Judge: Health Insurers Shouldn’t Have to Cover Cancer Screenings and Pregnancy Care

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By Keya Vakil

March 30, 2023

If the ruling is upheld by a higher court, health insurance companies would no longer be required to cover preventative care such as screenings for breast cancer, cervical cancer, and lung cancer.

Want to avoid cancer, diabetes, and pregnancy-related deaths?

It might be harder and cost you extra in the future, after a right-wing federal judge on Thursday struck down a portion of the Affordable Care Act (ACA) requiring health insurance companies to cover free, life-saving preventative care, such as cancer screenings, HIV/AIDS screenings and prevention, and pregnancy-related care.

US District Judge Reed O’Connor of the Northern District of Texas ruled that the ACA’s preventative care coverage requirements are illegal, because the federal agency that decides which care insurers must cover, the US Preventive Services Task Force, is unconstitutional and therefore has no power to enforce the requirement.

O’Connor’s ruling effectively invalidates the provision nationwide, meaning that health insurance companies would no longer be required to cover services such as screenings for breast cancer, cervical cancer, and lung cancer. The changes would go into effect in 2024, or whenever your insurance plan’s next coverage year kicks in. 

Other services that would no longer be covered for free include diabetes screenings, anxiety and depression screenings in children, and various screenings, interventions, and types of care for pregnant people.

The Biden administration is certain to appeal O’Connor’s ruling, which means there’s a reasonable chance a higher court could overturn it. But if it is ultimately upheld, it could represent an enormous blow to the American healthcare system and the roughly 150 million Americans who benefit from the preventative care coverage requirements.

Medical and patient advocacy groups—who previously warned that a nationwide order could lead to preventable deaths and higher costs—were quick to criticize O’Connor’s decision on Thursday.

“Judge O’Connor’s decision will increase costs and hurt millions of families across the country who depend on free preventive care to stay healthy.” Leslie Dach, chair of Protect Our Care, said in a statement. “As a result of this devastating ruling, Americans will again be at the mercy of insurance companies who could increase costs for cancer screenings, prenatal care, mental health screenings, and more. This ruling will upend how Americans receive preventive care in this country, and more Americans will die because their cancers will be detected too late or they won’t receive the mental health or prenatal care they need.”

O’Connor’s ruling comes in a case filed by two Christian-owned business and six individuals, all in Texas, who argued the preventative services requirement was unconstitutional and that being required to cover preexposure prophylaxis (PrEP), a medication for HIV prevention, violated their religious rights because it would “encourage homosexual behavior, prostitution, sexual promiscuity and intravenous drug use.”

The plaintiffs also argued that the task force was illegal because its members are not directly appointed by the president—an argument O’Connor seems to have bought. The business and individuals were represented by the right-wing America First Legal Foundation, a group founded by Stephen Miller, a former advisor to Donald Trump.

O’Connor—a George W. Bush appointee who has a history of trying to strike down the ACA—previously ruled last September that PrEP should not have to be covered under the ACA.

“From the start, this was a politically-driven lawsuit, financially supported by people with extreme views, and placed in front of a judge with a proven record of attempting to dismantle the ACA,” Dach said. 

He also called on the courts to temporarily block O’Connor’s decision pending appeal, warning that “the health and financial security of millions of Americans is now at grave risk.”


  • Keya Vakil

    Keya Vakil is the deputy political editor at COURIER. He previously worked as a researcher in the film industry and dabbled in the political world.

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