurers to cover preventive services that include screenings for cancer, diabetes and mental health.Other no-cost services, including HIV screenings, are also impacted under the ruling by U.S. District Judge Reed O'Connor that opponents say will jeopardize preventive care for millions of Americans.Experts cautioned that insurers are unlikely to stop any coverage immediately. The Biden administration was expected to appeal and seek a stay of the ruling.“This 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,” 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, ruled that the entire health care law also known as “Obamacare" 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 — including screenings for multiple types of cancer — 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 “unlawful" 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 the 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.“Fundamentally, 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,” Barry said.White House Press Secretary Karine Jean-Pierre said the Department of Justice and the Department of Health and Human Services were reviewing the ruling, but called the case “yet another attack” 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 “could create extraordinary upheaval in the United States’ public health system.” More than 20 states, mostly controlled by Democrats, had urged O’Connor against a sweeping ruling that would do away with the preventive care coverage requirement entirely.The ruling applies to recommendations made by the task force after March 2010, when the Affordable Care Act was enacted. Some of the nation's largest medical groups came out against the lawsuit, warning that insurers in the future could impose cost-sharing on patients for screenings that are now fully covered.Levitt said if O'Connor's ruling is allowed to stand, insurers are likely to look at changes in coverage beginning in the next calendar year, since existing contracts are already in effect.Although the ruling impacts a broad spectrum of preventive care, it does not wipe out coverage for all preventive screenings. For instance, experts said the decision would not overturn coverage for preventive women's health services that were approved outside the task force.Some cancer screenings approved before 2010 would also not be affected, including screenings for cervical and colorectal cancer, said Alina Salganicoff, senior vice president and director for women's health policy at the Kaiser foundation. But she said screenings for lung and skin cancer, which were more recently approved, could be affected.In September, O'Connor ruled that required coverage of the HIV prevention treatment known as PrEP, which is a pill taken daily to prevent infection, violated the plaintiffs' religious beliefs. That decision also undercut the broader system that determines which preventive drugs are covered in the U.S., ruling that a federal task force that recommends coverage of preventive treatments is unconstitutional.Employers’ religious objections have been a sticking point in past challenges to former President Barack Obama’s health care law, including over contraception.The lawsuit is among the attempts by conservatives to chip away at the Affordable Care Act — or wipe it out entirely — since it was signed into law in 2010. The attorney who filed the suit was an architect of the Texas abortion law that was the nation’s strictest before the Supreme Court overturned Roe v. Wade in June and allowed states to ban the procedure.___Associated Press reporters Amanda Seitz and Seung Min Kim in Washington contributed to this report.

Other no-cost services, including HIV screenings, are also impacted under the ruling by U.S. District Judge Reed O'Connor that opponents say will jeopardize preventive care for millions of Americans.

Experts cautioned that insurers are unlikely to stop any coverage immediately. The Biden administration was expected to appeal and seek a stay of the ruling.

“This 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,” 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 “Obamacare" 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 — including screenings for multiple types of cancer — 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 “unlawful" 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 the 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.

“Fundamentally, 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,” Barry said.

White House Press Secretary Karine Jean-Pierre said the Department of Justice and the Department of Health and Human Services were reviewing the ruling, but called the case “yet another attack” 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 “could create extraordinary upheaval in the United States’ public health system.” More than 20 states, mostly controlled by Democrats, had urged O’Connor against a sweeping ruling that would do away with the preventive care coverage requirement entirely.

The ruling applies to recommendations made by the task force after March 2010, when the Affordable Care Act was enacted. Some of the nation's largest medical groups came out against the lawsuit, warning that insurers in the future could impose cost-sharing on patients for screenings that are now fully covered.

Levitt said if O'Connor's ruling is allowed to stand, insurers are likely to look at changes in coverage beginning in the next calendar year, since existing contracts are already in effect.

Although the ruling impacts a broad spectrum of preventive care, it does not wipe out coverage for all preventive screenings. For instance, experts said the decision would not overturn coverage for preventive women's health services that were approved outside the task force.

Some cancer screenings approved before 2010 would also not be affected, including screenings for cervical and colorectal cancer, said Alina Salganicoff, senior vice president and director for women's health policy at the Kaiser foundation. But she said screenings for lung and skin cancer, which were more recently approved, could be affected.

In September, O'Connor ruled that required coverage of the HIV prevention treatment known as PrEP, which is a pill taken daily to prevent infection, That decision also undercut the broader system that determines which preventive drugs are covered in the U.S., ruling that a federal task force that recommends coverage of preventive treatments is unconstitutional.

Employers’ religious objections have been a sticking point in past challenges to former President Barack Obama’s health care law,

The lawsuit is among the attempts by conservatives to chip away at the Affordable Care Act — or wipe it out entirely — since it was signed into law in 2010. The attorney who filed the suit was an architect that was the nation’s strictest in June and allowed states to ban the procedure.

___

Associated Press reporters Amanda Seitz and Seung Min Kim in Washington contributed to this report.

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