Richard H. Hughes, IV, Member of the Firm in the Health Care & Life Sciences practice, in the firm’s Washington, DC, office, was featured in a video titled “Braidwood v Becerra Has Major Implications on Available Preventive Services,” where he responded to questions from Julia Bonavitacola of The American Journal of Managed Care®.
Following is a transcript:
What is the Braidwood v Becerra lawsuit and what does it affect?
So this is a case where the plaintiffs are challenging the requirement under the Affordable Care Act [ACA] to cover certain recommended preventive services. Initially they brought a set of constitutional claims, and they brought claims under the Religious Freedom Restoration Act. What the case before the Supreme Court really involves is the constitutional claims, and the remaining claims at this point are only related to the US Preventive Services Task Force.
What's in front of the court right now is the constitutionality of the role of the US Preventive Services Task Force in determining which services must be covered by health insurance plans in the United States, and this is a requirement that impacts not only all Americans who have private health insurance, but also applies directly to the individuals, the adults who also have Medicaid expansion coverage as well.
What are the major implications of the lawsuit when it comes to the ACA?
It is really another one of those significant Affordable Care Act cases, like we've seen in the past, but it's really the first that challenges the preventive services coverage requirement. So it's a really significant case when we think about access to preventive care in the United States. Before the Affordable Care Act, there was no requirement that commercial health insurance plans or Medicaid cover these types of preventive services. So it's definitely something that risks access for over 150 million Americans to recommended preventive care.
How might this lawsuit affect contraception and immunizations covered under the ACA?
So the question before the Supreme Court at this point in time does not involve the Advisory Committee on the Immunization Practices [ACIP], which recommends immunizations, or the recommendations by the Health Resources and Services Administration, or HRSA, which is where we see the contraceptive mandate. So immunizations, the contraceptive mandate, off the table before the court right now. I will say this was an issue that was raised at the lower court level. The plaintiffs did not want to have to cover certain recommended immunizations or contraceptives.
The lower court ruled in favor of the plaintiffs on the task force, but not with respect to immunizations and contraceptives. And so the lower court found that the way those bodies operate in determining coverage requirements under the ACA is constitutional, and so that's something that we could see come back up at a later date. Certainly the the plaintiffs did ask the Supreme Court to reconsider the constitutionality of the ACIP and HRSA roles. But for now, contraceptive mandate, immunizations off the table in this case. It's really focused on the US Preventive Services Task Force and required coverage of its recommendations.
