ACA Preventive Services at the Supreme Court

Copy link to quick take

Days before President-elect Trump takes office, the Supreme Court has taken the Biden administration’s appeal of the 5^th Circuit ruling in the case, Braidwood Management v Becerra, challenging the ACA’s preventive services requirements. While the plaintiffs challenged all the preventive services requirements, the Supreme Court’s review will be limited to whether the US Preventive Services Taskforce has the constitutional authority to issue binding recommendations on covered preventive services. The timing of this case raises questions about whether the Trump administration will take the same position as the Biden administration and defend the structure of the US Preventive Services Taskforce.

If the Court rules in favor of Braidwood, private health insurers would no longer be required to cover, without cost sharing, certain preventive services recommended by USPSTF after 2010 when the ACA was enacted. Any service that was first recommended by USPSTF after March 2010 (and is not also recommended under the Health Services and Resources Administration (HRSA) for women or children or the CDC’s Advisory Committee for Immunization Practices (ACIP for vaccines) would no longer be required to be covered without out-of-pocket costs. For example, services and medications like statins to prevent heart disease, lung cancer screening, and PrEP to prevent HIV could be subject to copays, deductibles, or coinsurance (Table 1).

This term, the Supreme Court is not considering the plaintiffs’ challenges to recommendations made by HRSA or ACIP, only the Task Force. However, this part of the case is being considered by the district court and could re-emerge at the high court in the future. 

The Supreme Court has not yet set the date for oral argument, and it is not yet known if the Trump administration will argue the case or if potentially a state, such as California, will step in to defend the ACA requirement, as they have in the past.