Preventive Care Coverage Threatened by Federal Court Ruling

Carmel Shachar, JD, MPH¹; Elizabeth Kaplan, JD¹

Originally published in JAMA. Published online September 23, 2024. doi:10.1001/jama.2024.16439

The latest case out of Texas and the US Fifth Circuit Court of Appeals to threaten vital public health policies is Braidwood Management Inc v Becerra.¹ The Braidwood plaintiffs seek to end the Patient Protection and Affordable Care Act (ACA) requirement that insurance plans cover a range of recommended preventive services without cost-sharing. The Fifth Circuit called its June 2024 decision in this case “a mixed bag” in that it ruled in favor of the plaintiffs but limited the influence of the case to just the parties who sued and did not reshape private health insurance nationwide.²

But a more apt metaphor than a mixed bag is that serious storm clouds are on the horizon. Advocates anticipated that the Fifth Circuit’s ruling would be similar to that of the district court and that this case would proceed quickly to the Supreme Court. Instead, the Fifth Circuit remanded—or sent back to the district court—key aspects of this case while providing a road map for the plaintiffs, or future parties in copycat lawsuits, to expand their narrow win to apply more broadly. This Viewpoint highlights the 2 most concerning aspects of the Braidwood ruling and their potential effect on health equity.

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