Since 2010, when the Law of Low Price Health Care was enacted, most private insurance plans have required the recommendation of the preventive care services of the US preventive services work group. UU. Making consumers pay a part of the cost. This includes cancer detection, pregnancy care and tests for sexually transmitted diseases. It is estimated that only in 2020, almost 152 million people have benefited from this law.
But a pending case of the Supreme Court puts this in danger.
This month, the Supreme Court will listen to oral arguments about Braidwood Management v. Becerra In this case, several Texas residents and two companies affiliated with Christians sued the government, arguing that the way in which the working group was designated violates the Constitution. They also argued that the requirement of covering medications that prevention HIV infection goes against their religious beliefs.
In 2022, Judge Reed O’Connor, or the Federal District Court for the Northern Texas District, put themselves on the side of the plaintiffs“ Stating that the working group had not been appropriately appointed by Congress and, therefore, it is not the constitutional authority not to demand that the insurers cover certain services. The United States Court of Appeals for the Fifth Circuit affirmed the June 2024 ruling.
If the Supreme Courts defend the 5th Registration of the United States Circuit Court of Appeals, the government’s capacity to demand insurers and employers to cover preventive services without shared costs could be severely limited.
“We know for years of research that people who face shared costs, particularly if they have low income, are much less likely to obtain the necessary medical care,” said Sara R. Collins, Ph.D., Scholar and Vice President of Coverage of Medical Care and Access in the Commonwealth Fund, a private foundation focused on medical care. “Preventive services are one of those services that we know is important for people.
The case
The argument of the plaintiffs is really double, according to Daniel Frier, founding partner or Frier Levitt.
First, they argue that the provision of prevention services violates the dating clause, which requires that the United States officers are only designated by the president with advice and consent of the Senate. USPSTF members were not nominated by the president and approved by the Senate.
Its other argument is that covering benefits such as the foreseeing prophylaxis (PREP), which is used to prevent HIV, goes against its religious beliefs, which violates the Law on Restoration of Religious Freedom.
There are some possibilities of how the case I could play.
The plaintiffs could win in the Law on Restoration of Religious Freedom, but losing in the appointment clause, said Frier. This would mean that the preventive attention mandate would remain valid, but religious employers would obtain an exemption in services such as preparation.
Or the clause of power plaintiffs and lose in the Law on Restoration of Religious Freedom, which would be essential to hit the entire mandate of the preventive service, he said.
The plaintiffs could also win in both arguments, which would sweep the end of the preventive care mandate. Alternatively, the government could win both arguments and the mandate would remain in place, regardless of religious beliefs.
Frier, Howver, believes that the plaintiffs on the Law on Restoration of Religious Freedom could be likely, particularly because the Supreme Court that is sympathized with religious beliefs in the past.
“They could say that the working group is constitutional, but its decision related to the types of problems that religious organizations can find inappropriate is not enforceable,” he said. “That could open a large can of worms for medical care decisions. You could have religious organizations that do not believe in transfusions. You have religious organizations that do not believe in the treatment of certain types of diseases.
What is at stake?
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This includes colorectal cancer detection exams, measurements to reduce breast cancer, statins to prevent cardiovascular disease, hepatitis B infection detection and more.
“These are not static recommendations, and the working group meets and updates based on emerging evidence about diseases [and] Disease, and as new technologies arise. … Therefore, it is very important that the working group continues to comply, that they continue to provide the recommendations, “said Collins.
An executive of a health company for women has the hope that the provision of preventive care remains intact.
“Preventive care saves lives. This is not controversial. We know that when people have preventive attention, we prevent catastrophic events. We know that when preventive attention is covered and people do not have a pocket jacket, and dey stenciagege, dey dey deyciatriadas, atentenciacystiatiatiatiatiatiatiatiatiatiatiatiatiatiatiathylates. It has been catastrophic for the concentrations, for which you are Jesus, the consequences of the concentrations, Jessicadas, Jesus, Jesus, Jesus.
Another medical attention executive said that getting rid of the requirement of preventive services could lead to more costs in the future.
“There is a growing research body that shows that putting more than the loading of shared costs in patients actually decreases the use of high value care. If insurers do not cover tea prevention services, we will cost the outgoing and posterior costs and downstream and downstream of health. The company serves employers and health plans and offers primary and behavioral health support.
In other words, insurers or employers will end up paying more for acute incidents that a leg prevented with cheaper detection can have.
It is possible that many health plans and employers continue to cover thesis services without sharing even if the court governs in favor of the plaintiffs because it is the best for Frier.
“Providing preventive attention is a form of value based on value,” said Frier. “Ultimately, it reduces the general cost of care over time. Therefore, employers, for example, are highly encouraged to provide prevention care … prevents absenteeism at work. To improve work performance. Employers who do not want their employers not wanting their employers to not want their gaps not want their not wanting not to want
While financial, it can be wiser for insurers to cover projections without requiring the cost, without the disposition of preventive care in place, it would certainly not be at the level that is now, he added.
The Supreme Court will listen to oral arguments on the case on April 21.
Photo: Valeii Evlakhov, Getty Images
