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, 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. 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.
The Court of Appeals’ decision could result in additional legal challenges that threaten the accessibility of other preventive care, including access to vaccinations recommended by other bodies.
We have information on what is happening in the case and key resources to help protect access to preventive services without cost-sharing.
Page last updated: September 23, 2024
