Having repeatedly seen the Affordable Care Act (ACA) escape near death at the hands of the courts, advocates said Wednesday that a key provision in the 13-year-old landmark health insurance law is in new jeopardy.
This time the focus is on a requirement in the law for free coverage of preventive health care.
A federal judge in Texas struck down the requirement, ruling in March that it is unconstitutional. A federal appeals court ruling imposed a partial stay on the order, allowing the preventive health care provision to continue while the lower court ruling is appealed.
The free preventive care provision is “part of what the ACA does that has made it so valuable and so effective in improving public health,” Wisconsin Attorney General Josh Kaul said Wednesday. “It’s preventative care for things like mental illness and substance abuse, preventive care for diabetes, preventive care for HIV. That kind of preventative care helps save lives and helps people live healthier lives. And it’s critical that we protect it.”
Attorney General Josh Kaul speaks at a press conference about the importance of preserving free preventive health care under the Affordable Care Act. Behind him, left to right, are Joe Zepecki of Protect Our Care, Brendan Hill of Vivent Health, and Mona Williams of Planned Parenthood of Wisconsin. (Wisconsin Examiner photo)
Kaul spoke during a news conference organized by Protect Our Care, an ACA advocacy group, held at the Madison offices of Vivent Health. The multi-state nonprofit agency provides health care, social services and HIV prevention.
Wisconsin is one of more than 20 states to have signed on to a friend of the court brief in the preventive care case, Kaul said.
He noted that after taking office in 2019, he withdrew Wisconsin from the lawsuit by GOP-led states to throw out the ACA entirely and instead joined a friend of the court brief supporting the act that ultimately succeeded.
“And what that has meant is that millions of Americans have been able to keep their health insurance coverage,” he said. “And people have been able to get care whether or not they have a preexisting condition.”
Vivent’s interim president and CEO, Brandon Hill, said the organization’s more than 5,000 Wisconsin clients account for more than half of the state’s residents living with HIV.
“Most of our people face economic insecurity, with 87% below the federal poverty line,” he said. Half or more of Vivent’s clients in the state are people of color and more than half identify as gay, bisexual or transgender.
“These are also the communities whose health and well-being are being targeted time and time again by these public policies and attacks,” such as the current lawsuit, Hill added. “These attacks force our friends, our neighbors, our community members who are part of these groups further and further away from health care.”
Hill said the court ruling would thwart progress in the efforts to end the spread of HIV and to reduce health disparities that affect people of color and the LGBTQ community.
Brendan Hill, interim president and CEO of Vivent Health. (Wisconsin Examiner photo)
“The wrong decision in this case would mean that employers could determine what health care was available for their employees [through] their benefits,” he said.
Eliminating free coverage for preventive services and imposing new cost-sharing requirements on the patients who use them “would target low-income communities, low-income communities of color, and low-income LGBTQ communities,” Hill added. “It would overturn all of the significant gains we have made in reducing the rates of HIV in the state in the country.”
One key preventive treatment for people at continuing risk for HIV is pre-exposure prophylaxis, or PrEP for short, a regimen of continuing medication. Cutting off access “would force elevated rates of HIV infection and increase new rates among those living in poverty,” Hill said, with particular harm to the most vulnerable people. “Now is not the time to go backwards.”
Mona Williams, of Planned Parenthood of Wisconsin, said the importance of providing robust preventive care was illustrated by the story of a patient she encountered when working in patient care at one of the agency’s 22 health centers in the state.
The patient had never had a well-woman physical. After treating the woman’s recurring vaginal bleeding that had prompted her visit and that her primary doctor had failed to address, the well-woman exam revealed she had advanced cervical cancer, Williams said.
The patient was “a Black woman whose concerns were ignored time and time again by her primary care provider,” Williams said. “If she had access to the preventive care she needed earlier, she would have had a better chance at a quality of life.”
Williams said the patient was emblematic of those who would be most harmed if the ruling against free preventive care stands.
“Restrictions on access to prevent sexual and reproductive health disproportionately harms Black, Latina and indigenous communities who already face barriers to health care due to systemic racism and discrimination,” Williams said. “Rural communities and young people also face disproportionate barriers to sexual reproductive health care access.”
Williams tied the ruling to continuing threats to reproductive rights. And Kaul said that while it is “not directly related” to the attacks on public health that emerged during the COVID-19 pandemic, the ruling is part of a broader trend.
“What we have seen is broad efforts to undermine programs that are designed to promote public health,” Kaul said. “What this is about is whether we are valuing people’s health and their lives, or bottom-line profits for insurers.”
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originally published at https%3A%2F%2Fwisconsinexaminer.com%2F2023%2F07%2F20%2Fattorney-general-providers-warn-of-harm-if-court-undermines-aca-preventive-care%2F by Erik Gunn
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