US Appeals Decision Striking Free Access to Key Health Services

The US Friday told a Texas federal judge that it’s challenging a decision that threatens to strip millions of Americans of free access to potentially life-saving preventive services.

Judge Reed C. O’Connor, of the US District Court for the Northern District of Texas, on Thursday found that the US Preventive Services Task Force had been unconstitutionally appointed, and therefore its recommendations—requiring cost-free insurance coverage for treatments deemed essential—were unenforceable.

The Justice Department, noting that the “Affordable Care Act has ensured that millions of Americans have access to critical preventative health care” for over a decade,” acted quickly in filing its notice of appeal just one day after the Biden administration said it was considering its options.

The case will now go to the US Court of Appeals for the Fifth Circuit. The Fifth Circuit is made up of mostly conservative judges, many of whom were appointed by former president Donald Trump. It’s generally been critical of Obama and Biden administration policies.

If upheld, the decision means that people throughout the US won’t have access to free health services that detect conditions like various cancers, diabetes, and mental health issues or free access to drugs like those used to prevent the transmission of HIV and AIDs.

Speaking at a Protect Our Care press conference Thursday, American Public Health Association Executive Director Georges C. Benjamin said the decision impacts nearly every leading cause of death in the US.

The preventative services identified by the PSTF were intended to detect potentially deadly conditions so that they can be treated before they become fatal. If people don’t get those services because they can’t afford them, then the costs of treating the conditions will increase dramatically, and “more preventable deaths” will occur, Benjamin said.

The government also is likely to ask O’Connor to delay implementing his decision while the appeal plays out. Protect Our Care Chair Leslie Dach said during the conference that a stay is “crucial” to ensure people have access to preventative services while the case proceeds.

O’Connor’s decision only applies to PSTF recommendations. It doesn’t affect preventative services recommended by the Health Resources and Services Administration and the Advisory Committee on Immunization Practices, including contraceptive care and immunizations.

Jonathan Mitchell of Austin, Fillmore Law Firm LLP, and America First Legal Foundation represent the plaintiffs.

The case is Braidwood Mgmt., Inc. v. Becerra, N.D. Tex., No. 20-cv-283, notice of appeal filed 3/31/23