Several federal agencies have jointly addressed the current state of preventative care services in response to the recent federal court decision Braidwood Mgmt. Inc. v. Becerra, 2023 WL 2703229 (N.D. Tex. 2023). In Braidwood, the U.S. District Court for the Northern District of Texas determined that enforcement of the U.S. Preventative Services Task Force’s (PSTF) recommendations on preventative care services violated the Appointments Clause of the U.S. Constitution because the PSTF members were not appointed properly. Therefore, the Court ruled that any actions taken based on PSTF’s recommendations were vacated.
The U.S. Department of Labor, the U.S. Department of Health and Human Services, the U.S. Treasury, and the Office of Personnel Management issued FAQs to help people understand the Affordable Care Act’s (ACA) preventative services mandate and how to comply in light of Braidwood.
The departments distinguish between preventative care services that were recommended before and after March 23, 2010, which was the date the ACA was signed into law. The departments clarify that the Braidwood decision only applies to preventive care services that were required to be covered by plans and issuers without cost sharing based on the PSTF’s “A” or “B”-level recommendations on or after March 23, 2010. This means that plans and issuers must continue to cover preventative care services without cost-sharing that were recommended by the PSTF before March 23, 2010. The departments can continue to enforce the recommendations made before March 23, 2010.
Although plans and issuers are not required to cover the items and services recommended on or after March 23, 2010, the departments strongly encourage them to continue to cover such items and services without cost sharing. This is to help people avoid acute illness, identify and treat chronic conditions, reduce the risk of cancer or facilitate early detection, and improve health.
To see the department’s full FAQs, please visit: https://www.dol.gov/agencies/ebsa/about-ebsa/our-activities/resource-center/faqs/aca-part-59