Today, the U.S. Court of Appeals for the Fifth Circuit partially reversed a district court decision that had invalidated key provisions of the Affordable Care Act (ACA) in the case of Braidwood v. Becerra, finding cost-free preventive services could remain in place for the vast majority of individuals protected by the provisions. Under the Fifth Circuit's decision, coverage of United States Preventive Services Task Force (USPSTF) recommendations was invalidated only for the plaintiffs, rather than for the entire population as had been decided by the district court.
The public health implications of the case are enormous, with overwhelming research showing even relatively small levels of cost-sharing, from $1 to $5, are associated with reduced use of care.
Concern over access to no-cost preventive services has also grown in response to the case. A majority (52%) of cancer patients and survivors selected protecting access to no-cost preventive services as their top policy priority, according to a February survey by the American Cancer Society Cancer Action Network (ACS CAN), compared to a similar survey in 2020 showing 37% of respondents prioritized the same issue.
Following a series of joint amicus brief filings throughout the case, the groups, including ACS CAN, Arthritis Foundation, American Kidney Fund, Cystic Fibrosis Foundation, The Leukemia & Lymphoma Society, The National Multiple Sclerosis Society, and The AIDS Institute, issued the following statement in reaction to today’s ruling:
“We applaud the circuit court’s decision to uphold the critical patient protections in the ACA for the vast majority of individuals covered, and protect continued, broad access to cost-free preventive services for the more than 150 million eligible individuals. We are pleased the Fifth Circuit's decision specifically noted amicus briefs, such as the one filed by our groups, providing scientific data on the importance of preventive services and expressing concern about the collateral effects if the district court's decision had been implemented across the country.
“Still, we’re disappointed to see the Fifth Circuit uphold some aspects of the district court’s decision that leave some individuals at risk. We know coverage of recommended preventive services without cost-sharing has saved millions from cancer, kidney disease, HIV/AIDS and other leading diseases in our nation, with even relatively small levels of cost-sharing associated with reduced use of care, including for necessary services.
“As such, we remain concerned about some elements of the underlying decision. Everyone deserves to live a long, healthy life and should have access to these lifesaving services that have been proven to help ensure they do.”