• Posted April 21, 2025

Supreme Court Case Targets Free Preventive Care Provided By The Affordable Care Act

Colonoscopy for younger adults. Chest CT scans for lung cancer. Statin meds to lower cholesterol. Screening for drug addiction.

More than 150 million Americans might lose no-cost access to these and other preventive care services under a case being heard Monday at the U.S. Supreme Court.

“Most people probably haven't even heard of the case, but for many people, they feel it's going to be the most impactful case in this Supreme Court session,” Michael Sapienza, chief executive officer of the Colorectal Cancer Alliance, said in an interview with HealthDay TV.

The case — Kennedy v. Braidwood Management — questions the way that the government under the Affordable Care Act (ACA) decides which preventive care services should be covered at no cost to patients.

The ACA designated the U.S. Preventive Services Task Force (USPSTF), an independent panel of national experts, as the body that would review available medical evidence and judge which preventive measures best benefit people.

Members of the USPSTF are selected by the secretary of health and human services, a post now held by Robert F. Kennedy Jr. 

The lawsuit was originally filed in 2022 by Braidwood Management on behalf of a group of conservative Christian employers in Texas who were opposed to covering medication to protect against HIV. More broadly, they argued that requiring private insurers to cover USPSTF recommendations was unconstitutional.

Under the Appointments Clause of the U.S. Constitution, they argued, USPSTF members actually should be appointed by the president and confirmed by the Senate.

If the Supreme Court agrees, insurance companies would not be required to fully cover preventive care measures that the USPSTF has recommended since the ACA’s passage in 2010, Sapienza said. One of those recommendations supports prescription medication to prevent HIV transmission.

“Basically, it would revert back to pre-ACA recommendations,” he said. “Since 2010, a lot of things have changed, whether we're talking about cancer screenings or heart disease screenings or hypertension screenings.”

For example, the USPSTF in 2021 lowered the screening age for colon cancer from 50 to 45, making earlier screening available to millions of Americans, Sapienza said.

“Colorectal cancer is the No. 1 cause of cancer-related deaths in men under 50, so there's a big reason why they lowered that screening age to 45,” Sapienza said. 

“If the Supreme Court rules that this is unconstitutional," he continued, "we would revert back pre-2010 recommendations, which did not recommend that people 45 to 49 would have their screenings covered.”

Overturning the ACA’s coverage of early colon cancer screening could lead to a 5% annual increase in colon cancer cases and a nearly 9% increase in colon cancer deaths by 2055, according to an analysis by the journal Health Affairs.

During Trump's first term, his administration supported the suit. Now, the Trump administration is arguing against this lawsuit — meaning that it wants the USPSTF's recommendations since 2010 to stand.

“I think that everybody in this country, whether you are Republican, Democrat or independent or other, believes that preventative services…should be free,” Sapienza said. “The Alliance was really, really happy to see that the Trump administration was going to be arguing against ruling that this is unconstitutional. That's a really good sign from both the president himself plus HHS secretary R.F.K. Jr., that they also believe in these preventive services.”

Arguments that members of the USPSTF aren’t qualified or are selected to grind a certain political axe are spurious, Sapienza said.

“I've known many members of the United States Preventative Services Task Force in the last 15 years, and every single one of them are hardworking, smart, top-of-their-field people that understand what is best for the American people,” Sapienza said. “I've never ever seen one instance of any political interference.”

Congress and the Trump administration should be looking into ways to boost the USPSTF's funding, Sapienza said.

Historically, he said, the task force has been very slow, because of their funding. 

“They're only funded, I think it's about $11 or $12 million, and they're in charge of deciding 66 preventative services that affect the health of all these people,” Sapienza said.

“We should be talking about how do we fund the Preventative Services Task Force in a way that we can speed up them looking at recommendations for Americans to make them healthy,” Sapienza concluded.

More information

KFF has a list of preventive services that could be affected by the Kennedy v. Braidwood Management decision.

SOURCE: HealthDay TV, April 21, 2025; Health Affairs, April 18, 2025