The Supreme Court on Monday should hear arguments in a case contesting a provision of the affordable care law which obliges private insurers to cover the screening, tests and health care controls free of charge.
Experts say that the court’s decision in the case, called Kennedy v. Braidwood Management, could have radical consequences for access to patients for preventive health care in the United States.
Since the ACA was adopted in 2010, most insurers had to cover a wide range of prevention services free of charge for patients – including cancer screening, mammograms, statins for heart disease and HIV prevention drugs.
About 150 million people are currently enrolled in private health insurance plans that cover free prevention services, according to KFF, a non -partisan group looking for health policy problems. A KFF analysis revealed that 1 person out of 20 – around 10 million people – received at least one prevention service in 2019.
“This is a really crucial case,” said Arthur Caplan, head of the Nyu Langone Medical Center medical ethics division in New York, noting that many Americans say they cannot afford the high cost of medical care. “The price will be paid in corpses if the court governs.”
The trial was filed in 2022 by a group of conservative Christian employers in Texas.
They argued that the ACA rule forced them to cover the preparation of HIV prevention pills in their employee health plans has violated their religious rights.
They also challenged the working group on American preventive services – an independent panel which recommends the preventive services that insurers must cover – the unconstitutional caller because its members are not appointed by the president or confirmed by the congress.
Last year, the 5th Circuit Court of Appeals in the United States reassured himself with employers, but limited the decision to eight Texas companies involved in the case. The court refused to make the decision applying to the national level.
The federal government, under the Biden administration, appealed the case at the Supreme Court. The Trump administration then declared in the court in February that he intended to defend the requirement.
What happens if the Supreme Court makes rules?
The Supreme Court is expected to make a decision in June.
If the court stimulates the ACA rule, this would mean that insurers could refuse the coverage of the preventive services recommended by the working group, said Laurie Sobel, associate director of the women’s health policy in Kff.
“The recommendations would return to March 2010,” said Sobel, referring to the year of the ACA adoption. The notable changes, she added, could include the starting age that most insurers cover colorectal cancer screens as well as the preparation of the preparation. The current age recommended for the screening for colon cancer is 45 years, which the working group lowered 50 years in 2021 and is recognized for saving thousands of lives.
If the requirement of free preventive services disappears, Richard Hughes, lawyer for Epstein Becker Green and principal lawyer of the HIV + Hepatitis Policy Institute, said the coverage could vary according to the insurance company.
“I think you will see progressive erosion at all levels,” said Hughes, referring to the services that insurers cover. “I think you will see a restriction of access, you will see the share sharing applied to certain services, and this has proven to be an obstacle, because people are more inclined to move away from a service when they are presented with a cost of the pocket.”
It will also be more difficult to bring people into the doctor’s office to ask for preventive care, said Sobel. “Right now, we can say, if you are on a private health insurance scheme … then you are entitled to cost sharing,” she said.
Even if the Supreme Court is on the side of the Trump administration, Sobel said, there are concerns about what health secretary Robert F. Kennedy Jr. could do the working group.
In a judicial file, the Trump administration said that members of the working group “are lower officers, because the secretary of HHS – a main director par excellence – remains responsible for final decisions as to whether the recommendations of the working group will legally link insurance issuers and group health plans.”
“Even a decision in favor of the federal government does not necessarily guarantee that the preventive services will remain how they are at the moment,” said Sobel.
Chronic conditions such as heart disease, cancer and diabetes are the main causes of death and illness in the United States, according to centers for Disease Control and Prevention. A 2024 report of the Center for American Progress revealed that the ACA rule was linked to more Americans with better blood pressure, blood sugar and global heart health. Other studies suggest that it has increased the diagnosis of cancer at an early stage.
Caplan said he hoped that Kennedy himself was wearing on the case.
“It makes no sense to continue talking about rendering America again healthy while removing preventive services,” he said.
A spokesman for the Ministry of Health and Social Services did not immediately respond to a request for comments.
