NEW! ACG Joins 38 Organizations United to Protect Access to Lifesaving Cancer Screenings
On Monday, April 21, the Supreme Court will hear oral arguments in Kennedy v. Braidwood.
ACG stands with 37 other healthcare organizations from the colorectal cancer community in urging the court to #SaveCRCScreenings.
ACG Champions the Importance of Preventive Care and Colorectal Cancer Screening in Supreme Court Amicus Brief
On Monday, March 3, the American College of Gastroenterology championed the lifesaving benefits of colorectal cancer (CRC) screening in filing a “friend of the court” amicus brief with the U.S. Supreme Court in Kennedy v. Braidwood. This spring, the court will decide the validity of the U.S. Preventive Services Task Force (USPSTF) and its recommendations that guide policy decisions under the Patient Protection and Affordable Care Act (ACA). ACG alerted the court of the practical implications on access to colorectal cancer screening for millions of Americans.
ACG represented the interests of GI clinicians and their patients before the nation’s highest court. In the brief, the College outlined the success of colorectal cancer screening as a public health victory, while also emphasizing the need to reduce barriers to access.
“Simply put, the implications of the Court’s upcoming decision on patient care and public health should not be understated,” said Amy S. Oxentenko, MD, FACG, President of ACG. “We informed the Supreme Court of how much progress we’ve made in recent decades in preventing colorectal cancer deaths through colonoscopy with polypectomy, but also warned the justices how much is at stake in this moment – especially as incidence rates continue to rise among younger Americans.”
The case comes at a particularly perilous time in the colorectal cancer fight. Overall, incidence rates of colorectal cancer have fallen by nearly 50%, largely attributed to increases in screening. Colorectal cancer is often considered an older person’s disease, but by 2030, early-onset colorectal cancer is expected to be the leading cause of cancer death in people aged 20 to 49.
The ACA’s preventive services mandate has saved countless lives by eliminating patient cost-sharing, a major barrier to care. Studies show these out-of-pocket expenses deter patients, particularly those of lower socioeconomic status, from getting screened. ACG cautioned the Court that the U.S. could experience lower screening rates and higher death rates if the lower court’s decision in Braidwood was upheld.
While ACG did not argue the constitutional and legal questions, the College did focus on the public health implications in the event the USPSTF’s recommendations are invalidated. The stakes of this case are high: in addition to potentially affecting Americans whose insurance plans are regulated by the ACA (e.g., certain private plans, Medicare, or Medicaid), the USPSTF’s recommendations are also leveraged by sixteen states in their colorectal cancer screening insurance mandates. It is unclear if the Supreme Court will provide guidance on whether their decision impacts these states, potentially inviting more litigation in state courts.
FAQs About Kennedy v. Braidwood and ACG’s Amicus Brief
What is the background of this case?
In 2022, a group of employers (‘Braidwood’) challenged whether theACA’spreventive services mandate was constitutional, and whether it violated the Religious Freedom Restoration Act. Specifically, these employers wanted to offer health insurance to employees that did not include certain preventive services mandated by the ACA that conflicted with their religious beliefs (i.e., contraception, PrEP for HIV transmission, and the HPV vaccine, among others).
In 2023, a Texas district court agreed, invalidating any USPSTF recommendations issued after the ACA’s effective date of March 23, 2010. In its ruling, the court found that USPSTF members should be subject to Presidential nomination and Senate confirmation. The court concluded that, because these members were unconstitutionally appointed, their recommendations cannot be used by HHS to require insurance coverage of any services, nationally. This would have included the USPSTFs’ colorectal cancer screening recommendations.
In 2024, the Fifth Circuit Court of Appeals agreed that the members of the USPSTF were not constitutionally appointed. But they found the original ruling went too far by invalidating all USPSTF recommendations nationally.
Finally, on January 10, 2025, the Supreme Court agreed to hear an appeal in this case. On February 18, the Trump Administration agreed to take over the case, arguing that the HHS Secretary has ultimate oversight of the USPSTF members and its recommendations.
What will happen next?
The Supreme Court will hear arguments on April 21 and is expected to issue a ruling sometime later in the spring.
We don’t know what will happen if the court agrees with the Braidwood employers. However, we do know that if the court strikes down the preventive services mandate, patient access to critical screenings like colonoscopy would be in jeopardy.
What is an amicus brief?
An amicus brief is a legal document written by a person or organization not directly involved in the case. The term amicus curiae is Latin for “friend of the court,” and the briefs are common in all Supreme Court cases. They provide outside information, expertise, and arguments to help the court decide.
Why did ACG file an amicus brief?
ACG felt it was crucial to represent the interests of GI clinicians and their patients before the Supreme Court. Our brief focused on the practical implications of this case, specifically: (1) the incredible progress the United States has made in preventing colorectal cancer deaths in recent decades, and (2) that access to these essential colorectal cancer screenings could be at risk for millions of Americans. ACG did not address the constitutional law questions in the case.