An advisory panel that issues preventive health care recommendations insurers use to determine coverage has been sidelined—again.
The Health and Human Services Department has canceled the March meeting for the U.S. Preventive Services Task Force, an HHS spokesperson confirmed Tuesday to National Journal. It marks roughly a full year since the panel last met, raising concerns that Secretary Robert F. Kennedy Jr. could disband the panel altogether.
The panel makes recommendations based on the latest studies regarding screenings, counseling, and preventive medicine. Most insurance plans are obligated to cover these services for free based on the panel’s findings. Those include services doctors routinely prescribe for their patients, such as screenings for cancer, behavioral disorders, and sexually transmitted diseases.
The risks of the USPSTF not meeting range from immediate to long-term. The inability to finalize recommendations—particularly those currently in limbo—directly inhibits further coverage of preventive care for millions of Americans.
It’s the latest example of Kennedy’s willingness to shake up the health establishment and disregard traditional guardrails, exemplified by his unorthodox approach to vaccines and nutrition as he promotes the Make America Healthy Again movement.
Amid already festering concerns about the panel’s future based on previous cancellations, an HHS spokesperson said the meeting scheduled for later this week would be “rescheduled in the coming months” but did not specify when. The USPSTF usually meets three times a year to discuss and vote on recommendations.
Why the panel matters
The task force, which was created in the 1980s and largely remained out of the spotlight, is an independent panel of primary-care clinicians who issue recommendations on preventive care services. These recommendations, which are graded on a scale, dictate which services insurers are mandated to cover with no cost-sharing under the Affordable Care Act—affecting roughly 152 million privately insured individuals who benefit from such care.
Many medical professionals are expressing concern that not reviving the task force signals the administration's intent to dismantle it, as it has done to other health panels, such as the Advisory Committee on Immunization Practices. That committee was dismissed last June and reappointed with vaccine skeptics.
“The task force not doing its work is catastrophic for our country, and … it’s even anti-MAHA,” said Alexander Krist, a former USPSTF chair and practicing family physician based in Virginia. “If clinicians stop trusting the task force, they’re not going to know who to look [to] for prevention."
A spokesperson for HHS also did not respond to questions on why the meeting was removed from the schedule, or whether members would be replaced on the USPSTF.
Since July, meetings for the task force have been consistently postponed. That’s prevented the panel from generating reports, and voting on recommendations. While members are able to review studies and scientific evidence ahead of meetings, they’re unable to vote and publish recommendations.
More than a dozen recommendations in limbo
Currently, the panel is finalizing recommendation statements on cervical-cancer screening, preventive interventions for perinatal depression, screenings and behavioral counseling for unhealthy alcohol use in adolescents and adults, and vitamin D supplementation for the prevention of falls and fractures in seniors. In January, an agency under HHS endorsed the recommendation on cervical-cancer screening—effectively sidestepping the panel to ensure that insurers cover the service starting Jan. 1, 2027.
There are currently 14 draft recommendations still in review under the USPSTF, ranging from screenings for autism and chronic kidney disease, to medication to reduce the risk of breast cancer, and HIV screenings.
With the task force not meeting, all this work still stands in limbo. As a marker of comparison, the committee usually publishes 20-25 recommendations a year, according to Krist.
In a sign of how vital the recommendations are to clinicians, Krist emphasizes that he “literally, not figuratively” uses the panel’s recommendations a “hundred times a day” when treating patients. The recommendations serve as a baseline that defines preventive care in the country as clinicians and primary care doctors rely on the committee’s work to ensure that the care they’re giving to patients is evidence-driven and backed by scientific studies, Krist said.
“There's a lot of misinformation out there—there's a lot of companies and industries that try and sell preventive services,” he said. “Clinicians need to know not only what they need to give to people, but they need to know what they shouldn't be routinely doing. And the cornerstone of the task force, the reason I think it's so important, is because it has the trust of primary-care clinicians in America.”
By the end of December, five members were expected to rotate off the USPSTF, with terms expiring at the end of 2025, per the committee’s protocol. Members serve four-year terms, with a possible one-year extension. This means that the committee would be working in a diminished capacity with 11 members compared to its usual 16, according to AcademyHealth, a health-policy research group that tracks the work of the panel.
