Preventive Services Coverage: Implications of the Supreme Court Case
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Preventive Services Coverage: Implications of the Supreme Court Case

/ Essay

In the US Supreme Court case Kennedy v. Braidwood Management, private organizations are challenging certain provisions of the Affordable Care Act (ACA) related to free preventive health services. Preventive services that could be affected by the decision and any subsequent lower court determination might include screening tests for diabetes, heart disease, and other chronic medical conditions; tests that screen for breast, lung, and colon cancer; medications that reduce the risk of heart attacks and breast cancer; medications for HIV prevention; and other preventive services, affecting more than 100 million Americans who get free preventive health services under the ACA.

In the US Supreme Court case Kennedy v. Braidwood Management, private organizations are challenging certain provisions of the Affordable Care Act (ACA) related to free preventive health services. Preventive services that could be affected by the decision and any subsequent lower court determination might include screening tests for diabetes, heart disease, and other chronic medical conditions; tests that screen for breast, lung, and colon cancer; medications that reduce the risk of heart attacks and breast cancer; medications for HIV prevention; and other preventive services, affecting more than 100 million Americans who get free preventive health services under the ACA.

A lower court overturned a provision of the ACA that requires insurance companies to cover these services at no cost to employees. If the Supreme Court lets stand the lower court ruling, it has potential implications for how these services could be covered in the future. This would impact millions of employees, who could be required to pay for certain but not all preventive care services required under the ACA.

At the same time, over 200 public health organizations have urged congressional support for the Prevention and Public Health Fund (Prevention Fund) established by the ACA, which funds public health programs in every state. These funds invest in the Centers for Disease Control and Prevention (CDC), mental health and substance abuse services, Alzheimer’s disease prevention, chronic disease management, etc.

Upcoming developments on this litigation and potential court decisions may require employers not to cover the full cost of any services recommended afte

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