Post Braidwood Coverage of USPSTF Recommendations
On Thursday, March 30, 2023, Judge O’Connor released a final opinion on remedies in Braidwood Management vs. Becerra, a case regarding the constitutionality of the ACA’s coverage of United States Preventive Services Task Force (USPSTF) recommended preventive services.[1] The ACA added section 2713 to the Public Health Service Act (“Section 2713”) which requires, among other things, that certain plans cover USPSTF A and B recommended services with no cost-sharing. In his final opinion, Judge O’Connor ruled that plans would only be required to cover USPSTF A and B recommended services with no cost-sharing that were in effect prior to March 23, 2010 (the date of enactment of the ACA).
The Judge’s ruling has a direct impact on what preventive services would be covered with no cost-sharing. There is concern that requiring plans to cover preventive services that existed as of March 23, 2010, discount the latest evidence around effective cancer prevention and early detection. ACS CAN created a chart comparing the current USPSTF recommendations to those that were in place as of March 23, 2010, showing the differences in the recommendations that would be impacted by the ruling.[2]
Research has consistently shown the benefits of providing coverage of preventive services at no cost to individuals. ACS CAN is disappointed in the March 30th ruling in the Braidwood case, which threatens to erode more than a decade of progress reducing cancer deaths and suffering. ACS CAN will continue to closely monitor the ongoing litigation and will continue to support and advocate for coverage of evidence-based preventive services at no cost sharing.
[1] The case also challenged recommendations made by the Advisory Committee on Vaccine Practices (ACIP) and the Health Resources and Services Administration (HRSA), but the judge ruled in the government’s favor on those claims, so this reference is limited to USPSTF recommendations. Both plaintiffs and the government are appealing the decision to the US Court of Appeals for the Fifth Circuit. See Braidwood Management Inc. v Becerra, (4:20-cv-00283), District Court, N.D. Texas.
[2] Note that some of the pre 2010 USPSTF recommendations are written to explain the risks and benefits and are not as clear recommendation statements as newer recommendations. Therefore, some of the differences may not be clear or subject to interpretation.
