The 16-member panel of medical and health experts decides which preventive health services—such as cancer screenings and PrEP—must be covered by insurance
U.S. Health and Human Services (HHS) secretary Robert F. Kennedy, Jr., is said to be planning to dismiss the U.S. Preventive Services Task Force (USPSTF). Made up of doctors, nurses and public health experts, the all-volunteer panel makes evidence-based recommendations about preventive services such as screenings for diabetes, cancer and STIs, behavioral counseling and preventive medications such as PrEP.
The Wall Street Journal first broke the news in a story posted July 25, reporting that Kennedy believes the 16 members of the independent panel are “woke.”
The USPSTF was established in 1984 to advise the federal government on preventive health. In 2010, under the Affordable Care Act (ACA; known as “Obamacare”), the task force was empowered to determine which preventive services must be covered by insurance, at no cost to patients.
With its June 2019 recommendation of the use of pre‑exposure prophylaxis (PrEP) medication to prevent HIV, the USPSTF required that insurers cover PrEP. That recommendation was reaffirmed and expanded in August 2023 to include long-acting injectable PrEP. However, Jeremiah Johnson, executive director of PrEP4All, pointed out: “While Apretude [brand name of cabotegravir as the two-month injectable for PrEP] is mentioned in the USPSTF’s PrEP recommendation, lenacapavir is not.” Approved by the FDA in June, lenacapavir is the first ever six-month injectable for PreP from drugmaker Gilead Sciences, marketed in the U.S. under the brand name Yeztugo. “This spells trouble for Gilead’s efforts to get the task force to incorporate Yeztugo into the PrEP recommendation.”
Alarm bells went off in early July when Kennedy’s office sent a last-minute email to task force members abruptly “postponing” their scheduled July 10 meeting. The move prompted an open letter to Congress, signed by 104 medical organizations, calling on lawmakers to, “preserve the integrity” of the USPSTF.
Concern about the fate of the task force had been growing since June, when the U.S. Supreme Court ruled that task force members essentially serve “at will” and could be fired by the HHS secretary. That ruling came in the case of Kennedy v. Braidwood Management, Inc.
A family-owned company in Texas, Braidwood Management sued the federal government, charging that the USPSTF’s insurance requirement of PrEP violated the family’s religious beliefs against homosexuality. Instead of arguing on First Amendment grounds, Braidwood lawyers challenged the ACA, claiming that the task force did not have constitutional authority to make insurance mandates.
In a 6-3 decision, the justices upheld the ACA provision and the USPSTF’s role. However, the court agreed with the Trump administration that as HHS secretary, Kennedy has final say over USPSTF decisions and has the authority to remove and replace task force members.
Kennedy has already exercised such power. In June, he fired all 17 members of the Advisory Committee on Immunization Practices, the volunteer panel that makes recommendations to the Centers for Disease Control and Prevention about vaccines. Kennedy replaced them with eight new members, including some who are known vaccine critics.
“PrEP and HIV testing are particularly vulnerable given RFK’s well documented and utterly insane belief in AIDS denialism,” said PrEP4All’s Johnson. “By turning the USPSTF into his own personal puppet, he’ll have free reign to impose his arrogant and misguided views of science on over a decade of carefully developed guidelines, undercutting essential services that keep Americans healthy. And it will literally cost all of us; insurers will be able to pass along costs for testing, screening, and preventive treatments that are currently free.”
Firing members of the USPSTF won’t simply be an anti-science decision. While Kennedy has voiced skepticism about HIV as the cause of AIDS, the USPSTF has come under fire from political conservatives. In July, The American Conservative published a commentary by its associate editor titled, “Time for Kennedy to Kill the UPSTF.”
Citing the Braidwood decision, Joseph Addington attacked the USPSTF as, “One festering corner of woke bureaucracy that should draw the attention of the Trump administration.”
His commentary called out PrEP: “The most controversial recommendation from the USPSTF is its endorsement of preventive prophylaxis for HIV, commonly known as PrEP, for individuals at risk of infection with that disease. This population consists almost entirely of sexually active gay men, which has led a number of Christian employers who provide insurance to protest that the ACA (and its instrument, the USPSTF) are requiring them to subsidize activities they oppose on moral and religious grounds.”
“No final decision has been made on how the USPSTF can better support HHS’ mandate to Make America Healthy Again,” said an HHS spokesperson.
This report was compiled from various news accounts, with additional research.