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Millions may lose free preventive health care after ruling by federal judge in Texas

JUANA SUMMERS, HOST:

Americans may lose access to preventative health care services that are required to be free under the Affordable Care Act. A federal judge struck down that provision in the ACA. NPR's Will Stone has more.

WILL STONE, BYLINE: Dr. Mark Fendrick helped draft the preventive care mandate that was part of the Affordable Care Act, so this case has made him very nervous.

MARK FENDRICK: The clinical benefits, the economic benefits and the equity benefits of expanded access to preventive care will be markedly diminished.

STONE: Fendrick is a professor at the University of Michigan. Estimates are more than 150 million Americans can get preventive health care with no cost sharing because of this provision in the ACA. Specifically, the ruling takes aim at any health screenings or treatments that were recommended since 2010. This includes everything from screenings for lung cancer or skin cancer to statins to some medications for people at high risk of breast cancer.

FENDRICK: What concerns me is that if we fall back and people say, oh, we have to put the pre-2010 recommendations in place, there is significant potential for either obsolete or, in my opinion, potentially harmful recommendations.

STONE: The ruling also jeopardizes access to the HIV prevention drug PrEP. Dr. Michelle Cespedes chairs the HIV Medicine Association.

MICHELLE CESPEDES: I consider this a major setback to all of the efforts that we put toward ending the HIV epidemic.

STONE: PrEP had been covered by the ACA mandate, but the lawsuit, which was brought by a group of Christian business owners, also claimed that requiring coverage of PrEP violated their religious beliefs, and the judge, Reed O'Connor, agreed. Cynthia Cox at the Kaiser Family Foundation says some of the most common preventive services won't be affected, for example, screenings for breast cancer and cervical cancer, as well as routine childhood immunizations.

CYNTHIA COX: Assuming that this ruling stands, what this does is it turns decisions back over to insurers for certain services.

STONE: The Biden administration is appealing the ruling. In the meantime, health insurers have said there won't be any immediate disruptions in care or coverage. Will Stone, NPR News. Transcript provided by NPR, Copyright NPR.

Will Stone