No-Cost Preventive Services in Danger
Since the passage of the Affordable Care Act (ACA), women and LGBTQ+ people have benefited from the following lifesaving adult preventive services recommended by the U.S. Preventive Services Task Force (USPSTF) at no-cost:
- Screening for diabetes and hypertension
- Screening for colorectal cancer and lung cancer
- Screening for sexually transmitted infections, such as gonorrhea, chlamydia, syphilis, hepatitis B and C
- Breast cancer screening for high-risk women
- HIV prevention via pre-exposure prophylaxis (PrEP)
Judge Reed O’Connor’s ruling in Braidwood Management v. Becerra jeopardizes these and other important preventive services and treatments. In Braidwood Management, Judge O’Connor ruled unconstitutional a key provision of the ACA preventive health services requirement. This would undermine access to cost-free coverage for chronic disease screenings, cancer screenings, and preventative interventions that over 150 million people benefit from. If this ruling stands, it would also open the door for health insurers and plans to deny lifesaving coverage of HIV and AIDS prevention treatment and contraception.
Equitable access to preventative services is especially crucial for mitigating the disproportionate burden of systemic racism and discrimination on the health of women of color, the LGBTQ+ community, those with disabilities, and those living at the intersection of these marginalized identities. For example, Black women face a 40% higher breast cancer mortality rate than white women. The possible effect of this ruling on BRCA-1 and BRCA-2 breast cancer screening for high-risk patients would only widen this gap. Women in the LGBTQ+ community also face higher rates of chronic disease and poor mental health compared to heterosexual women, which is compounded with about 1 in 4 LGBTQ people, including 40% of transgender people, reporting avoiding preventative screenings due to cost. The potential lack of access to no-cost depression and anxiety screening would again only worsen already existing inequities faced by LGBTQ+ people.
This decision is a blatant attack on the health and economic stability of women and families. The provision of no-cost preventive services as part of ACA is a necessary step to address inequitable access to health care. Amidst a maternal mortality crisis and in a post-Roe reality, this decision further endangers the health and well-being of the black, brown, disabled, and LGBTQ+ community. This ruling is another in a long, unjust pattern of assaults on women and LGBTQ+ people and the health care they receive.
While the case moves up through the courts, the stakes are high for women and families. In the meantime, it is important to note that recommended preventive services are still covered free-of-cost by health plans. More information can be found at KFF’s Preventive Services Tracker.
Judge O’Conner’s ruling is yet another shameful example of how extremist judges and courts are undermining the health and autonomy of millions of Americans, and it is critical that lifesaving no-cost coverage for preventive services recommended by USPSTF is protected and expanded.
Learn more about the National Partnership’s work on the ACA.