Supreme Court to hear challenge to Obamacare rule on free preventive care
Experts say the court's ruling in the case, called Kennedy v. Braidwood Management, could have sweeping consequences for patient access to preventive health care across the United States.
Since the ACA was passed in 2010, most insurers have had to cover a wide range of prevention services at no cost to patients — including cancer screenings, mammograms, statins for heart disease and HIV prevention medications.
About 150 million people are currently enrolled in private health insurance plans that cover free prevention services, according to KFF, a nonpartisan group that researches health policy issues. A KFF analysis found that 1 in 20 people — about 10 million people — received at least one prevention service in 2019.
'This is a really crucial case,' said Arthur Caplan, the head of the division of medical ethics at NYU Langone Medical Center in New York City, noting that many Americans say they can't afford the high out-of-pocket cost of medical care. 'The price will be paid in dead bodies if the court rules against.'
The lawsuit was filed in 2022 by a group of conservative Christian employers in Texas.
They argued that the ACA rule requiring them to cover the HIV prevention pill PrEP in their employee health plans violated their religious rights.
They also challenged the U.S. Preventive Services Task Force — an independent panel that recommends which preventive services insurers must cover — calling it unconstitutional because its members aren't appointed by the president or confirmed by Congress.
Last year, the 5th U.S. Circuit Court of Appeals sided with the employers, but limited the decision to just the eight Texas companies involved in the case. The court declined to make the ruling apply nationwide.
The federal government, under the Biden administration, appealed the case to the Supreme Court. The Trump administration then told the court in February that it intended to defend the requirement.
The Supreme Court is expected to make a decision sometime in June.
If the court strikes down the ACA rule, it would mean insurers could deny coverage for preventive services recommended by the task force, said Laurie Sobel, an associate director for women's health policy at KFF.
'The recommendations would go back to March 2010,' Sobel said, referring to the year the ACA was enacted. Notable changes, she added, could include the starting age that most insurers cover colorectal cancer screens as well as coverage of PrEP. The current recommended age for colon cancer screening is 45, which the task force lowered from age 50 in 2021 and is credited with saving thousands of lives.
If the free preventive services requirement goes away, Richard Hughes, a health care attorney for Epstein Becker Green and lead counsel for the HIV+Hepatitis Policy Institute, said coverage could vary by insurance company.
'I think you'll see some gradual erosion across the board,' Hughes said, referring to the services that insurers cover. 'I think you're going to see some restriction of access, you're going to see cost sharing applied to certain services, and that's been shown to be a barrier, because people are more inclined to walk away from a service when they're presented with an out-of-pocket cost.'
It'll also be harder to get people into the doctor's office to seek preventive care, Sobel said. 'Right now we can say, if you're on a private health insurance plan … then you're entitled to no cost sharing,' she said.
Even if the Supreme Court sides with the Trump administration, Sobel said, there are concerns about what Health Secretary Robert F. Kennedy Jr. could do to the task force.
In a court filing, the Trump administration said task force members 'are inferior officers, because the Secretary of HHS — a quintessential principal officer — remains responsible for final decisions about whether Task Force recommendations will be legally binding on insurance issuers and group health plans.'
'Even a ruling in favor of the federal government doesn't necessarily assure that the preventative services will remain how they are right now,' Sobel said.
Chronic conditions such as heart disease, cancer and diabetes are the leading causes of death and illness in the United States, according to the Centers for Disease Control and Prevention. A 2024 report from the Center for American Progress found the ACA rule has been linked to more Americans with better blood pressure, blood sugar levels and overall heart health. Other studies suggest it increased early-stage cancer diagnosis.
Caplan said he hopes Kennedy himself weighs in on the case.
'It doesn't make any sense to keep talking about Make America Healthy Again while taking away preventive services,' he said.
A spokesperson for the Department of Health and Human Services did not immediately respond to a request for comment.
