Mifepristone: Science vs Politics discussed the ruling of a Federal District Judge in Texas on Alliance for Hippocratic Medicine v. FDA that banned the use of mifepristone for abortions. After many challenges, including the current administration, this ruling was mitigated by the 5th U.S. Circuit Court of Appeals which provided a compromise ruling that allowed the use of mifepristone, but only until seven weeks after conception; down from the previous ten weeks limit. This ruling only affected a small number of people.
A different conservative Federal District Judge in Texas has now made a ruling on Braidwood Management v. Becerra that involves the Affordable Care Act (ACA) could affect all of those with healthcare insurance.
Both cases were deliberately brought before judges that would favor the plantiffs and are probably headed to the Supreme Court for final resolution.
The ACA made major contributions to improving healthcare in this country. One of the most effective measures to do this is preventive care. The ACA did this by mandating that insurance companies pay the full cost of proven preventive care measures, such as vaccinations, yearly check-ups, mammograms, and screening for colon cancer.
This ruling stopped the ACA mandate that insurance companies pay the full cost of proven preventive care measures.
The suit was primarily based on the plaintiff’s religious objections to contraception and a form of preventive care — the pre-exposure prophylaxis pill (known as PrEP) used to prevent transmission of HIV during sexual encounters. The plaintiffs claim that use of PrEP violates their religious rights and equates to encouraging homosexuality, promiscuity, and intravenous drug use.
In addition to these specific objections, the case challenged all preventive care claiming that, because the United States Preventive Services Task Force consists of outside experts who were neither Senate-confirmed nor chosen by a Senate-confirmed agency head, some of the preventive care requirements under the ACA are unconstitutional — this judge had previously tried to rule that the entire ACA was unconstitutional. The judge ruled that recommendations of what services should be covered by insurance must be “set aside” and can’t be enforced.
The ruling meant that insurance companies would no longer be required to pay for any preventive healthcare services. After many objections, challenges, including the current administration, the 5th U.S. Circuit Court of Appeals mitigated this situation by proposing a compromise ruling that restores the preventive care mandate, but allows some of the plaintiffs to provide insurance plans that don’t include the preventive care.
Like the mifepristone ruling before it, this was a political statement. In order to impose his biased agenda the judge ignored the well-documented evidence that the covered forms of preventive care are effective to detect many conditions early and improve overall health.
This ruling also demonstrated an enormous amount of hubris by single-handedly deciding that this case should affect all insured patients and not considering the negative consequences that the resulting reduction in preventive care will have.
As a physician I am concerned that these rulings have empowered those who value opinion/convictions over science and opened the door to even more invasive and wide-ranging political interference in our healthcare, especially if The Supreme Court upholds these rulings.
