Detroit clinic speaks on ruling to strike down ACA preventative care mandate
(CBS DETROIT) – A Texas federal judge ruling may change the amount you pay the next time you go to the doctor's office.
On Thursday, U.S. District Judge Reed O'Connor declared a portion of the Affordable Care Act requiring insurance companies to cover preventive services without charging patients is unconstitutional.
The decision is expected to impact at least 150 million people.
"I think this speaks to decision makers not really being attuned to the challenges that our patients face," said Dr. Kimberly Farrow, President and CEO of Central City Integrated Health.
The clinic, located at 10 Peterboro Street in Detroit, provides healthcare to the city's neediest.
"We do things such as blood pressure monitoring, cancer screenings, wellness checks, and all these things are bundled into what's called preventative care," Farrow said.
Central City can offer its services to the uninsured and underinsured as a federally qualified health center for $5.
However, in a traditional practice, an annual checkup can cost 33 times more than that.
"The cost for an organization to do a complete wellness check can be anywhere from $165 to $200 depending on all of the assessments that were done during that encounter," Farrow said.
Following O'Connor's ruling, insurance companies will be allowed to implement co-pays for preventive care, especially for services that were covered after 2010, like anxiety screening for adolescents, lung and skin cancer screenings, certain statins, and HIV prevention medication known as PrEP.
"After this judge's decision, employers and insurance companies may decide to ask patients to pay out of pocket to access that medication. And we've got very good evidence, people to pay for something, they're going to get less of it," said Nicholas Bagley, professor at the University of Michigan Law School.
Since the ruling, health insurance companies have said there wouldn't be immediate changes in coverage. But come next year, all bets are off.
"They're running businesses, and they're going to make our business judgment about whether they can afford to give $0 coverage and whether that makes sense for them," Bagley said.
Farrow believes the decision, which is expected to impact marginalized groups the most, may result in more people visiting her clinic.
"Unless there are significant efforts made to improve the care for these populations, to ensure that these populations have access to high-quality health care services, by the way of insurance, for example, we are going to see a significant downturn turn in the care and the clinical health care outcomes for these populations," Farrow said.
The government is expected to appeal the decision.
Bagley wouldn't be surprised if it makes it all the way up to the U.S. Supreme Court.
