Over a decade has passed since the Affordable Care Act (ACA) became law, requiring certain preventive services to be covered without patient cost-sharing, including lung cancer screening for those at high risk and tobacco cessation coverage. A federal court case, Kennedy v. Braidwood (formerly Braidwood v Becerra), challenges the ACA’s requirement that most plans cover preventive services without cost-sharing.
U.S. District Judge O’Connor ruled in September 2022 that the USPSTF coverage requirement must be vacated and cannot be enforced by the U.S. Department of Health and Human Services (HHS). On March 30, the judge ruled that all ACA-compliant plans including employer-sponsored and Medicaid expansion plans are no longer required to cover USPSTF preventive services that were decided upon after March of 2010, without cost-sharing. Judge O’Connor declined to stay his remedy through the appeals process; the 5th Circuit Court of appeals has stayed the decision pending their review of the case.
On June 21, 2024, the 5th Circuit Court of Appeals issued a ruling that limits the initial decision to the individual plaintiffs that brought the case. As a result, the preventive services requirement is largely preserved for most people in the United States. On September 19, 2024, the Justice Department filed a petition to the U.S. Supreme Court, asking them to review the 5th Circuit’s decision on the USPSTF preventive services requirement and reverse the decision.
On June 27, 2025, the U.S. Supreme Court ruled in favor of the government’s position in Kennedy v, Braidwood, confirming that all ACA-compliant plans must cover preventive services without cost-sharing. However, the Court also reaffirmed that the Secretary of HHS has the authority to accept or deny any recommendations received and to appoint, supervise, and remove USPSTF members, leaving the possibility of future changes to preventive services from the Secretary open.
We have information on the case and key resources to help protect access to preventive services without cost-sharing.
Page last updated: July 15, 2025
