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Legal, medical, and public health scholars assess the ramifications of the Kennedy v. Braidwood verdict
Today’s Supreme Court decision in the case of Kennedy v. Braidwood Management maintains the Affordable Care Act clause that enables specific preventive care to be accessible to patients without any expense, provided they satisfy requirements outlined in the guidelines from the U.S. Preventive Services Task Force.
However, the ruling further specifies that members of the USPSTF can be substituted by the secretary of Health and Human Services.
This same ACA clause mandates no-cost coverage for vaccines suggested by the Advisory Committee on Immunization Practices; its members were recently substituted by the current HHS secretary.
Experts from the University of Michigan are ready to discuss the ramifications of the Braidwood case. They are all part of the U-M Institute for Healthcare Policy and Innovation. U-M experts are also available for commentary on the dismissal of ACIP members.
Nicholas Bagley, a faculty member at the Law School, has examined and authored work on Kennedy v. Braidwood from the start. In April, he explored the concern regarding the nature of the appointments of the U.S. Preventive Services Task Force and the authority of the Health and Human Services secretary to dismiss members.
“The key takeaway is that the task force’s recommendations are obligatory, just as the ACA’s creators intended. Yet, this framework is constitutional only because (HHS Secretary) Kennedy can exert almost complete oversight over task force recommendations. It’s a mixed outcome!” he stated on social platforms.
Bagley’s social media post clarifying the ruling, using excerpts from the court’s determination.
Contact: [email protected]
A. Mark Fendrick is a faculty member of internal medicine at the Medical School and leads the Center for Value-Based Insurance Design. He has dedicated over 20 years to examining how out-of-pocket expenses influence the choices made by patients and providers regarding care, and his research aided in shaping the ACA provision central to the case.
“As prevention and early diagnosis are crucial for alleviating the clinical and financial load of chronic conditions, having access to effective screening is fundamental,” he stated. “The Supreme Court’s determination to uphold the widely supported ACA mandate that insurance plans provide coverage for preventive services that earn an A or B rating from the United States Preventive Services Task Force at zero cost (i.e., no copays, coinsurance, or deductibles) to patients is a victory for patients, healthcare providers, and the challenged U.S. healthcare system.
“This provision improves coverage for over 200 million insured Americans, with around 60% utilizing at least one of the covered services annually, resulting in superior patient outcomes and, in some cases, reduced medical expenses.
“Health professionals depend significantly on the recommendations offered by the thoroughly assessed USPSTF. In a new context where USPSTF members are appointed by the secretary, health providers might have to consult alternative sources to obtain impartial scientific information required to advise their patients. Such a shift will complicate further the already burdened workforce and may confuse patients.
“Given that numerous insured Americans who qualify for no-cost preventive care have yet to receive these potentially life-saving services, the court’s ruling presents a ‘second chance’ for crucial stakeholders, including those who initiate screenings and diagnose and manage these conditions, to better inform eligible individuals about no-cost screenings and assist them in navigating the screening process.”
Contact: Kara Gavin, [email protected]
Minal Patel, a scholar of health behavior and equity at the School of Public Health, investigates how the financial strain of chronic illness influences individuals’ ability to manage their health.
“Today’s ruling acknowledges a fundamental truth: Prevention is not a luxury—it’s essential for helping individuals realize their potential,” she remarked. “As we witness cancer cases emerging in younger individuals, it’s a stark reminder that early detection via accessible screenings can mean the difference between a manageable condition and a life prematurely ended.
“By maintaining no-cost preventive care, the court affirms that a person’s capability to identify health issues early should not hinge on their ability to cover a copay. This implies more parents will be present for their children’s important life events, more young people will obtain early interventions that pave the way for healthier futures, and more families won’t have to decide between getting screened today or affording groceries this week.”
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Diane Harper serves as a professor of family medicine at the Medical School, where she has researched both cervical cancer screenings and the vaccine for the human papillomavirus designed to avert cervical cancer. While both services are included under the ACA provision, follow-up testing post-screening is not covered, resulting in some patients opting not to pursue follow-up care due to financial concerns. Last year, she and her team published a study examining the potential consequences of a greater number of eligible individuals receiving both screening and follow-up tests.
“The contributions of the USPSTF, comprised of expert generalists who provide a population-oriented perspective on health matters, are essential,” she stated. “This group facilitates advancements in healthcare practices based on robust evidence viewed from a population standpoint. I sincerely wish for the USPSTF to remain an unbiased entity, well-represented across generalist specialties, to offer guidance in updating clinical practices.”
Contact: Kara Gavin [email protected]
Geoffrey Hoffman is an associate professor at the School of Nursing focused on preventing falls and injuries related to falls in older individuals. In a recent commentary in the Journal of the American Geriatrics Society, he discussed the ramifications of the case concerning coverage for exercise-based programs endorsed by the USPSTF, aimed at diminishing the risk of falls among older adults.
“It is imperative to implement policies that promote—rather than restrict—access to fall prevention screenings and interventions,” he indicated. The decision “provides a ‘second chance’ for essential stakeholders, including those evaluating fall risks and supplying interventions to avert falls and manage their consequences, to enhance education for eligible patients regarding the advantages of screening and preventive measures against falls.”
“A greater frequency of risk assessment and acceptance of cost-free preventive exercise interventions could enhance patient wellness, lower healthcare costs, and generate a rare ‘triple-win’ situation for patients, healthcare providers, and the Medicare program.”
Contact: Laura Bailey [email protected]
Anna Lok and Elliot Tapper are liver specialists and professors of internal medicine at the Medical School who recently authored an article regarding the possible influence of today’s ruling on efforts to eradicate hepatitis C.
A one-time screening for hepatitis C is among the preventive measures currently recommended by the USPSTF. The treatment landscape for hepatitis C has been revolutionized by direct-acting antivirals, which can successfully cure 95% of cases. However, individuals can only achieve a cure if they receive timely diagnoses.
“It is crucial to uphold all existing recommendations from the U.S. Preventive Services Task Force,” expressed Lok, who is the director of clinical hepatology at U-M Health. “Amendments to those recommendations must be informed by scientific data, including insight from experts and the public.”
“Awareness is crucial: We cannot save lives from hepatitis C if we do not identify those affected,” stated Tapper, who heads the U-M Health Cirrhosis Program. “The only means to ascertain this is through testing. As individuals who are deeply committed to mitigating the harms and expenses associated with cirrhosis and liver cancer, we aspire for a future devoid of barriers to testing.”
Contact: Sam Page [email protected]
David Hutton holds the position of professor of health management and policy as well as in global public health at the School of Public Health, and is also a professor of industrial and operations engineering at the College of Engineering. His research centers on health policy and medical decision-making, particularly regarding mathematical models that aid in resource allocation for health. He has acted as a consultant, advisor, and collaborator with the World Health Organization, the U.S. Department of Health and Human Services, and the U.S. Centers for Disease Control and Prevention.
Contact: [email protected]
Kao-Ping Chua, an associate professor of pediatrics at the Medical School and director of the Susan B. Meister Child Health Evaluation and Research Center, notes that the legal case leading to today’s ruling originated over the issue of providing pre-exposure prophylaxis, or PrEP, medication to individuals at high risk for HIV, the virus responsible for AIDS. Chua and colleagues, led by Nina Hill, recently published a study revealing that utilization of PrEP among young adults surged eightfold in the first decade post-introduction. The USPSTF initially recommended PrEP in 2019.
Contact: Kara Gavin, [email protected]
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