Federal Judge Ruling Threatens No-Cost Preventive Care Provided by Affordable Care Act

The American College of Radiology® (ACR®) is deeply concerned about a Texas federal judge’s March 30 ruling in a lawsuit that would block the federal government from enforcing mandates for no-cost preventive care provided by the Affordable Care Act (ACA). The ACA requires insurers to provide no-cost coverage of screening services endorsed by the United States Preventive Services Task Force (USPSTF), preventive services for women included in Health Resources and Services Administration (HRSA) guidelines, and certain Centers for Disease Control and Prevention (CDC)-recommended immunizations. The court decision does not affect ACA coverage for preventive services provided by HRSA guidelines or CDC-recommended immunizations.

If the link between the ACA and USPSTF recommendations is dropped, the judge’s ruling will have major public health ramifications across a broad range of preventative services. The lawsuit would impact all services recommended by the USPSTF on or after March 23, 2010, the day the ACA was signed into law. If not overturned by appeal, this decision will have a significant negative impact on patients’ access to lifesaving cancer screening services. For example, lung cancer screening was not endorsed by the USPSTF until December 2013, which could lead to out-of-pocket costs for patients. In addition, CT colonography for colorectal cancer screenings currently covered by private insurers through the ACA would also be impacted. The effects of co-pays and deductibles would severely impact individuals most at risk and with the least ability to pay, including minorities and those in underserved areas.

The Justice Department filed a notice of appeal March 31. The ACR and other stakeholders are hopeful the ruling will not be implemented during what could be a lengthy appeal process.