Legal Update: ACA Case Highlights Lingering Uncertainty for Preventive Services



A recent court ruling is reactivating HR and benefits concerns for employers around coverage for preventive services allowed under the Affordable Care Act (ACA) with no cost-sharing to patients. The ruling in the case, Braidwood v. Becerra, found that employer-sponsored medical plan coverage for certain preventive services violates religious beliefs.

The case involved Braidwood Management, Inc., a Christian nonprofit that challenged the legality of some ACA preventive service requirements under the Religious Freedom Restoration Act. Specifically, Braidwood took exception to coverage for preexposure prophylaxis (PrEP) drugs preventing HIV, claiming the ACA preventive service mandates deprive the organization of the ability to choose how their plan covers preventive care on religious grounds. Braidwood had excluded coverage for PrEP drugs and other preventive services in its self-insured plan and faced penalties for not complying with ACA preventive service coverage requirements.

Judge Reed O’Connor, whose previous ruling that ACA was unconstitutional in its entirety was overturned by the Supreme Court in 2018, ruled in September 2022 in favor of Braidwood, finding that the Fifth Circuit U.S. Court of Appeals stayed O’Connor’s ruling, essentially pausing any actions or changes.

Potential implications for DEI programs

While there is no immediate action for employers to take at this point, this is an important case to watch going forward because of its potential implications for not only HR and benefits, but also DEI (diversity, equity, and inclusion) programs and policies that aim to create and stigma-free workplaces. It’s notable that this week marked Zero HIV Stigma Day (July 21) with global efforts to raise awareness about HIV stigma and how to eliminate it.

As employers of all sizes, including small and medium-sized businesses (SMBs) continue to make strides toward more diverse, equitable, and inclusive work environments, it’s important to keep benefits top of mind as discussed in Mineral’s recent webinar, “From Performative to Purposeful: Small Business Strategies for DEI.”

Watch or listen to the session on-demand here.

Author: Mineral
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