1164: Why States Are Watching the U.S. Preventive Services Task Force

JOHN SHEEHAN: 

This is Public Health Review Morning Edition for Monday, July 13, 2026. I'm John Sheehan with news from the Association of State and Territorial Health Officials.

Millions of Americans receive preventive health services such as cancer screenings, diabetes tests, and other essential care without out-of-pocket costs, but recent federal actions involving the U.S. Preventive Services Task Force have raised new questions about how those coverage decisions are made and whether they should change.

Today, ASTHO's Andy Baker-White, senior director for state health policy, tells us about his recent health policy update that focuses on the role the U.S. Preventive Services Task Force plays in shaping preventive care recommendations and why those recommendations have become foundational to insurance coverage across the country.

ANDY BAKER-WHITE: 

The Task Force was formed in the early 1980s. It's a volunteer panel of national experts, and what they do is they come together, they look at scientific evidence for preventive care services, and they issue letter-graded recommendations for those services to help clinicians. With the passage of the Affordable Care Act, any of the Task Force recommendations that are graded "A" or "B" are to be covered by private insurance that's regulated by the federal government, as well as Medicaid and Medicare. Not all insurance is regulated by the federal government. A lot of insurance across the country is regulated by states and so states also use those Task Force recommendations to require services without cost sharing by the insurance that they regulate. We can see the scale of the Task Force and its recommendations through an estimate that by 2020, that roughly 150 million Americans had at some point received one of the services that was recommended by the Task Force.

SHEEHAN: 

And so, what has happened recently? What recent federal developments have called into question this stability of these recommendations?

BAKER-WHITE: 

So, about a year ago, in June 2025, the Supreme Court issued a decision in Kennedy v. Braidwood, and one of the things that the court found or confirmed was that the Health and Human Services Secretary has the authority to block or rescind Task Force recommendations and can also remove Task Force members. Later that summer, there were reports Secretary Kennedy intended to remove all of the Task Force members. That didn't happen, but in May of this year, we did see that the Task Force's chair and vice chair were actually fired. Why this really matters is kind of not knowing whether a recommendation is going to remain or remain in place can really create uncertainty about whether those services will remain to be no cost under state insurance law.

SHEEHAN: 

Yeah, that's a huge development, one that may go under the radar in national media coverage, but certainly that's a big potential cost to citizens. What are dynamic references to Task Force recommendations, and what risks are created if those recommendations change?

BAKER-WHITE: 

So, a dynamic reference within state law, what it does is it automatically ties the state's coverage requirements to the most current version of the Task Force recommendations. So, that means that the law updates automatically updates when the Task Force recommendations update. So, the risk is that if a recommendation is withdrawn, then the dynamic reference offers no fallback, really, means that coverage for that service could simply go away, unless there's some sort of additional state action.

SHEEHAN: 

Yeah, and so let's talk about some of those state actions. What are states doing to protect themselves against some of this coverage going away?

BAKER-WHITE: 

So, there's a few strategies states can use to maintain the recommendations. One is locking in a fixed date for Task Force recommendations. So, for example, in Massachusetts, Task Force recommendations that are in effect as of July 1, 2023, are water being used. So, what it does is it sets a permanent coverage floor that is immune to any sort of future rollbacks. Although, also comes with its own risk, which means that newer recommendations don't automatically get added, again, would require additional state action. Another strategy states are using is kind of using like a carve out. So, Guam has a couple examples there. If the Task Force changes their colorectal screening recommendations, then the health director can choose to maintain those recommendations. Also, in Guam, the health director can adjust diabetes screening recommendations if the Task Force recommendations change. A third strategy states are using is to create state level authority to make recommendations. So, in Maryland, they have both locked the recommendations as of December 31, 2024, but also the health secretary now has the power to adopt different recommendations going forward.

SHEEHAN: 

Okay, what are some of the biggest potential ripple effects that people should be watching out for?

BAKER-WHITE: 

So, one of the things to watch out for is just changes to things other than insurance law. So, Task Force recommendations aren't just in state insurance law; they're also embedded in disease-specific statutes. So, kind of when a screening or follow-up should be done might be based on a Task Force recommendation. They're also found in state employee health plans, as well as Medicaid rules and provider manuals. And Task Force recommendations may also be used to actually set the standard of care within a state, so the practice of medicine can be really tied to Task Force recommendations. As a as a practical matter, health officials might be asked to inventory statutes and rules to see whether or not the law in their state uses dynamic or fixed date references. They could also be asked to coordinate across state agencies with insurance commissioners, Medicaid directors, and so forth to evaluate and interpret current state law. And also, this is really a case study of how a change to a single federal level panel can destabilize preventive care coverage for tens of millions of people.

SHEEHAN: 

Andy Baker-White is senior director for state health policy at ASTHO. To read his recent ASTHO health policy update, click the link in the show notes.

The California Academic Health Department project, supported by the California Endowment and led by the Public Health Institute's Center for Health Leadership and Impact, brought together local health departments, schools, and programs of public health to develop a streamlined workforce pathway system for recent public health graduates. The program matched qualified candidates with participating health departments for CAHD summer internships, six-month part-time fellowships, and 12-month full-time residency positions. The project covered a portion of the stipends provided to each CAHD participant. Learn more about it at the link in the show notes.

Join ASTHO on July 13 for the final Lunch and Learn series webinar focused on preserving institutional knowledge during workforce transitions in public health agencies, and the implications for STI and infectious disease programs. As part of ASTHO's Policy Institute, this session will examine the challenges health departments face when staff retire, change roles, or leave organizations, and how these transitions can affect program effectiveness and continuity. Register at the link in the show notes. 

This has been Public Health Review Morning Edition. I'm John Sheehan for the Association of State and Territorial Health Officials.