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State Leaders: Affordable Care Act Ruling in Texas Does Not Currently Change Covered Preventive Care
September 14, 2022
Media Contact: Laura Hall, 517-290-3779, DIFSfirstname.lastname@example.org
Consumer Hotline: 877-999-6442, Michigan.gov/DIFScomplaints
FOR IMMEDIATE RELEASE: September 14, 2022
(LANSING, MICH) State of Michigan health leaders are advising Michiganders that a Texas federal judge’s decision in Braidwood Management Inc. v. Xavier Becerra does not currently change the preventive care to which they are entitled under the Affordable Care Act (ACA). Though the Braidwood ruling does not take immediate effect, and proceedings are ongoing, this case could ultimately have long-term impacts on the ACA and the health of Americans nationwide.
“Under the ACA, life-saving preventive services like cancer screenings, immunizations, and statin treatments to prevent strokes must be covered by most health plans, an important consumer protection that contributes to Michiganders’ overall health,” said DIFS Director Anita Fox. “It is important to note the Braidwood decision does not take immediate effect, so preventive services, including the HIV medication at issue in this case, must still be covered in Michigan and around the country. For questions about health insurance, you can call DIFS at 877-999-6442, Monday through Friday from 8 a.m. to 5 p.m. or visit Michigan.gov/HealthInsurance.”
“Science has given us the tools to end life-threatening epidemics and prevent illness or serious health conditions,” said Dr. Natasha Bagdasarian, Michigan Department of Health and Human Services chief medical executive. “Coverage of HIV-prevention medication is absolutely vital to reducing the burden of this preventable infection on people and their communities. Michiganders are urged to talk with their health care provider about all forms of HIV prevention.”
The decision in Braidwood Management Inc. v. Xavier Becerra focuses on the HIV-prevention medication known as pre-exposure prophylaxis, or PrEP. PrEP is specifically named as one of the preventive treatments that must be covered by most health plans under the ACA. Braidwood holds that an employer’s religious beliefs can allow the employer to refuse to provide health insurance coverage for this highly effective medication for their employees. The Braidwood decision does not take effect immediately and is very likely to be appealed to the United States Supreme Court (SCOTUS), a decision that could have implications for other types of preventive care and potentially bring about the end of the ACA’s preventive care mandate.
In addition to PrEP, the ACA’s preventive care mandate requires that most health plans cover a variety of medical treatments to prevent serious medical conditions including heart disease, cancer, depression, and must also provide coverage for contraception. These preventive services must be covered without copay or coinsurance requirements. Ending this mandate could significantly increase the cost of these services, effectively putting them out of the reach of many individuals and families.
This ruling does not yet affect Michiganders or the preventive services to which they are entitled under their health plan. Michiganders can continue to seek these services as prescribed by their doctors. For more information about health insurance and how to use it, visit Michigan.gov/HealthInsurance or call 877-999-6442, Monday through Friday from 8 a.m. to 5 p.m.
Open enrollment for 2023 health insurance is currently scheduled to begin on November 1, 2022. Michiganders can obtain coverage by visiting the Health Insurance Marketplace or by calling 800-318-2596 (TTY: 1-855-889-4325). During open enrollment, Michiganders will be able to choose from 233 health plans on the Marketplace, 59 more than last year. For the overall individual market, which includes off-Marketplace plans, 308 plans will be available, 52 more than last year.