Braidwood v. Kennedy Puts Preventive Health Services at Stake for Millions of Midlife Adults

This week the Supreme Court is hearing oral arguments in Braidwood v. Kennedy, a case challenging the requirement for private health insurers to cover certain recommended preventive health services with no cost-sharing. AARP previously examined the implications of the case, finding that more than 12 million 50 to 64-year-olds with private health coverage could lose access to no-cost lifesaving preventive health care. As the Supreme Court deliberates its decision, it’s important to consider the critical role of preventive services for adults ages 50-64.

The importance of preventive care

The preventive health services at stake are those recommended by the United States Preventive Services Task Force (USPSTF). In March 2023, a Texas district court ruled that health plans do not need to cover USPSTF-recommended services, a requirement created under the Affordable Care Act of 2010 (ACA). In June 2023, the Fifth Circuit Court of Appeals issued a stay, requiring insurers to continue covering these services while the case is being appealed.

Evidence-based preventive health services (e.g., cancer screenings, behavioral counseling, and medications used to prevent disease development) allow for earlier detection, diagnosis, and treatment of health conditions, ultimately improving patient health outcomes. Left undetected, many health conditions will cost patients and the health care system much more than if those conditions had been treated at early stages. Moreover, because the prevalence of many chronic diseases increase with age, preventive care is especially important for older adults. Offering preventive services without cost sharing makes them more accessible to patients who might otherwise be unable to afford them.

Loss of preventive service access for millions of older adults

To understand how the Braidwood v. Kennedy decision could affect older adults, AARP previously estimated the number of people ages 50 to 64 accessing one of the eight preventive services that would be affected by the court ruling. As shown in the table below, in 2022 more than 12 million adults ages 50 to 64 accessed at least one of the eight recommended preventive services that are currently provided without cost sharing. That year more than a quarter (26 percent) of 50- to 64-year-olds with private insurance coverage benefited from at least one of the eight recommended services.

Supreme court ruling implications

If the district court ruling in Braidwood v. Kennedy is upheld, only USPSTF recommendations that predate ACA’s enactment on March 23, 2010, would be covered by the ACA’s requirement. USPSTF-recommended services added after that date, including such important ones as screenings for prediabetes/type 2 diabetes and anxiety disorder, would no longer be subject to the ACA requirement.

Additionally, upholding the district court’s Braidwood v. Kennedy decision would cause USPSTF recommendations to revert to their status as of the enactment of the ACA in 2010, thereby locking in place policies that were established based on scientific evidence that was current more than fifteen years ago. Such a decision would undo the scientific progress achieved in the interim that has enabled the USPSTF to update their recommendations based upon the best evidence available.

The Braidwood v. Kennedy Supreme Court decision has the potential to affect Americans of all ages, resulting in a higher prevalence of preventable health problems and increased health care costs down the road. AARP will be watching the case closely to determine the implications of the ruling, which is expected by June.

In 2022, over 12 Million Adults Ages 50 to 64 Received at Least One of the Eight USPSTF-Recommended Services Potentially Impacted by Braidwood v. Kennedy