ACA Preventive Services Coverage Rules

Summary

This practice note discusses the rules under the Patient Protection and Affordable Care Act (ACA) dealing with mandatory coverage for preventive services. The ACA added Section 2713 to the Public Health Service Act (PHS Act), which is incorporated into the Employee Retirement Income Security Act (ERISA) and the Internal Revenue Code. It requires non-grandfathered group health plans and health insurance coverage to provide certain specified preventive health services without cost sharing. This practice note explains the preventive services ACA requirements, including new proposed rules that would provide a workaround for accessing contraceptive services when a plan or issuer refuses to cover those benefits based on sincerely held religious beliefs. The practice note discusses the impact on preventive services coverage of the 2023 U.S. District Court decision in Braidwood Management Inc. v. Becerra.