OBR OncologyCourt Ruling with Big Oncology Implications Looms

ACA’s Preventive Care Mandate: A Constitutional Dilemma with Broad Implications for Oncology

The Affordable Care Act’s (ACA) mandate for first-dollar coverage of select preventive care services is under constitutional scrutiny in the case of Braidwood Management, Inc et al. v Xavier Becerra et al. The outcome of this case could have far-reaching implications for access to high-value health care services, particularly in oncology, where early detection and diagnosis are critical.

Key Points

• The ACA provision mandates access to high-value health care services, defined as services graded “A” or “B” by the US Preventive Services Task Force (USPSTF), with zero cost sharing.
• This provision, also known as value-based insurance design (V-BID), has significantly impacted rates of cancer screenings and early-stage cancer diagnoses.
• The case initially focused on whether a Christian-owned management company could be forced to cover preexposure prophylaxis medication to prevent HIV transmission for its employees.
• The plaintiff recently requested that additional no-cost preventive services also be blocked, raising the stakes in this case.
• Since the ACA’s passage, more than 150 million Americans have benefited from no-cost preventive services, such as cancer screening, tobacco cessation, and immunizations.

As a physician, I see firsthand the results that ensue when patients face choices such as whether to spend money either on their kids’ shoes for going back to school or on the copay for a medication for which they may not immediately feel the effects of going without. If I were in their shoes, I am not so sure that I would make these decisions any differently.
— Samyukta Mullangi, MD, MBA, Medical Director, Thyme Care

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