Court hearing on ACA preventive care takes up judicial power
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A high-profile appellate court hearing on Tuesday took up whether a single judge could halt the Affordable Care Act's preventive health services mandate nationwide.
Why it matters: Nationwide injunctions have become a hotly contested topic in several cases involving health care, with critics questioning if one judge should be able to shape national policy on matters like drug safety.
Driving the news: A three-judge panel of the 5th U.S. Circuit Court of Appeals heard arguments on whether to unfreeze an injunction issued by U.S. District Judge Reed O'Connor that struck down the ACA's preventive care provision.
- Legal experts say that a ruling could come as soon as this week.
- O'Connor's ruling grants relief not only to plaintiffs who challenged the mandate but could potentially eliminate cost-free coverage of HIV prevention, cancer screenings and other services recommended by the U.S. Preventive Services Task Force.
By the numbers: If the ruling is affirmed, it could shift some costs of preventive care services to more than 150 million people.
Details: Alisa Klein, an attorney for the Justice Department, argued that O'Connor committed a "legal error" when he issued the universal injunction, and that he failed to consider the "public interest" in his ruling.
- O'Connor's ruling "extinguished the rights of about 150 million people who are not parties in the case," Klein said.
- Jonathan Mitchell, who represents the companies that challenged the mandate, urged the court to let the injunction take effect, but the judges grilled him on whether universal remedy was even called for.
- The judges seemed to doubt that some of the plaintiffs who've opposed the ACA mandate and haven't bought insurance since 2019 would buy coverage if the requirement went away.
What they're saying: The court is really evaluating whether it should "disrupt the national market" based on hypotheticals that lack concrete evidence that Mitchell's clients would even participate on the market, said Andrew Twinamatsiko, associate director of the O'Neill Institute at Georgetown Law School.
Zoom out: The subject of nationwide injunctions issued by singular district judges has been in the spotlight particularly since U.S. District Judge Matthew Kacsmaryk ordered the FDA to halt its approval of the widely-used abortion pill mifepristone. That order has since been blocked by the Supreme Court.
- The justices have previously warned lower courts to be cautious about issuing nationwide injunctions that could negatively impact the rule of law.
- But they have never ruled on whether nationwide injunctions are constitutional.
- Similarly, the 5th Circuit has previously overturned these types of injunctions, arguing that a universal remedy must be "justified" before it is issued.
