Groom principal and health services practice co-chair Lisa Campbell was featured in Law360 for their article, “ACA Ruling Could Mean Narrowed Benefits From Health Plans,” to provide her insight on a March 30 ruling from a Texas court that blocked the government from enforcing preventative services requirements under the Affordable Care Act.
As Groom attorneys discussed in a March 31, 2023 alert, this Texas district court ruling “vacated all of the actions of the Departments of Health and Human Services, Labor, and Treasury (“Departments”) implementing and enforcing the ACA’s requirement to cover without cost-sharing USPSTF preventive services with “A” or “B” ratings and enjoined enforcement of those requirements in the future.”
Law360 reported, “[Campbell] said a question we have been getting since the decision on preventative services is, ‘Do we have to change our plans to stop covering these without cost sharing?’” “And the answer,” she said, “is no, issuers and plans have flexibility to maintain what they’re doing.”
When asked about whether plans will reduce benefits, Campbell said, “I do at some point think there will be a cost-benefit analysis,” and noted that issuers “will have to wait” to change benefits until the new plan year.
Campbell continued, “From what we’re hearing from plans, they do think that preventative services are important generally speaking,” as research shows “preventive services do, in the long run, lower costs.”
