By: Mia Hoetzlein-Sirman, Staff Writer
The Affordable Care Act, colloquially known as Obamacare, is currently facing a challenge as Kelley v. Becerra, which calls into question the legality of the preventative care provision of the Act, sits in front of a federal judge in Texas. The provision ensures that preventative care measures are covered by the plans offered under Obamacare and most private plans.[1] This preventative care provision covers vaccinations, screenings for various disorders and diseases, screenings and treatments for HIV and other STDs, wellness visits, birth control, and cancer screenings.[2] Although the court case expressly focuses on the birth control and STD screening aspect of the provision, a ruling in favor of the plaintiff would dissolve the entire provision.
This provision of Obamacare is especially important as covering the cost of preventive care is proven to help reduce the cost of healthcare for individuals, increase the utilization of screenings, vaccinations, and wellness visits, and collectively reduce the societal cost of healthcare. Around 20% of women and 16% of men have previously postponed preventative care due to cost.[3] Since Obamacare was adopted, women have saved 1.4 billion dollars annually on birth control while the overall cost of treating cancer and chronic diseases has decreased.[4] The CDC estimates that chronic diseases that would have been avoidable with preventative care costs make up 75% of Americans’ spending on healthcare and results in lower economic output for the United States.[5] This shows the importance of the preventative care provision, as it has the potential to provide preventative care at a low cost which could prevent the development of chronic illnesses and the costs associated with them.
The plaintiffs in Texas are attempting to repeal the preventative care provision based on their belief it violates the Religious Freedom Restoration Act and the Nondelegation Doctrine, arguing that it is too vague to be applicable.[6] The Kelleys stated that they do not have a reason to use the birth control offered and therefore object to paying for plans that allow access to it. Since the plaintiffs are Christian, they also feel that they should not have to pay for the treatment and screening of STDs or HIV, as the Religious Freedom Restoration Act protects religious freedom by preventing a burden from being placed on individuals that interfere with their religion.[7] The Kelleys stipulate that due to their Christian religion, they do not engage in “homosexual behavior” or “intravenous drug use,” which means that having to pay for these screenings is a violation of their religious freedoms. Additionally, they believe that it increases the cost of their plan, which is unfair since they do not require these services.
The Nondelegation Doctrine prevents Congress from delegating its legislative power, which the plaintiffs stipulate Obamacare did by relying on independent groups to identify what constituted preventative care.[8] Since these independent groups identified the preventative care, the plaintiffs argue that Congress delegated too much of the specifics of the provision. They also believe that for birth control to be covered by Obamacare, it should have been specified in the language of the provision.[9]
This lawsuit threatens the entire preventative care provision of Obamacare, despite the plaintiffs mainly taking issue with providing free access to birth control. Multiple state attorneys have filed amicus curie briefs in defense of the preventative care measures, and many people are worried about the impacts this could have on access to preventative care.[10] Regardless of the recent controversies surrounding reproductive care, the preventative care provision in Obamacare provides coverage for many health concerns beyond that and provides a great benefit to those impacted by it. The decision of the federal court judge in Texas will be released in the coming days; if it overturns this provision, the case is expected to continue to the Supreme Court.
[1]https://www.npr.org/sections/health-shots/2022/08/09/1115454627/preventive-care-such-as-birth-control-anti-hiv-medicine-challenged-in-texas-laws
[2] Id.
[3] https://www.kff.org/health-reform/fact-sheet/preventive-services-covered-by-private-health-plans/
[4] https://aspe.hhs.gov/sites/default/files/documents/786fa55a84e7e3833961933124d70dd2/preventive-services-ib-2022.pdf
[5] Id.
[6]https://www.npr.org/sections/health-shots/2022/08/09/1115454627/preventive-care-such-as-birth-control-anti-hiv-medicine-challenged-in-texas-laws
[7] https://uscode.house.gov/view.xhtml?path=/prelim@title42/chapter21B&edition=prelim
[8]https://www.npr.org/sections/health-shots/2022/08/09/1115454627/preventive-care-such-as-birth-control-anti-hiv-medicine-challenged-in-texas-laws
[9] Id.
[10] Id.
