A U.S. district judge in Texas, known for his hostility towards the Affordable Care Act, delivered a significant blow against the law’s critical preventative care provisions in a Wednesday ruling.
First, Judge Reed O’Connor ruled that the U.S. Preventive Services Task Force, or PSTF, is unconstitutional, finding that its members are not appointed properly. PSTF is a group of experts that makes recommendations for what qualifies as a preventive measure covered by the ACA.
He did not settle on a remedy for what he claims is an unlawful body and asked for further briefings. His decision, depending on its ultimate scope, could let private health insurers stop covering an incredibly wide swath of preventative care: from cancer screenings to sexually transmitted infection tests to pregnancy care.
According to the American Medical Association, the ACA provision mandating that insurers cover over 100 preventative care services for free resulted in about 151 million people getting those services in 2020 alone.
O’Connor also ruled in favor of a business owner who claimed that the ACA’s mandate that he must provide coverage for PrEP drugs — which work to prevent the transmission of HIV — violated his religious beliefs.
The business owner, conservative activist Steven Hotze, argues, among other things, that providing the coverage “facilitates and encourages homosexual behavior, intravenous drug use, and sexual activity outside of marriage between one man and one woman.”
When the government disputed that assertion, O’Connor brushed the rebuttal aside, saying that its factual merit didn’t matter.
“Defendants inappropriately contest the correctness of Hotze’s beliefs, when courts may test only the sincerity of those beliefs,” he writes.
Reed is seeking more briefings on the remedies to the parts of the law he deemed illegitimate, making it unclear how far-reaching the ultimate conclusion will be.
While his final decision, when it’s issued, is likely to be appealed, the legal path ahead is littered with landmines for the ACA: the uber-right wing Fifth Circuit Court of Appeals, then the heavily conservative Supreme Court.
O’Connor has consistently ruled against ACA-related provisions, deeming the entire law unconstitutional in 2018. He was overturned at the Supreme Court by a 7-2 majority, which included many of the Court’s conservatives.
Some of the plaintiffs are longtime ACA enemies as well: Hotze has brought multiple challenges to the ACA. Plaintiff John Kelley also filed an earlier lawsuit against the ACA’s contraceptive mandate.
The lawyers working for the plaintiffs are familiar faces too. The lead attorney is Jonathan Mitchell, best known for his crafting of SB 8, the Texas bounty hunter-style abortion ban. They are also being represented by the America First Legal Foundation, an organization led by Trump administration alums including former adviser Stephen Miller and former Chief of Staff Mark Meadows.
Read the opinion here:
