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🏛️ U.S. Supreme Court Upholds ACA Preventive Care Mandate

📅June 27, 2025 — In a landmark decision, the U.S. Supreme Court upheld a central provision of the Affordable Care Act (ACA), affirming that health plans and issuers must continue covering the full range of recommended preventive care services without cost sharing.

⚖️ The Case: Kennedy v. Braidwood Management, Inc.
The ruling reverses a previous decision by the 5th Circuit Court and affirms that the ACA’s preventive care mandate is constitutional. As a result, health plans and issuers must continue offering free preventive services—including immunizations and screenings—as long as they’re provided by in-network providers.

💡 Reminder: These services must be offered without deductibles, copayments, or coinsurance.

🩺 What’s Included in Preventive Care Coverage?
Under the ACA, non-grandfathered health plans are required to cover:

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🚨 Big News: HHS & Insurers Unite to Fix Prior Authorization!

HHS Secretary Robert F. Kennedy Jr. announced that nearly 50 major insurers — including Blue Cross Blue Shield, Cigna, Humana, UnitedHealthcare, and others — are voluntarily committing to overhaul prior authorization, making it simpler, faster, and more transparent.

🩺 What’s Changing?

📌 Prior Authorization = insurer permission before care
⏳ Known for delays and red tape

🔑 6 Insurer Commitments:

1. 📲 Standardize electronic prior auth submissions
2. ✂️ Reduce services needing prior auth
3. 🔁 Honor approvals when patients switch plans
4. 🔍 Transparency in decisions and appeals
5. ⚡ Faster approvals — real-time when possible
6. 👩‍⚕️ Medical professionals to review all denials

📅 What’s Next?

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