Appeals court does not block US mandate to cover cancer screenings, HIV drugs By Reuters

Written by Brendan Pearson

(Reuters) – A U.S. appeals court on Friday declined to block a federal order requiring health insurers to cover preventive care services such as cancer screenings and HIV prevention drugs at no additional cost to patients, but ruled against the government in a major legal case and the state's future is up in the air. doubt.

A unanimous panel of the 5th U.S. Circuit Court of Appeals agreed with a group of Christian businesses that filed a lawsuit challenging the mandate that claimed the way services were selected for coverage violated the U.S. Constitution.

However, the panel found that U.S. District Judge Reed O'Connor in Fort Worth, Texas, went too far in blocking the nationwide mandate in March 2023, instead blocking its implementation only against the companies that filed the suit. O'Connor's ruling was suspended while the case was heard by the Court of Appeal.

Major US medical groups said eliminating the preventive care mandate would put patients at risk and increase health care costs.

The committee also ordered O'Connor to reconsider his decision to support mandatory coverage of certain vaccines and pediatric screening services, which the companies also objected to. The committee said O'Connor did not take into account some relevant legal issues, although it did not consider how the decision was made.

While the Fifth Circuit's ruling allows the government to continue implementing the mandate, it could provide support to employers or other insurers who want to challenge it.

The plaintiffs were represented by the conservative legal group America First. Gene Hamilton, the group's executive director, in a statement called Friday's decision “a victory for the Constitution, the rule of law, and every American who doesn't want unelected bureaucrats making decisions about their health care coverage.”

The US Department of Health and Human Services (HHS) did not immediately respond to a request for comment.

In the 2020 lawsuit, the companies objected to covering HIV pre-exposure prophylaxis on religious grounds, but also argued that the entire mandate violates the U.S. Constitution by appointing a task force appointed by the Department of Health and Human Services to choose which treatments to cover. A task force with that much authority would have to be appointed by the president and confirmed by the Senate, they said.

Both O'Connor and the Fifth Circuit agreed with this argument, and the Fifth Circuit rejected the government's claim that HHS Secretary Xavier Becerra could retroactively resolve the issue by “certifying” the task force's decisions.

Two members of the committee, Circuit Judges Don Willett and Corey Wilson, were appointed by former Republican President Donald Trump. The third, Circuit Judge Irma Carrillo Ramirez, was appointed by Democratic President Joe Biden.

The preventive care mandate is part of the Affordable Care Act of 2010, often called Obamacare because it was championed by then-President Barack Obama. O'Connor drew widespread attention in 2019 by ruling the entire law unconstitutional, which was later overturned.

Its ruling on the preventive care mandate did not apply to preventive services recommended by the task force before enactment of the Preventive Care Act, including breast cancer screening.

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