Boston University, Boston, MA, USA.
Am J Law Med. 2023 Mar;49(1):112-119. doi: 10.1017/amj.2023.19. Epub 2023 Jun 28.
This article discusses how in March of 2023 a District Court in Texas enjoined the U.S. government from enforcing certain preventive care requirements under the ACA for private health insurers. The current order by the Court enjoined enforcement of the ACA preventive care requirements based on those recommendations made on or after the date of March 23, 2010, by the U.S. Preventive Services Task Force. This article discusses the Court's analysis and the remedy the Court decided on after finding violations under the RFRA and Appointments Clause. The article also discusses the implications and effects of this decision on whether previously covered services that the ACA didn't allow cost sharing for will now have cost sharing by private health insurers and how that will affect consumers. The article concludes that despite lack of enforcement, private health insurers should not require cost sharing for previously covered services that the ACA didn't allow cost sharing for before this most recent decision. Cost sharing for previously covered services would increase costs for those enrolled in private health insurance plans and could lead to a reduction in access to preventive services and healthcare.
本文讨论了 2023 年 3 月，德克萨斯州的一个地区法院禁止美国政府对私营医疗保险商执行《平价医疗法案》（ACA）规定的某些预防保健要求。法院目前的命令基于美国预防服务工作组在 2010 年 3 月 23 日或之后提出的建议，禁止执行 ACA 的预防保健要求。本文讨论了法院的分析和在发现违反《宗教自由恢复法案》和《任命条款》后法院决定的补救措施。文章还讨论了这一决定对 ACA 不允许分担费用的先前涵盖服务现在是否会由私营医疗保险商承担费用分担以及这将如何影响消费者的影响和效果。文章的结论是，尽管缺乏执行，私营医疗保险商不应要求为 ACA 之前不允许分担费用的先前涵盖服务分担费用，因为这是最近的决定。对于先前涵盖的服务分担费用将增加参加私人医疗保险计划的人的成本，并可能导致预防性服务和医疗保健的获取减少。
