Our nation’s hard-fought right to preventive care is at risk

The Affordable Care Act has transformed healthcare in the U.S. by ensuring access to no-cost preventive care services, such as cancer screenings, immunizations and contraceptives, for millions of Americans. However, the Supreme Court's decision to review the constitutionality of this provision, as highlighted in Becerra v. Braidwood Management Inc., threatens to undermine a critical component of the law.

The implications of this case extend beyond legal nuances, touching the health and well-being of millions of individuals. The preventive-care mandate must be upheld because it promotes public health, reduces healthcare costs and aligns with fundamental principles of equity and access to care.

Preventive care plays a pivotal role in safeguarding public health by identifying and addressing potential health issues before they become severe. Cancer screenings, for instance, enable early detection, which significantly increases treatment and survival odds. Similarly, immunizations protect individuals and communities from the spread of infectious diseases, reducing hospitalizations and deaths. Contraceptives empower individuals to plan their families, improving maternal and child health outcomes.

The U.S. Preventive Services Task Force, responsible for setting these care guidelines, bases its recommendations on rigorous scientific evidence. By mandating that these services be offered at no cost, the Affordable Care Act has removed financial barriers that often deter individuals from seeking necessary care. Striking down this provision will mean fewer people use these life-saving services, resulting in more sickness and death and an increased strain on the healthcare system.

Beyond its health benefits, preventive care saves money. Early intervention prevents the escalation of diseases, thereby avoiding costly treatments and hospitalizations. For example, it costs far less to prevent a heart attack by managing your cholesterol than it does to have expensive heart surgery and subsequent rehabilitation. Similarly, immunizations reduce the economic burden of outbreaks by minimizing lost productivity and healthcare costs associated with treating preventable diseases.

Critics argue that the Affordable Care Act's preventive-care provision imposes undue financial and regulatory burdens on businesses. However, the economic gains from a healthier workforce far outweigh these costs. Employees who receive regular preventive care are more likely to stay healthy, reducing absenteeism and improving productivity. Removing the mandate could create disparities in coverage, leading to a patchwork system where only the privileged can afford consistent, comprehensive care.

Access to preventive care is a cornerstone of an equitable healthcare system. Without the mandate, under-resourced populations — including low-income families, racial and ethnic minorities, and rural communities — would face significant obstacles to care. Health inequities, already pervasive in the U.S., would deepen as financial barriers force individuals to forgo preventive services.

The plaintiffs in Becerra v. Braidwood Management Inc. have raised religious objections to certain provisions of the mandate, such as the coverage of pre-exposure prophylaxis medications and contraceptives. While religious freedom is a fundamental right, it should not come at the expense of public health and individual autonomy. Employers should not be allowed to impose their personal beliefs on employees, particularly when doing so compromises access to essential healthcare services.

Moreover, the argument that the Preventive Services Task Force’s composition violates the appointments clause detracts from the broader issue at stake: the health and well-being of millions of Americans. The task force operates independently to ensure that its recommendations are guided by science, not politics. Undermining its authority risks politicizing healthcare decisions, to the detriment of patients of every political persuasion.

Those of us working in health policy are keen to follow these developments. However, we all must stay alert — the Supreme Court's review, by July of this year, of the Affordable Care Act's preventive-care provision is a critical moment Americans’ future health. Upholding the mandate is not just a legal matter; it is a moral imperative to protect public health, reduce healthcare costs and promote equity. The provision has already demonstrated its value by improving health outcomes and reducing disparities, and its potential loss could have catastrophic consequences.

The Affordable Care Act’s preventive-care mandate embodies a commitment to a healthier, more equitable society. It ensures that no one is denied essential care due to financial constraints or ideological objections. The Supreme Court must recognize the far-reaching benefits of this provision and affirm its constitutionality to safeguard the health of the nation.

Nathan Boucher, M.D., is associate professor of medicine, nursing and public policy at Duke University, Durham, N.C.

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