Supreme Court Skeptical of Overriding Preventive Medical Tests in Obamacare
WASHINGTON — The Supreme Court is trying to decide whether to keep an Affordable Care Act provision that requires insurers to offer no-cost preventive care tests.
The court heard arguments Monday on whether the procedure for deciding which tests can be included under the national insurance program is legally flawed.
A group of Christian plaintiffs are most bothered by the requirement for insurers to provide free HIV tests and medications.
They said in their court filings that their contributions to the health insurance fund are inadvertently making them “complicit in facilitating homosexual behavior.”
If they win their lawsuit, insurers could be relieved of the costs of the tests, passing them back to patients and undercutting a key provision of the Affordable Care Act, also known as Obamacare.
The free tests are one of the most popular parts of the 15-year-old health insurance law, allowing early warning detection of high cholesterol, cancer, diabetes and other potentially deadly ailments.
Obamacare is credited with cutting the U.S. uninsured population in half, reforming health care delivery systems that were blamed for high costs, and expanding Medicaid eligibility.
It also was controversial because of its payment mandates for nearly all taxpayers that were essentially the same as a new tax. Much of the act remains in effect, but with additional opt-out provisions.
The lack of consumer choice for the insurance programs overseen by the Department of Health and Human Services were a significant part of the issue in Supreme Court arguments Monday.
Two Christian-owned businesses and four Texas residents argued that the task force created by the law to recommend services health insurers must cover has become so powerful that its members must be appointed by the president and confirmed by the Senate.
They said the Constitution requires presidential appointments for organizations that operate independently with a profound effect on the nation’s economy and citizens.
The task force is supposed to be appointed by the secretary of the Department of Health and Human Services. The plaintiffs in the case said that instead, the task force operates independently with loose rules that are unclear about who is in charge.
The task force consists of volunteer medical experts who review evidence before making recommendations on preventive services insurers should cover.
“They’re exercising quasi-legislative power,” said Attorney Jonathan F. Mitchell, the conservative lawyer representing the plaintiffs.
He added that “their preventive care coverage mandates are neither directed nor supervised by the secretary of Health and Human Services.”
As a result, their decisions that require insurance companies to offer no-cost HIV tests and medications should be invalidated by the Supreme Court, he said.
The New Orleans-based Fifth U.S. Circuit Court of Appeals mostly agreed with the plaintiffs in a ruling last year, which prompted the federal government to appeal to the Supreme Court.
Hashim M. Mooppan, an attorney for the U.S. Office of the Solicitor General, said the plaintiffs misinterpreted the law by incorrectly concluding the task force exceeded its authority without the permission of the president and Congress.
“That is obviously wrong on its face,” Mooppan said.
Decisions on appointments of the task force, as well as preventive services required of insurers, are “vested by law in the secretary” of the Department of Health and Human Services, Mooppan said. “The secretary has complete control in that situation.”
The Supreme Court justices were largely skeptical of the plaintiffs during the oral arguments.
Justice Elena Kagan suggested the plaintiffs were asking the Supreme Court to take action that is reserved by the Constitution to Congress.
“We don’t just go around creating independent agencies,” she said.
Justice Ketanji Brown Jackson disagreed the task force acted too independently. The law says its members are supervised, appointed and could be fired by the secretary of Health and Human Services, she said.
“The statute does not have specific blocks” on the secretary’s authority over the task force, Jackson said. “The statute doesn’t say he can’t.”
A Supreme Court decision in the case is expected in June.
The case is Kennedy v. Braidwood Management Inc. et al.
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