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Trump to decide fate of free preventative care under ACA

The Trump administration will have to decide whether to defend a key part of the Affordable Care Act, after the Supreme Court agreed to hear a case challenging the law’s requirement to cover preventive services.

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The health law requires insurers to cover, without cost-sharing, more than 100 preventive health services recommended by the U.S Preventive Services Task Force (USPSTF), a volunteer panel of national experts in disease prevention and evidence-based medicine who advise the Department of Health and Human Services.

But a group of Christian employers in Texas sued the administration, arguing the panel is unconstitutional because its members aren’t confirmed by the Senate or appointed by an agency head who is Senate-confirmed, yet its recommendations are binding.

Conservative lower courts have mostly ruled in favor of the plaintiffs.

A federal judge in Texas in 2022 ruled in favor of the plaintiffs and blocked the requirement nationwide. The U.S. Court of Appeals for the 5th Circuit in New Orleans ruled last summer that the coverage mandate was unconstitutional, but only the companies that sued were permitted to exclude USPSTF recommended services from their plans.

The Biden Justice Department urged the justices to take up the case, petitioning the court to uphold the task force as constitutional.

If the court were to rule in favor of the employers it could jeopardize coverage for tens of millions of people, putting patients on the hook for the full cost of potentially lifesaving treatments and screenings that are currently free and reshaping the health coverage landscape.

However, the timing of the case means it will be up to the Trump administration to decide if it wants to continue defending the law.

Since the enactment of ObamaCare in 2010, more than 2,000 legal challenges have been filed in state and federal courts contesting all or part of the law, including efforts championed by Trump in his first term. While the law remains popular, lawsuits and conservative judges continue to try to weaken it.

Welcome to The Hill’s Health Care newsletter, we’re Nathaniel Weixel, Joseph Choi and Alejandra O'Connell-Domenech — every week we follow the latest moves on how Washington impacts your health.

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