Kennedy v. Braidwood case threatened decades of progress on colorectal cancer screening
Today, the U.S. Supreme Court voted 6-3 to uphold the U.S. Preventive Services Task Force’s (USPSTF) role in recommending which services must be covered with no cost sharing for patients under the Affordable Care Act (ACA) – a significant decision that ACG hopes will protect decades of colorectal cancer screening progress.
“Gastroenterologists know firsthand that limiting access to colorectal cancer screening would have deadly consequences,” said Amy S. Oxentenko, MD, FACG, President of ACG. “We appreciate that the Supreme Court heard the College’s warning and urge the U.S. Department of Health and Human Services (HHS) to maintain the USPSTF’s essential role moving forward.”
As ACG noted in an amicus brief to the Supreme Court, the ACA’s preventive services mandate has saved countless lives by eliminating patient cost-sharing for screening colonoscopies. One study also projected that eliminating the mandate would have increased colorectal cancer incidence and death rates, treatment costs, and health disparities. In 2025, more than 40% of ACA marketplace enrollees fall within the age range recommended for colorectal cancer screening.
The case was decided during a pivotal 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 erroneously considered a disease of older patients; by 2030, early-onset colorectal cancer is expected to be the leading cause of cancer death in people aged 20 to 49.
In this context, ACG urges HHS Secretary Robert F. Kennedy, Jr., to maintain the integrity and independence of USPSTF members and the task force’s existing role within the ACA. Since 1984, clinicians and the public have looked to the task force and its experts for gold standard recommendations. In addition, USPSTF recommendations have guided policy decisions for the ACA, state screening mandates, and insurers.
Given the court’s ruling, ACG renews our call for HHS to take additional steps to improve colorectal cancer screening access, including coverage of surveillance colonoscopy – which is simply screening colonoscopy on shorter intervals for those with personal or family history – accompanying bowel prep prescriptions as preventive care. This would be in line with nearly three decades of Congressional action mandating expanded access to colorectal cancer screening for all Americans.