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Uncertain Future for ACA Preventive Services Mandate


Pursuant to provisions of the Affordable Care Act (ACA), most employer-sponsored health plans must cover 100% of the cost of preventive care services without regard to deductible and other out-of-pocket costs, such as co-payments. In upholding in part a ruling of the U.S. District Court for the Northern District of Texas, the 5th Circuit Court of Appeals ruled last week in Braidwood Management, Inc. v. Becerra that portions of the preventive care mandate violate the Appointments Clause of the U.S. Constitution. However, the 5th Circuit removed the nationwide ban on enforcement of certain aspects of the preventive care mandate and remanded the case back to the district court for more deliberations.

This issue and its impact on employer-sponsored health plans is uncertain. Before making changes to the preventive services coverage under your employer-sponsored health plan, careful consideration of this case and its reach to your plan is recommended. The Employee Benefits team at Quarles will continue to monitor and provide updates on this situation.

For more information or if you have any questions about the information in this newsletter, please contact your Quarles & Brady counsel or:

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