How Advocates Can Respond to Kennedy v. Braidwood Management, Inc.

This case was formerly known as Braidwood Management, Inc. v Becerra.

Threats to No-Cost Preventative Care Could Deepen Inequity and Drive More People into Medical Debt  

The U.S. Court of Appeals for the Fifth Circuit issued its ruling on June 27, 2025 and upheld the authority of the U.S. Preventive Services Task Force (USPSTF), ruling that insurance providers must continue to cover PrEP medication and other HIV preventative services. However, the real threat revealed in the case looms in the form of political interference undermining what preventive care gets covered without copays or deductibles.

The U.S. Preventive Services Task Force (USPSTF) is an independent panel of experts in prevention and evidence-based medicine that makes recommendations about clinical preventive services — such as screenings, counseling services, and preventive medications — to improve the health of people nationwide. Their guidelines help determine which preventive services are covered without out-of-pocket costs under the Affordable Care Act.

In the original case, known as Braidwood Management, Inc. v Becerra, the Fifth Circuit Court of Appeals was appealed by the Biden administration in April of 2023, and heard oral arguments in a case that could jeopardize access to no-cost preventive care for more than 150 million people.

This is a critical moment for advocates for health and economic justice to demonstrate the harm of taking away access to no-cost preventative care – especially those already struggling to afford the cost of health care.   

Access to no-cost preventive care is one of the most popular components of the Affordable Care Act (ACA) and has helped millions of people get and stay healthy – covering things like cancer screenings, HIV/AIDS prevention drugs, and mental health services for new moms, and more without copays. The services covered, and now at risk, are based on sound research and medical expertise, and could worsen inequity in communities already struggling to make ends meet.  

That’s why Community Catalyst and a growing movement of local, state, and national partners are working together to share facts about the case and what is at stake.   

This ruling was the result of a concerning trend we are seeing in the courts of partisan/activist judges using their power to chip away at important protections within the ACA – and it could leave even more people with medical debt, delay important care, and more.  

What happened in Braidwood v. Becerra?

For fourteen years, the ACA has required most private health insurance plans to cover, without a co-pay or deductible, a range of preventive health care services recommended by the United States Preventive Services Task Force.  

However, the original case of Braidwood v. Becerra threatened to eliminate that protection by allowing insurers to charge co-pays and deductibles for several types of preventive care – including vaccines. This jeopardized access to preventive care for over 150 million people across the country.  

The case centered around pre-exposure prophylaxis (PrEP), a medication proven to reduce the risk of HIV transmission. Plaintiffs made the discriminatory claim that covering PrEP and its related medical services, at no-cost, violated “their religious beliefs by making them complicit in facilitating homosexual behavior, drug use, and sexual activity outside of marriage between one man and one woman.” A federal judge in Texas ruled in favor of these plaintiffs, meaning health insurance plans now have the option to drop coverage for PrEP entirely or impose cost sharing if they claim a religious objection.  

Timeline: 

• On September 7, 2022, Judge Reed O’Connor issued a ruling in the case Braidwood Management v. Becerra, a lawsuit that challenges the requirement that most health plans cover preventive services at no cost under the Affordable Care Act. 
• On March 30, 2023, this same federal judge issued another ruling, clarifying his decision applies nationwide and not just to the parties involved in this case. With this additional ruling, access to a range of critical preventative care for more than 150 million people is now at risk – including approximately 37 million children. 
• On April 13, 2023, the Biden administration received a stay in the case, successfully arguing that “[e]fforts to strip away access to preventive health care are harmful and unacceptable.” This helped ensure that coverage for no-cost care would still be made available while the case made its way through the appeals process. 
• On August 7, 2023, a cross-appeal was filed with the Fifth Circuit Court of Appeals to expand the scope of the challenge, further threatening no-cost access to the full range of ACA preventive services. 
• On March 4, 2024, the Fifth Circuit Court of Appeals heard oral arguments. The future of free preventive care will likely be decided by the Supreme Court.
• On June 27, 2025, the Fifth Circuit Court of Appeals ruled that insurance providers must continue to cover PrEP medication and other HIV preventative services.

“No-cost preventive care is one of the most popular and effective parts of the Affordable Care Act. People count on it to stay healthy. Undermining it through political interference is not just dangerous, it is deeply out of step with what communities want and need.”

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