This article was originally published on NBCNews.com
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Boston Globe
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NBC News
3 hours ago
- NBC News
Anti-vaccine myths surged on social media ahead of the CDC shooting
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That narrative, though, is not correct. The paper identified lingering amounts of spike protein — a component of the coronavirus that helps it invade cells — in some people's blood samples. But its authors have said vaccines themselves aren't likely to be the cause. The spike-protein mRNA they contain degrades after a few days and is not itself infectious. Fears that vaccines are dangerous and that doctors are covering up the side effects have also drawn interest on Capitol Hill. In July, Sen. Ron Johnson, R-Wis., held a hearing with testimony from people who said vaccines injured them or their loved ones, and clips from the hearing spread on Facebook and other platforms. Representatives for Johnson didn't respond to a request for comment on the CDC gunman. CDC Director Susan Monarez pointed to the harms of misinformation at an agency all-hands meeting Tuesday that addressed the shooting, according to a transcript obtained by NBC News. 'We know that misinformation can be dangerous. Not only to health, but to those that trust us and those we want to trust. We need to rebuild that trust together,' she said. Dr. Dan Barouch, director of the Center for Virology and Vaccine Research at Beth Israel Deaconess Medical Center in Boston, said he's not aware of evidence that depression is a side effect of vaccination. 'Depression is very common, and the vaccine is common, and so it's not clear … whether there may be a causal association,' he said. 'The questions about either mental health or post-vaccine syndrome, those deserve to be studied. More data is better, and data should lead the way as opposed to speculation,' he said. Kennedy once called the Covid vaccine 'the deadliest vaccine ever made,' despite data showing it's safe, though he doesn't appear to have linked Covid shots specifically to depression. Kennedy has, on multiple occasions, tried to draw a connection between depression and a different vaccine, the one designed to protect against the human papillomavirus, or HPV. In a post on X in 2019 and in a 2020 podcast episode with anti-vaccine activist Del Bigtree, Kennedy asserted without evidence that the HPV vaccine, which can prevent 90% of cervical cancers, was responsible for depression among teenagers in the United States. Kennedy has also helped organize litigation over the HPV vaccine, but a federal judge ruled against the plaintiffs in March, saying their evidence was 'lacking'; the plaintiffs are appealing. The CDC says the HPV vaccine is safe and effective. It lists common side effects as arm pain, fever, headache, nausea and muscle or joint pain. While Covid vaccines have saved many lives, they and all other medical treatments have some risk of side effects. A small number of people, disproportionately young men, develop a form of heart inflammation known as myocarditis after having gotten the shot, although Covid itself is likelier to cause heart problems, including myocarditis. In a 2021 study, the CDC reported fewer than 41 cases of myocarditis per million vaccine doses among boys and men ages 12 to 29. In a 2022 paper from CDC researchers published in The Lancet Child & Adolescent Health, young people who developed myocarditis after Covid vaccinations often reported depression, with 46% of myocarditis patients surveyed saying they had it. A study published in the journal npj Vaccines in July, whose release coincided with a spike in online searches for 'vaccine depression,' found a similar rate of depression among young people with post-vaccination myocarditis. It's not known whether the CDC shooter had myocarditis. A different study last year looked at mental illnesses among Covid patients. The paper, which British researchers published in JAMA Psychiatry, found that depression and other mental illnesses were elevated for up to a year in people with severe Covid who hadn't gotten a Covid vaccine. And in the Yale preprint paper, posted on an online platform where researchers can share and receive feedback about unpublished work, researchers outlined what they called a 'post-vaccination syndrome,' a collection of various symptoms that they said resembled long Covid. The report looked at 64 people — 42 with the proposed syndrome and 22 without — and found that participants with the syndrome reported depression at higher rates than other vaccinated people. The aim of the report wasn't to find out whether Covid vaccines were linked to depression, nor did it establish such a link. Instead, it examined how people's immune systems reacted to the shots. 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Gaffney, of Harvard Medical School, said some of the preprint paper's authors are 'very serious scientists and people held in high esteem,' but he called the symptoms branded as 'post-vaccine syndrome' in the paper 'disparate.' 'We should just think twice before we enshrine new diagnoses that are premised on a cause-and-effect relationship that may be tenuous,' he said. Vaccine opponents and skeptics have taken the research and run with it, stretching the limits of what experts say is accurate. After the Yale preprint paper was published, Rogan mentioned the research on his show. Rogan, the No. 1 podcaster in the country by some charts, generally referred to vaccine side effects in the segment and said the findings in the preprint paper — which he referred to as a 'study' without noting that it hadn't yet been published in a peer-reviewed journal — were evidence of a massive cover-up. 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In an email Tuesday, Berenson said he doesn't have a view on whether vaccines can cause depression, but he noted the link between the Covid vaccines and myocarditis and said that could be a potential mechanism that ultimately leads to depression. He said he stood by his X post in February and called the Yale preprint paper 'highly concerning.' He also said it would be foolish to blame vaccine skeptics for the CDC shooting. Similar ideas had been bubbling in anti-vaccine circles for a while before the Yale preprint report. At least two other posts on X alleging vaccines cause depression got more than 1 million views, both citing a study out of South Korea last year that suggested an increased risk of depression after Covid vaccination but a decreased risk of other psychiatric conditions. The study, which didn't prove causation, was based on data from South Korea's national health insurance system. The authors said Covid infections were also associated with depression and cognitive impairment. A large study published in July found that the pandemic generally had adverse effects on brain health. Woolley said people are more prone to gravitate toward conspiracy theories during emergencies like the Covid pandemic because they are scared. 'When crises happen — whether it's the Covid pandemic or an earthquake — we see spikes in the spread of misinformation and disinformation,' he said. For some people, pandemic lockdowns worsened an ongoing loneliness epidemic that has yet to subside, especially among young people. An NBC News Stay Tuned Poll from April found that nearly a third of U.S. adults under 30 are feeling lonelier and more anxious about the future than their elders. And a Gallup Poll from May found that young men were particularly vulnerable to loneliness. That loneliness is now paired with social media recommendation algorithms designed to push persuasive or addictive content, often regardless of whether it's accurate. 'Not only are you super scared, but the algorithms have a track record of pushing more and more extreme and conspiratorial content the deeper you go,' Woolley said.
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