Challenges to the Affordable Care Act aren’t over

Another lawsuit challenging the Affordable Care Act is brewing in Texas.

The effort to tear down a section of the landmark health reform law shows that although the Supreme Court preserved the act for the third time on Thursday, it remains at risk.

The case centers only on the no-cost preventive services available under the Affordable Care Act and does not seek to overturn the entire law. It is before Texas District Court Judge Reed O’Connor, who in 2018 struck down the whole law in a separate legal battle that the Supreme Court decided on Thursday.

Under the law, insurers must offer certain preventive services — such as many immunizations, cholesterol and lung cancer screenings, mammograms, birth control and HIV prevention medications — at no charge to patients. This applies to most health plans, including those in the employer, individual and small business markets. Medicare enrollees also benefit from the provision.

In the case, Kelley vs. Azar, a group of individuals and businesses argue that mandate is unlawful for several reasons. They say that the three entities that determine what services are covered under the provision — the US Preventive Services Task Force, the Advisory Committee on Immunization Practices and the Health Resources and Services Administration — were not appointed properly and don’t have the authority to make such decisions.

The plaintiffs also raise free market and religious objections, saying they should be able to buy coverage that excludes or limits coverage of preventive services they don’t want or need. Some argue they are Christian and are unwilling to purchase plans that cover HIV prevention medications that “encourage and facilitate homosexual behavior.”

While comprehensive challenges to the Affordable Care Act are likely over, this case is concerning, said Tim Jost, emeritus professor at Washington and Lee University School of Law.

“It’s also indicative of what will continue to happen, which is lawsuits filed against specific provisions of the law or likely specific administrative decisions or rules,” he said.

Supreme Court keeps Affordable Care Act in place

The Supreme Court preserved the Affordable Care Act on Thursday, turning away a challenge from Republican-led states and the former Trump administration, which urged the justices to tear down the entire law.

The challengers did not have the legal right to bring the case, the justices said.

Filed after congressional Republicans failed to deliver on former President Donald Trump’s promised repeal of the landmark 2010 law, the case was the most serious threat to Obamacare in years.

A coalition of Republican state attorneys general led by Texas and joined by the Trump administration argued that the individual mandate is unconstitutional because Congress reduced the penalty for not having health insurance to zero as part of the 2017 Republican tax cuts — and that, as a result, the entire law must fall.

The Biden administration told the Supreme Court in February that it should uphold the Affordable Care Act, reversing the position of its predecessor.