Protecting Preventive Care: AHA Urges Supreme Court to Reverse 5th Circuit Ruling

The American Hospital Association (AHA) and its allies have filed a friend-of-the-court brief with the Supreme Court, urging the justices to reverse a ruling by the U.S. Court of Appeals for the 5th Circuit that threatens cost-free access to certain preventive services covered by the Affordable Care Act (ACA). The 5th Circuit's decision last year partially affirmed a lower court judgment that the Preventive Services Task Force (PSTF) violates the Appointments Clause of the Constitution.

In the brief, the AHA argues that the 5th Circuit's decision impedes access to vital preventive services, stating that if upheld, millions of patients may have to pay out-of-pocket or be subject to cost-sharing for many of these treatments. The cumulative societal impact of reimposing cost barriers to these services would be monumental, leading to undiagnosed diseases, shorter lifespans, and higher healthcare spending for everyone.

Joining the AHA in the filing were the Catholic Health Association of the United States, Federation of American Hospitals, America's Essential Hospitals, and the Association of American Medical Colleges.

The ACA's preventive care requirements have enabled millions of Americans to obtain preventive care and improved utilization of vital services nationwide for over a decade. The preventive services mandate requires most private insurers to cover recommended services without cost-sharing, including screenings for breast, colorectal, and lung cancer, as well as preventive medications like PrEP for HIV prevention.

However, the 5th Circuit's ruling threatens to strip these benefits from insurance policies entirely, despite being recommended by the U.S. Preventive Services Task Force, the nation's authoritative body of experts on preventive care. The ruling could lead to millions of privately insured people losing access to these services without cost-sharing, as insurers and employers might decide to require patients to share in the costs or drop the services altogether.

The AHA and its allies argue that the 5th Circuit's ruling threatens public health and access to care, as it could potentially eliminate free coverage of hundreds of preventive health benefits for more than 150 million privately insured Americans. The consequences of limiting access to these preventive services could be devastating for public health and the well-being of our communities.

The ACA's preventive care requirements have been a critical component of the law, leading to improved health outcomes and reduced healthcare costs. Numerous studies and data points support the AHA's arguments, such as:

* A review of 65 papers published between 2000 and 2017 that showed even small levels of cost-sharing can reduce the use of necessary services.

* A 2023 survey that found three out of ten people delayed or skipped health care due to income constraints, and at least half would not pay out-of-pocket for preventive services.

* A recent study that found 58% of cancer patients and survivors would be less likely to maintain preventive care if the coverage mandate was overturned.

The AHA and its allies urge the Supreme Court to reverse the 5th Circuit's ruling, ensuring that millions of Americans retain access to preventive services, protecting public health, and maintaining a constitutional appointment process for task force members. The Supreme Court's decision in this case will have significant implications for the future of preventive care mandates under the ACA and the overall health and well-being of the American public.