Debate: Is the ACA Preventive Care Mandate Unconstitutional?

A federal judge in Texas recently declared that the Affordable Care Act (ACA) preventive care mandate is unconstitutional under the Appointments Clause. The preventive care mandate requires health care providers to cover certain preventive services without requiring the patient to contribute to the cost (whether through deductibles, copays or otherwise).

Covered services are those that have an “A” or “B” rating, as determined by an advisory committee called the U.S. Preventive Services Task Force. Examples of covered services include cancer screenings and drugs that can reduce the risk of contracting HIV or lower the patient’s cholesterol (and similar preventive services). The Texas court has now issued a nationwide injunction, though the federal government is appealing the decision.

We asked two professors and authors of ALM’s Tax Facts with opposing political viewpoints to share their opinions about the recent Texas court ruling on the ACA preventive care mandate.

Below is a summary of the debate that ensued between the two professors.

Their Votes:

Bloink

Byrnes

Their Reasons:

Byrnes: The argument against mandatory preventive services under the ACA is a solid one. Members of the preventive services task force are not appointed by the president or the head of a governmental department. Because of that, they should be independent and not subject to political mandates and pressures like the ACA preventive services mandate. Based on the letter of the law, the mandate is unconstitutional as written and enacted in practice.

Bloink: The preventive services mandate is in place for a reason. These services are designed to reduce the overall cost of health care by keeping people healthier in the first place. When people receive preventive care and screenings, they’re much less likely to contract more serious illnesses or experience complications. The mandate benefits all Americans, and there is no sound reason for repealing it.

Byrnes: The preventive care mandate requires doctors to provide services that can be politically charged or involve controversial issues. Not all medical professionals agree with some of the mandatory preventive services that are covered under the mandate.