Possible Implications on Healthcare Screening Coverage
The U.S. Supreme Court heard oral arguments in Kennedy vs Braidwood Management this week, a case that has major implications for the coverage of preventative services that receive an A or B grade from the United States Preventive Services Task Force (USPSTF) with no cost sharing for the patient. Coverage was established for these services in the Affordable Care Act.
Braidwood Management, representing a conservative Christian group of employers, originally filed the lawsuit in Texas. The lawsuit contends that the requirement that private insurers cover certain preventive services violates their freedom of religion and that the broader coverage mandate of all services with an A or B grade from the USPSTF is unconstitutional because USPSTF members are not appointed by the president and confirmed by the U.S. Senate.
The U.S. District Court for the Northern District of Texas ruled in favor of Braidwood Management. The Biden Administration appealed that decision to the U.S. Court of Appeals for the Fifth Circuit. The appellate court affirmed the previous ruling in favor of Braidwood. However, it ruled that only the plaintiffs were allowed to exclude covering taskforce-recommended services for their employees. The Biden administration appealed to the Supreme Court, which is only deciding whether binding no-cost coverage to task force recommendations is constitutional.
The Trump administration is defending the constitutionality of the USPSTF, arguing that the ACA provision is constitutional because the secretary of Health and Human Services has authority over the USPSTF. The Supreme Court is expected to decide by July.
The American College of Radiology® (ACR®) is monitoring the case, which – depending on how any ruling is worded – could potentially affect full insurance coverage (with no copay) of at least some cancer screening exams.
If you have questions, contact Rebecca Spangler, ACR Senior Government Relations Director.
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