Advocates urge Supreme Court to protect ACA mammography coverage requirement

A patient advocacy group is urging the Supreme Court to uphold requirements to cover screening mammography, established under the Affordable Care Act. 

Two years ago, a U.S. District Court in Texas ruled that insurers do not have to cover the full cost of such preventive services, a decision that was upheld in June by an appeals court. The case has now made its way to the nation’s highest court, with oral arguments slated to begin in April. 

Susan G. Komen, the “world’s leading breast cancer organization,” filed an amicus brief late last month, asking SCOTUS to overturn the decision. 

“The ACA’s requirement that insurers cover these preventive measures has had a profound impact, including by increasing access to care, reducing treatment costs, and, ultimately, saving lives,” Komen wrote in its court filing. “Moreover, early detection can reduce the risk of being diagnosed with advanced cancer.”

The case is Braidwood Management Inc. et al v. Robert Kennedy Jr. et al (formerly v. Becerra). In place since 2010, the ACA provision has required insurers to provide no-cost coverage for screening services such as mammography that are endorsed by the U.S. Preventive Services Task Force. Christian business owners and individuals filed the lawsuit in 2020, claiming the ACA requirement violates their religious rights by forcing them to cover preventive drugs for HIV. Plaintiffs also have contended that members of the USPSTF and other such entities act as officers of the country but were not properly selected in accordance with the Constitution’s Appointments Clause. 

Komen noted that the June ruling only applied to the parties who filed the lawsuit. The Supreme Court could issue a ruling as early as June. Currently, more than 150 million Americans rely on preventive care services that are in jeopardy because of the courts’ rulings, Komen estimated. This year alone, 320,000 individuals will be diagnosed with breast cancer and 430,000 will die from it. 

“It is undeniable that the preventive care covered by the ACA has made a meaningful difference in the lives of people throughout the country,” SGK concluded. “Komen respectfully submits that the court should overturn the circuit court’s decision and the district court’s conclusion that preventive care recommendations are unlawful and unenforceable.” 

Previously, sides in the case had reached an agreement to keep the mandate in place while the case plays out, the American College of Radiology reported in 2023. ACR had noted that the case applies to all USPSTF recommendations issued on or after March 23, 2010, which was the day President Obama signed the ACA into law. This would include the task force’s December 2013 endorsement of regular lung cancer screening, with CT-based imaging of the colon likely also impacted.