The Department of Justice filed a motion on Friday to appeal a lower court decision that would allow insurers to stop covering certain preventive services for free in spite of an Affordable Care Act mandate.
The appeal follows a decision issued by Judge Reed O’Connor on Thursday that struck down requirements for health insurers to provide free coverage for certain preventive screenings and tests, including for sexually transmitted diseases, cancer and mental illness. The Affordable Care Act required this coverage beginning in 2011.
In his decision, O’Connor sided with a group of Christian business owners who argued their religious beliefs prevented them from participating in a health insurance plan that provided coverage that could make them “complicit in facilitating homosexual behavior, drug use, and sexual activity outside of marriage between one man and one woman.”
It is currently unclear which preventive services would be removed from the ACA’s coverage mandate under O’Connor’s decision. Coverage for PrEP, a drug used to prevent the transmission of HIV, was the only preventive service explicitly challenged in the case. But O’Connor’s decision could extend to screenings or exams for colorectal cancer, breast cancer, HPV vaccination and more, depending on which medical advisory board recommended the coverage and in what year.
O’Connor, a George W. Bush appointee, has made a name for himself as a fierce opponent of the Affordable Care Act. He has repeatedly overruled provisions of the law, including invalidating it entirely in 2018. That decision was overturned by the Supreme Court in 2021.
The appeal will be heard by the Fifth Circuit Court of Appeals, which is stacked with hardcore conservative Donald Trump appointees.