Prevent Cancer Foundation commends 5th Circuit decision upholding ACA preventive care mandate

On Friday, June 21, in a major win for cancer prevention and early detection advocates, the U.S. 5th Circuit Court of Appeals issued a ruling in Braidwood v. Becerra upholding a requirement of the Affordable Care Act (ACA) on preventive services. The ruling says that nationwide, ACA requirements can remain in place that obligate health insurers across the U.S. to cover preventive services recommended by the U.S. Preventive Services Task Force (USPSTF) at no cost to the patient. However, the court invalidated this coverage requirement for those within the 5th Circuit Court’s jurisdiction—Louisiana, Mississippi and Texas—and for the plaintiffs involved in the case.

The future of access to free, lifesaving cancer screenings hung in the balance following a March 2023 U.S. District Court ruling that would have blocked ACA coverage requirements for any recommendations made after March 23, 2010, when the ACA was signed into law. (While the USPSTF had recommended some preventive services prior to the ACA becoming law, nearly all recommendations have been updated or expanded since that date.) This would have had a massive effect on free preventive care for cancer, depression, diabetes and HIV.

The Biden administration appealed U.S. District Judge Reed O’Connor’s ruling, and the coverage rule were put on hold until a final ruling could be made.

The 5th Circuit did not address the challenges against the Advisory Committee on Immunization Practices and the Health Resources and Services Administration, leaving unresolved questions on the validity of their recommendations.

Insurance coverage for routine cancer screenings and other preventive services is critical—according to the Prevent Cancer Foundation’s 2024 Early Detection Survey, the most common reason uninsured adults are not up to date (or are not sure if they are up to date) on their routine cancer screenings is an inability to afford the cost.

“It’s a relief that coverage of preventive care is protected for millions of insured Americans, a significant aspect of ensuring access to essential health services that lead to healthier lives. But this ruling does not guarantee coverage for everyone,” said Jody Hoyos, CEO of the Prevent Cancer Foundation. “With portions of the case left unaddressed, the opportunity for some Americans to check their health in an affordable, accessible way is still in jeopardy.”

Ensuring affordability is essential to making lifesaving screenings accessible to everyone. Routine cancer screening can detect cancer early (even if you have no signs or symptoms) and early detection of cancer can lead to better health outcomes.

“We remain committed to ensuring everyone—including those within the 5th Circuit Court’s jurisdiction—has access to free preventive care and routine screenings that can result in better outcomes for all,” said Hoyos.

The Foundation is hopeful the Supreme Court will agree to hear an appeal to this case so more Americans have access to cost-free preventive services.

For information on free and low-cost cancer screenings, visit preventcancer.org/free.