In a country where universal healthcare is still a distant hope, the Affordable Care Act (ACA) has been a big push forward. One of its most impactful provisions is the requirement that insurers cover preventive services. That includes services like cancer screenings, vaccines, mental healthcare, and HIV prevention, all at no cost to the patient. These are not luxury perks. For many, they are the difference between catching a disease early or too late, between identifying and managing chronic illness or facing financial ruin.
But now that progress is under threat.
The U.S. Supreme Court is set to rule in June on Kennedy v Braidwood, a case challenging the authority of the U.S. Preventive Services Task Force, which determines which preventive services should be covered by insurance at no cost. While the court’s review focuses on the technicalities of how the task force was appointed, the consequences go far beyond the processes. If the court rules against the task force, insurers would be allowed to stop covering essential, life-saving services.
That means patients may soon face out-of-pocket costs for mammograms, colonoscopies, diabetes screenings and other basic preventive care. Millions of Americans could find themselves forced to make impossible choices like paying rent or getting a cancer screening. The cost of delaying care is substantial. Uninsured or underinsured individuals usually end up in emergency rooms, where care is more expensive, and outcomes are worse.
Early signals suggest the court may uphold the ACA’s preventive care provisions, for now. But the Kennedy v Braidwood case also poses a more troubling question: should employers have the power to deny coverage for certain services based on religious or moral objections? That means your access to screenings or HIV prevention could hinge on your boss’s personal beliefs. We’ve seen this logic before in cases about contraception or reproductive care. The result is always the same: people lose access to the care they need, and their health pays the price.
There is something unsettling about watching access to basic healthcare unravel in courtrooms. These are not theoretical debates. They are decisions that will affect whether a mother catches her cervical cancer in time or whether a teenager gets mental health support before it’s too late. Every ruling that chips away at the Affordable Care Act reinforces the need for a comprehensive universal healthcare system that protects access for all. Not one that leaves people’s health dependent on lawsuits, jobs, or ZIP codes.
Universal healthcare is not a radical idea. Nearly every other developed country has figured it out, from Canada to the U.K. to Japan. These countries spend less per capita on healthcare and have better health outcomes to show for it. A Lancet study estimated that a universal healthcare system in the U.S. could save $450 billion annually. That’s money that could be reinvested into communities, infrastructure, education and preventative care. Rather than being funneled into insurance companies’ profits and administrative bloat. More importantly, it could mean fewer lives lost simply because someone couldn’t afford to see a doctor.
The Affordable Care Act was a step forward, but it can’t be the finish line. We are still far from a system that offers consistent, reliable care to all people regardless of background, employment situation or where they live. Until we get there, we will continue to see cases like Kennedy v. Braidwood. Battles over whether people deserve care without going broke. It’s time to stop treating basic care as a privilege and start building a system that works for everyone.
Brooklyn Coston is a nursing student and mother based in Anchorage who is passionate about advancing healthcare equity and supporting underserved communities in Alaska.
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