Use of ACA preventive services potentially affected by Braidwood v. Becerra

This analysis uses private insurance claims data to examine the number of people who received preventive services that could be affected by a now-stayed U.S. District Court ruling in Braidwood Management v. Becerra, which found the Affordable Care Act’s (ACA) preventive services mandate partially unconstitutional.

The Affordable Care Act (ACA) requires most private health plans to cover some in-network preventive services without cost-sharing for enrollees. On March 30, 2023, the U.S. District Court in the Northern District of Texas excluded from the requirement all preventive care recommendations issued by the United States Preventive Services Task Force (USPSTF) on or after March 23, 2010, when the ACA was signed into law. The district court also found that preexposure prophylaxis (PrEP), medication recommended for HIV prevention, violates the religious rights of those who have objections to its use.

The analysis finds that about one in 20 privately insured people – about 10 million people in total – received at least one ACA preventive service or drug in 2019 that would no longer have to be covered without any cost sharing if the ruling is allowed to stand. Statins, which are used to treat people at risk of cardiovascular disease, are the most commonly used preventive service potentially affected.

The analysis is available through the Peterson-KFF Health System Tracker, an online information hub that monitors and assesses the performance of the U.S. health system.

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