American Health Policy Institute
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Appeals Court Maintains ACA Preventive Health Services Mandate

The Fifth Circuit Court of Appeals has temporarily blocked a lower court decision that struck down an ACA mandate requiring employer health plans to provide no cost coverage for certain preventive service recommendations.

Background: Since 2010, the Affordable Care Act (ACA) has required employer health plans to cover all the “A” and “B” recommendations the U.S. Preventive Services Task Force (USPSTF) publishes without charging deductibles or copayments.

A District Court struck down the mandate because members of the USPSTF are not nominated by the President and confirmed by the Senate – therefore the Task Force violates the appointments clause of the U.S. Constitution. The Fifth Circuit Court of Appeals temporarily reinstated the mandate while it reviews the case.

Little impact on employers for now. Despite the District Court decision, most, if not all, employers have continued to provide first dollar coverage for the USPSTF recommendations pending review by the higher courts.

D. Mark Wilson

President and CEO, American Health Policy Institute

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