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

Editor’s Note: The original version of this statement incorrectly stated that the 5th Circuit Court of Appeals had invalidated the coverage requirements for cost-free preventive services through the USPSTF for the entire 5th Circuit jurisdiction. This was incorrect. The court decision was invalidated only for the plaintiffs rather than for the entire population as decided by the district court. We strive to provide accurate and timely information, and we regret any confusion this error may have caused.

On Friday, June 21, in a win for cancer prevention and early detection advocates, the U.S. 5th Circuit Court of Appeals issued a ruling in Braidwood v. Becerra that partially reversed a district court decision on preventive services covered by the Affordable Care Act (ACA). The 5th Circuit Court of Appeals decision 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. Rather than invalidating the coverage requirement for the entire population—as had been decided by the district court—the coverage requirement was only invalidated for the plaintiffs involved in the case.

This ruling comes after a precarious period following a March 2023 U.S. District Court decision that threatened to block ACA coverage requirements for any USPSTF recommendations made after March 23, 2010, the date the ACA was enacted. Such a block would have drastically affected access to free preventive care for conditions like cancer, depression, diabetes and HIV. The Biden administration appealed this decision, putting the ruling on hold until the 5th Circuit’s recent verdict.

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.

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 indefinitely,” said Jody Hoyos, CEO of the Prevent Cancer Foundation. “With legal options remaining that could reverse coverage, the Foundation continues to monitor the case to ensure Americans can check their health in an affordable, accessible way.”

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.

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.

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