Affordable Access to Preventive Services Has Been Lifesaving. Will it End?

Photo:  Amy Lutz / Shutterstock.com

By Kelly Jordan

Early next week, the Supreme Court will hear oral arguments that could decide the fate of preventive health coverage in the United States. Under the Affordable Care Act, most health insurance plans are required to cover evidence-based services graded with an “A” or “B” by the U.S. Preventive Services Task Force, allowing people to access these services without meeting a deductible first or paying a copay.

This task force, created in the 1980s, is made up of 16 volunteers appointed by the secretary of the Department of Health and Human Services outside of Congress’s approval. The Kennedy v. Braidwood case being heard next Monday seeks to determine whether the Preventive Services Task Force is constitutional. If the court deems it is not, many of the services graded with an A or B may not be covered anymore.

Covered Services

Among the services that are currently covered include:

• Depression screenings in pregnant or postpartum people
• Mammograms
• Cervical cancer screening
• Colorectal cancer screenings
• Lung cancer screenings
• Pre-exposure prophylaxis (PrEP) medication to prevent HIV
• And more.

If the Supreme Court finds the task force unconstitutional and no-cost preventive care is removed, it will affect access to health screenings and medications across the board. This could impact rates of chronic conditions and infectious diseases in the United States, including cancer, diabetes, obesity, heart disease, depression, suicide, and HIV/AIDS.

Removing Affordable Access to PrEP Will Hurt Progress.

Monday’s hearing will revisit the Texas case, Braidwood v. Becerra, which took issue with certain aspects of the preventive services requirement, citing religious objections to several of the covered services, particularly access to PrEP medication. 

“It is tough to think about getting this far [with HIV prevention research, viral suppression, PrEP access, and dips in cases], only to remove policies that reduce out-of-pocket costs for PrEP, which is a big part of why we’ve found success,” says Patrick Sullivan, PhD, professor of epidemiology at Emory University’s Rollins School of Public Health. “This won’t just increase the rates of HIV in our country—and potentially cost us lives—it will cost the United States a lot of money.”

Approximately 1.2 million people are living with HIV in the United States. Of those, one in seven are not aware they are living with HIV. 

A Costly Decision

Cost and access to PrEP have served as major barriers for people most at risk for developing HIV. When not covered by insurance, the cost of generic versions of PrEP come out to about $1,200 a year. Costs are even higher for brand-name versions. By contrast, the cost of medications to treat a person with HIV is about $29,000 a year.

Recent research led by Sullivan projected that with even a modest reduction in PrEP use, the United States will fail to prevent over 8,000 new infections each year. The increase in lifetime treatment costs would be almost $2 billion.

Earlier this week, the White House’s 2026 budget plan was leaked. The document showed proposed cuts to the National Institutes of Health’s budget by about 40% and the Department of Health and Human services budget by 30%. To achieve this, many divisions and programs would be cut or reorganized. According to STAT News, this could include HIV/AIDS programs aimed at low-income people.

“We are so close to ending the HIV epidemic,” says Sullivan. “Pulling back on the throttle right now would waste the effort, dedication, and progress that we've made over decades. We're winning battles year by year. We're knocking down the obstacles. Stepping back and taking a pause is not an option.”

It’s a Scientific Enterprise. Not a Vacuum.

The process of discovery is slow, methodical, and interconnected—often in surprising ways. A researcher working on one disease could lead to the cure for an unrelated illness. There are many viruses in the same sort of family with similar characteristics to HIV.

So, while you may not know someone —to your knowledge—who uses PrEP. Or, if you assume HIV/AIDS care and research do not affect you. Think again. Research done today in a seemingly unrelated field may lead to the cure for your future illness.

Science is a long game, after all.