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Center Supports Free Preventive Care and Prescription Drug Negotiation

February 27, 2025

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This week the Center for Medicare Advocacy joined two amicus curiae (“friend of the court”) briefs in litigation of importance to older adults and people with disabilities.

In Kennedy v. Braidwood, CMA joined members of the Chronic Illness and Disability Partnership in urging the U.S. Supreme Court to ensure continued access to cost-free preventive health care. Under the Affordable Care Act, health insurers and group health plans must cover certain preventive services recommended by the U.S. Preventive Services Take Force without imposing any cost on patients. These services include screenings and medications that help people treat chronic illnesses and avoid serious illnesses through early detection. The issues before the Court are whether the structure of Task Force violates the Constitution’s appointments clause, and whether the lower court erred by failing to “sever” (remove) the provision of the law that it found to be unconstitutional.

The amicus brief explains that the preventive care coverage requirement promotes both individual and systemwide health by helping Americans avoid chronic disease. Such services include cancer-screenings, preventive diabetes care, and infectious disease screenings. In enacting the uniform and nearly-universal requirement for free preventive coverage, Congress recognized the importance of care that helps prevent and treat chronic illness, particularly in our fractured health care system in which people often switch among insurers and payors over their lifetimes. As the brief notes, “[t]he ACA extends no-cost-sharing preventive care benefits beyond employment-based health coverage and individual market plans by creating analogous requirements for the Medicare and Medicaid programs. Medicare now covers preventive services with a grade of ‘A’ or ‘B’ from the [Task Force] that the Secretary of Health and Human Services determines are appropriate Medicare beneficiaries and ‘reasonable and necessary for the prevention or early detection of an illness or disability.’” The cost-free coverage requirement thus operates on a “systemic level across dimensions of the healthcare industry to promote preventive services access.” It is “an essential tool in the U.S. response to the growing burden of chronic conditions.”

The brief was authored in part by the Center for Health Law and Policy Innovation at Harvard Law School, and other organizations that joined include the American Diabetes Association, the Medicare Rights Center, the Center for American Progress, the National Alliance on Mental Illness, and the AIDS Institute. The Supreme Court will hear oral argument in the case on April 21, 2025.

  • Read the amicus brief here.

In Novartis Pharmaceuticals Corp. v. Kennedy, the Center joined another amicus brief from a coalition of advocates led by AARP in support of the Medicare drug price negotiation program. Numerous cases have been brought by drug companies and their allies around the country challenging the program, which was established by the Inflation Reduction Act. Drug price negotiation allows Medicare to use its bargaining power to obtain lower prices for certain medications and help beneficiaries afford life-sustaining prescription drugs. The program will also help protect the financial integrity of Medicare and save taxpayers billions of dollars.

  • Read the amicus brief here.

February 27, 2025 – A. Bers

Filed Under: Article Tagged With: litigation update, Medicare Part D / Prescription Drugs, Preventive Benefits, Weekly Alert

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