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The United States Preventive Services Task Force (USPSTF), an independent, volunteer panel of medical experts, evaluates the benefits and harms of preventive health services offered to patients of all ages based on the current scientific evidence. Under the Affordable Care Act (ACA), preventive health services that receive A or B grades from the USPSTF must be covered by insurers at no cost to patients.
A Texas federal court recently ruled, in Braidwood Management Inc. et al. v. Becerra et al., that this ACA provision was unconstitutional, putting access to no-cost critical preventive health services in jeopardy for millions of Americans. That decision is now pending appeal. While a June 2023 stay is in effect, however, insurers are required to continue covering these services with no cost sharing.
Preventive Screenings for Older Adults
Evidence-based preventive health services help improve patient health outcomes and reduce longer-term costs to consumers and the health care system. Further, because the risks of many chronic diseases, such as heart disease, cancer, and diabetes, increase with age, preventive care is especially important for older adults.
To better understand how this legal challenge could affect older adults, this report estimates the number of people ages 50 to 64 who accessed one of eight common preventive services that would be affected by the court ruling. It finds that, in 2022, more than 12 million adults ages 50 to 64 accessed at least one of the eight services that we studied, indicating that many older adults value these important services.
The estimated number of older adults who accessed the following preventive screenings in 2022:
- Prediabetes and Type 2 Diabetes Screening 9,065,037
- Anxiety Disorder Screening 2,587,878
- Hepatitis C Virus Infection Screening 1,148,125
- HIV Infection Screening 586,337
- Unhealthy Drug Use Screening 562,415
- Hepatitis B Virus Infection Screening 558,162
- Prevention of Acquisition of HIV: Preexposure Prophylaxis 469,598
- Lung Cancer Screening 219,131
Preventive Screenings Improve Health Outcomes
These results represent only a portion of the Americans—of all ages—who would be affected if USPSTF-recommended preventive services were no longer available without cost sharing. Pediatric, adolescent, and young adult patients unable to access certain preventive services due to cost could experience more health problems as they age. It is important to note that if the Braidwood v. Becerra decision is upheld, insurers may choose to continue to provide preventive services at no cost.
Screening asymptomatic patients for certain health conditions allows for earlier detection, diagnosis, and treatment, ultimately improving health outcomes. Left undetected and untreated, many health conditions end up costing consumers and the health care system much more than if those conditions were detected and treated at an early stage. Delivering preventive services without cost further improves health outcomes by making these services more accessible to patients.