The U.S. Supreme Court in Washington. Photo: Diego M. Radzinschi/ALM
The U.S. Supreme Court recently issued a ruling that "saved" a big part of the Affordable Care Act preventive services benefits package.
Related: Supreme Court rules 6-3 for Affordable Care Act 'free' preventive care selection panel
But Katharine Marshall, a policy expert at Mercer, suggests in a commentary that employers and their benefits advisors should continue to watch carefully for changes in ACA preventive services benefits coverage requirements.
Employers should "consider whether they might continue no-cost coverage of particular preventive services if current recommendations are rescinded," Marshall writes.
ACA preventive services benefits basics: The Affordable Care Act requires all non-grandfathered major medical plans, including fully insured group health plans and employers' self-insured health plans, to cover checkups, vaccinations, cancer screenings and other services in the ACA preventive services package without imposing deductibles, copayments or other "cost-sharing" requirements on the patients.
The Secretary of the U.S. Department of Health and Human Services, who is now Robert F. Kennedy Jr., is supposed to pick the services that go into the package with help from the U.S. Preventive Services Task Force, the Advisory Committee on Immunization Practices and the Health Resources & Services Administration.
The Braidwood case: From the perspective of the Supreme Court, the case decided June 27, Kennedy v. Braidwood, hinged on the constitutionality of the process for creating the U.S. Preventive Services Task Force.
The U.S. Constitution appointments clause requires officers of the U.S. president to be confirmed by the Senate.
U.S. Preventive Services Task Force members are merely added by the HHS secretary, not confirmed by the Senate.
The Supreme Court majority ended up saving the task force member selection process by emphasizing that the members of the task force need not be confirmed by the Senate because the HHS secretary can clearly fire the task force members at will.
Kennedy recently replaced members of the Advisory Committee on Immunization Practices with critics of federal vaccination recommendations made in the past.
The implications: For now, Marshall said, the existing ACA preventive services requirements stay in place.
In the future, she said, Kennedy could make changes in the U.S. Preventive Services Task Force membership that could lead to changes in task force recommendations.
In addition, she said, court cases challenging the authority of the Advisory Committee on Immunization Practices and the Health Resources & Services Administration are still moving through the lower courts.
The outcome of the ACIP and HRSA litigation could eventually affect the ACA preventive services benefits package, Marshall said.
Changes in the preventive services benefits packages could help employers that want to save money by covering fewer preventive services, but it could cause headaches for employers that want to keep a stable preventive services benefits package in place, and especially for those encouraging workers to use programs that combine high-deductible health plans with health savings accounts.
A richer ACA preventive services benefits package can ease the impact of high deductibles by causing the HDHP to pay for more care before a patient reaches the deductible.
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