How RFK Jr. Could Disrupt Insurance Coverage Of Preventive Healthcare

Last updated: July 7, 2025 4:29 pm

The recent Supreme Court decision regarding the United States Preventive Services Task Force has sparked concerns about potential changes in healthcare coverage for preventive services. The ruling upheld the authority of the Secretary of Health and Human Services to appoint Task Force members without requiring presidential nomination and Senate confirmation. This decision gives Secretary Robert F. Kennedy Jr. broad power to shape the Task Force’s recommendations, which could lead to modifications in covered services.

One of the key issues in the case was the coverage of HIV prevention medications under the Affordable Care Act. The Task Force plays a crucial role in recommending preventive healthcare services that must be covered by insurers at no cost to patients. This includes essential interventions such as cancer screenings, cholesterol medications, and HIV prevention drugs like pre-exposure prophylaxis (PrEP). PrEP is a highly effective medication for individuals at high risk of HIV exposure through sexual contact or injection drug use.

Under the ACA, insurers are required to cover FDA-approved PrEP products without any out-of-pocket costs for patients. For the uninsured, programs are available to provide PrEP at reduced costs or for free. The Task Force’s expert panel evaluates scientific evidence to determine the effectiveness of preventive interventions, such as PrEP, in improving patient health outcomes.

The Supreme Court’s decision reaffirms Secretary Kennedy’s authority to appoint and supervise Task Force members. However, Kennedy’s past views on public health policies, including skepticism towards established expertise, raise concerns about potential changes in healthcare coverage. Kennedy’s recent actions, such as replacing the entire Advisory Committee on Immunization Practices with members who may lack relevant expertise, have raised questions about the future of preventive healthcare recommendations.

See also Eliminating Waste, Fraud, and Abuse in Medicaid My Administration has been relentlessly committed to rooting out waste, fraud, and abuse in Government programs to preserve and protect them for those who rely most on them. The Medicaid program was designed to be a program to compassionately provide taxpayer dollars to healthcare providers who offer care to the most vulnerable Americans. To keep payments reasonable, billable costs for such care were historically capped at the same level that healthcare providers could receive from Medicare. The State and Federal Governments jointly shared this cost burden to ensure those of lesser means did not go untreated. Under the Biden Administration, States and healthcare providers were permitted to game the system. For example, States "taxed" healthcare providers, but sent the same money back to them in the form of a "Medicaid payment," which automatically unlocked for healthcare providers an additional "burden-sharing" payment from the Federal Government. Through this gimmick, the State could avoid contributing money toward Medicaid services, meaning the State no longer had a reason to be prudent in the amount of reimbursement provided. Instead of paying Medicare rates, many States that utilize these arrangements now pay the same healthcare providers almost three times the Medicare amount, a practice encouraged by the Biden Administration. These State Directed Payments have rapidly accelerated, quadrupling in magnitude over the last 4 years and reaching $110 billion in 2024 alone. This trajectory threatens the Federal Treasury and Medicaid's long-term stability, and the imbalance between Medicaid and Medicare patients threatens to jeopardize access to care for our seniors. I pledged to protect and improve these important Government healthcare programs for those that rely on them. Seniors on Medicare and Medicaid recipients both deserve access to quality care in a system free from the fraud, waste, and abuse, that enriches the unscrupulous and jeopardizes the programs themselves. We will take action to continue to love and cherish the Medicare and Medicaid programs to ensure they are preserved for those who need them most. The Secretary of Health and Human Services shall therefore take appropriate action to eliminate waste, fraud, and abuse in Medicaid, including by ensuring Medicaid payments rates are not higher than Medicare, to the extent permitted by applicable law. This memorandum is not intended to, and does not, create any right or benefit, substantive or procedural, enforceable at law or in equity by any party against the United States, its departments, agencies, or entities, its officers, employees, or agents, or any other person. DONALD J. TRUMP

Furthermore, Kennedy’s controversial decisions regarding COVID-19 vaccine policies, including changes in recommendations for children and pregnant women, have faced legal challenges. Concerns have been raised about the impact of such changes on public trust in healthcare recommendations and insurance coverage for preventive interventions.

In light of these developments, experts warn that potential changes in the Task Force’s composition and recommendations could have far-reaching consequences. It is essential to ensure that decisions regarding preventive healthcare services are based on sound scientific evidence and prioritize the well-being of patients.