AFTER A FEDERAL Texas court ruling lobbed another potential grenade at comprehensive health coverage, a Massachusetts state board is pulling one of its lesser-known levers to make sure residents here don’t lose access to certain preventive services.

US District Court Judge Reed O’Connor issued an order in March limiting the scope of preventive services covered under the Affordable Care Act. The decision imperils coverage without cost-sharing for lung and skin cancer screenings, PrEP for HIV prevention, hepatitis B and C screenings, statins to lower cholesterol, and medications and certain screenings for  breast cancer. A contraceptive coverage provision made it out of the ruling untouched. 

While the ACA has mandated for the last decade that insurers cover these services without out-of-pocket costs for the insured, the new decision would place that discretion back in the hands of insurers and providers in the next round of coverage. 

The Biden administration is currently appealing the ruling, but it set off a slow-burning fuse to reduced coverage. If the ruling is upheld, it would apply to insurance policies beginning in 2024.

The state isn’t waiting around to find out. 

“I hope that we have a united community view that preventive services without cost-sharing are very important to public health, to individual health, to community health,” Massachusetts Health Connector board member Nancy Turnbull said at a recent board meeting.

The board voted to amend state Minimum Creditable Coverage, or MCC, standards for insurance plans to include the prevention services under threat by the federal ruling. Under Massachusetts’ individual coverage mandate, residents must have health care that covers specific services or pay a tax penalty, so the Health Connector board can nudge insurers into changing their offerings by changing the requirements for the minimum care.

“While MCC does not apply to the health plans directly, plans often choose to meet MCC standards so that their members don’t face tax penalties, and so that their coverage remains attractive to Massachusetts residents,” Kayla Scire, associate director of policy at that Massachusetts Health Connector, explained at the board’s recent meeting.

About 97 percent of Massachusetts residents have health insurance, according to the state, and the MCC regulations control coverage requirements for almost 5 million Bay State residents.

There would be little change for insurers under the new rules, health officials said, since these services have already been required under the ACA. 

Public hearings and comment periods will kick off in the next few weeks on the draft regulations. If the process chugs along as expected, the board would vote to approve and adopt the new regulations by early August.

Health Connector executive director Audrey Morse Gasteier said most Massachusetts companies have already said they plan to continue to provide coverage for these services regardless of the Texas ruling.

“These are services that consumers in Massachusetts, as well as across the country, have come to count on for the last decade, thanks to the Affordable Care Act,” she said. “So, we were really pleased and appreciative to see how rapidly the Massachusetts carrier market came to the table to say that erosion of these standards is not something that they were interested in seeing.”

JENNIFER SMITH

FROM COMMONWEALTH

A different side of Rachael Rollins: Two federal ethics reports paint a picture of US Attorney Rachael Rollins that is far different than the public image she crafted as a straight-talking, progressive Suffolk County district attorney. The reports indicate she flagrantly ignored ethics rules and leaked information and documents to reporters to help her preferred replacement as DA. She then lied about what she had done until she was confronted with text messages that said otherwise.

– “Her repeated efforts to leak non-public DOJ information for the purpose of harming a political candidate rank among the most flagrant violations of the Hatch Act that OSC has ever investigated,” the Office of Special Counsel said in a sprawling 161-page report. In his letter to President Biden conveying the report, Special Counsel Henry J. Kerner said Rollins’s behavior “constitutes an extraordinary abuse of her authority and threatens to erode public confidence in the integrity of federal law enforcement actions.”

– The two reports focused heavily on her role in supporting Ricardo Arroyo and opposing Kevin Hayden for DA and her decision to attend a Democratic National Committee fundraiser with Jill Biden in Andover. Her other transgressions were accepting 30 tickets from the Boston Celtics for youth basketball players as well as two for herself and accepting free travel without authorization.

– A darling of the Massachusetts political establishment and a lightning rod for conservative national politicians, Rollins indicated on Tuesday that she would resign on Friday. She said nothing about the allegations contained in the federal reports on Wednesday. Read more.

Rollins and the Globe, Herald: The federal ethics reports focused heavily on how US Attorney Rachael Rollins wheeled and dealed behind the scenes with the Boston Globe and the Boston Herald, providing a rare public glimpse of the underbelly of political reporting. The reports suggest that some reporters at the two newspapers had first-hand knowledge of Rollins’s shady behavior but didn’t report on it because she was their source. Read more.

OPINION

Shake up the US Supreme Court: Boston defense lawyer James Doyle takes aim at the US Supreme Court, saying it’s time for radical change, including breaking up “the club” and banning justices from accepting outside income. Read more.

FROM AROUND THE WEB

BEACON HILL

Gov. Maura Healey vows to double the state’s commitment to new bridges over the Cape Cod Canal to $700 million as part of an effort to draw federal funding for the effort. (Boston Globe) 

MUNICIPAL MATTERS  

Barbara Davis-Hassan, a member of the Planning Board in Lanesborough, is facing a State Ethics Commission investigation for her role in negotiating the sale of the Berkshire Mall by an Ohio company and receiving a $240,000 commission. (Berkshire Eagle)

The Boston City Council moves to make Malcolm X’s birthday a municipal holiday. (Boston Herald) 

Gloucester gears up for this season’s out-of-town beach parking, where spots are sold in advance online. The cost runs as high as $35 on weekends and holidays at Good Harbor and Wingaersheek beaches. (Gloucester Times)

Officials say brush fires in Lynn Woods Reservation were intentionally set. (Daily Item)

HEALTH/HEALTH CARE

Americans With Disabilities Act complaints have been filed after Mass General Brigham told patients they could not ask medical staff to wear masks. Though the hospital removed that guidance, immunocompromised patients say this places an unreasonable burden on them to ask staff to wear protective gear. (GBH News)

ELECTIONS

Voting rights advocacy groups are seeking to intervene in the federal court case over redrawing the political boundaries of the nine Boston City Council district seats. (Dorchester Reporter)

EDUCATION

Framingham is dealing with a teacher shortage by recruiting foreign, bilingual educators with H-1B visas. (WBUR)

Parents react to the transphobia allegations at Amherst Regional Middle School. (Daily Hampshire Gazette)

ENERGY/ENVIRONMENT

A federal judge rejected claims by a group called Nantucket Residents Against Turbines that federal agencies violated the Endangered Species Act by approving permits for Vineyard Wind.

CRIMINAL JUSTICE/COURTS

Superiors of Jack Teixeira, the Massachusetts Air National Guard member charged with leaking highly classified military documents, flagged concerns multiple times about his handling or viewing of classified information. (MassLive)

MEDIA

The Columbia Journalism School is going to offer loan repayment assistance to graduates who go to work for nonprofit news outlets.