The panel is also legally mandated to provide an annual report to Congress that details its work and knowledge gaps in the area of preventive care. These reports are delivered to an agency under the National Institutes of Health to recommend areas that may need further research funding. A report was not issued for 2025.
Free screenings at risk
The USPSTF has also long been considered the “gold standard” for its process of crafting evidence-based preventive recommendations, according to Krist. Its inactivity could cause the U.S. to fall behind other developed nations that have similar panels, such as Canada, as new evidence on preventive care continues to emerge.
Furthermore, health groups and medical societies have expressed concern that the politicization of the task force would lead to the revising or rescinding of recommendations that are politically sensitive to the Republican-led administration, particularly recommendations dealing with drug use, sexually transmitted diseases, HIV infection, or mental health. Coverage that millions have long enjoyed for free, such as mammograms and colonoscopies, could be taken away if current recommendations are altered. And recommendations that prioritize services for high-risk groups, such as minority or LGBTQ+ populations, could be taken out.
Two former health care officials who have long observed the history of the 42-year-old panel—one as the committee’s first chair and the other as the first scientific adviser—outlined these possibilities in an article for the Annals of Internal Medicine.
“What is happening to scientific advisory groups under the current administration poses a larger threat to evidence-based policy and could easily return health care and public health practice in the United States to the conditions of the early 1980s,” Robert Lawrence and Steven H. Woolf wrote ahead of this week's meeting postponement. “The disorganized proceedings of the current ACIP remind us of the slipshod methods we abandoned decades ago.”
A 'woke' committee?
Along with deriding the USPSTF as a “woke” committee, a number of Republican doctors in Congress have been calling for the panel to hire more specialists—a call that many experts say would undermine its work.
The panel is made up of volunteer members from various areas of primary care that range from behavioral health to geriatric medicine. While the members often consult the guidance issued by specialty groups based on relevance to the topic at hand, appointing a specialist on the panel wouldn’t work, experts argue, because the USPSTF’s portfolio ranges widely on dozens of topics.
“Let's use a urologist as an example: The task force has one recommendation out of 138 letter grades that apply to prostate cancer,” Krist said. “In my eight years of being on the task force, that came up once. So how does the urologist sit there … and be an expert on prevention on all these other topics that they don’t know anything about? It makes no sense.”
Such concerns come amid calls from medical groups, such as the National Kidney Foundation and the American Urological Association, for a shake-up of the panel. These groups have argued for years that USPSTF has been too insulated in its approach, disallowing “meaningful contributions from medical specialists and the public who add credibility to research and evidence-based decision making on preventive care and treatment.”
A Wall Street Journal report published in July of last year said Kennedy was planning on overhauling the USPSTF in a similar fashion to what he did to the Advisory Committee on Immunization Practices, which was disbanded and replaced with vaccine skeptics. National Journal had reported last July that the White House was vetting possible replacements for weeks leading up to the cancelled meeting.
In the days leading up to the July meeting, the Supreme Court had issued a ruling that would preserve the task force and require insurance companies to cover its recommendations. However, the high court also reinforced the principle that the HHS secretary has the power to ignore the recommendations, fire the members, and appoint replacements.
The case before the high court, Kennedy v. Braidwood Management, was brought by conservatives who challenged the constitutionality of the panel requiring insurers to cover certain services with no cost-sharing—particularly, the coverage of the HIV-prevention medication PrEP.
Following reports of the panel’s potential dismantling, Kennedy had faced an outside pressure campaign—including a joint letter from several medical societies, such as the American Academy of Pediatrics and the American Academy of Family Physicians—that urged the secretary not to follow through with the dismissal.
Congress has also tried to levy its powers to rein in Kennedy. A Senate version of a Labor-HHS appropriations bill would have required the Agency for Healthcare and Research Quality—the agency that houses the panel—to give the Senate Appropriations Committee a monthly briefing on the AHRQ’s activities, along with a 48-hour notice of any USPSTF meeting cancellations or disbandment. However, that language was stripped out of the final bill that was passed into law in February.
The final bill requires HHS to “support staffing levels necessary to fulfill its statutory responsibilities including carrying out programs, projects, and activities funded in this title of this Act in a timely manner.”
Sens. Angus King and Elizabeth Warren have released a resolution affirming support for the USPSTF.
“We make America healthier when we follow the best medical research and advice available to us,” Warren told National Journal. “Secretary Kennedy continues to push in the opposite direction, and that's bad for us.”
