WASHINGTON (CN) — The Supreme Court agreed Friday to decide whether health insurance companies must cover preexposure prophylaxis, known as PrEP, under the Affordable Care Act.
Under the law, private insurers must cover certain categories of preventative care based on advice from the Preventative Services Task Force. Since the ACA’s enactment, the medical community reported an increased use of preventive services that would save over 100,000 lives and billions of dollars each year.
A lawsuit from four individuals and two small businesses challenged the ACA’s requirement that insurers and plans cover PrEP, which is used to prevent HIV infection for at-risk individuals. They say that the medication encourages homosexual behavior in violation of their religious beliefs.
Their lawsuit, however, targeted the task force’s structure, and they claimed it is unconstitutional under the appointments clause. U.S. District Judge Reed Charles O’Connor of the Northern District of Texas, an appointee of President George W. Bush, agreed, ruling that task force members are principal officers who must be appointed by the president.
According to the government, O’Connor’s ruling would eliminate coverage for any preventative services the task force has recommended since 2010. The Biden administration said that would leave health plans to eliminate coverage for screenings for diseases like lung cancer or diabetes, or restrict medications such as statins for cardiovascular disease and stroke.
“If all post-2010 Task Force ‘A’ and ‘B’ recommendations became nonbinding nationwide, a material number of issuers and group health plans would be expected to ‘drop coverage or impose cost sharing for certain preventive services,’” the government wrote.
Although the plaintiff individuals and businesses supported disputed the government’s dire predictions, they supported the petition for certiorari, saying the question was a matter of exceptional importance that the Supreme Court should weigh in on.
In another appeal from the Biden administration, the justices agreed to review borrowers’ defense to be relieved of certain student loans. After the 2015 collapse of Corinthian Colleges, the Education Department created a process for reviewing claims for similarly situated borrowers.
Borrowers flooded the department with claims, leading to a backlog of 210,000 pending applications. In 2022, the Biden administration proposed a rule to streamline the process. The rule allows the department to review requests for an administrative discharge based on a borrower’s defense to repayment and to discharge a borrower’s loan when the department finds a defense valid.
A trade association representing for-profit Texas colleges sued to block the rule. An appeals court found that the association was likely to prevail in its challenge against recoupment for discharged loans.
The justices will also review the authority of the Internal Revenue Service to collect unpaid taxes when there is no longer a live dispute over the proposed levy that ignited the proceeding.