Case Threatens Insurance Coverage of Mammograms, Genetic Testing, Care to Lower Breast Cancer Risk
WASHINGTON, DC – Susan G. Komen®, the world’s leading breast cancer organization, today urged the United States Supreme Court to overturn a lower court’s decision to end insurance coverage of annual mammograms and vital care needed to detect and lower one’s risk of developing breast cancer. Komen made its plea in an Amicus Brief in the case of Braidwood Management, Inc. et al v. Robert Kennedy Jr. et al.
The Affordable Care Act (ACA) requires insurers to cover the cost of annual screening mammograms for women age 40 and older; risk-modifying medications such as tamoxifen, raloxifene, or certain aromatase inhibitors for women at higher than average risk of developing breast cancer; and genetic counseling and testing for some individuals who have a personal or family history of breast, ovarian, tubal, or peritoneal cancer, or an ancestry associated with breast cancer susceptibility.
“The ACA’s requirement that insurers cover these preventive measures has had a profound impact, including by increasing access to care, reducing treatment costs, and, ultimately, saving lives. Moreover, early detection can reduce the risk of being diagnosed with advanced cancer,” Komen wrote.
In March 2023, a U.S. District Court in Texas ruled that insurers do not have to cover the full cost of some preventive breast cancer services, which would limit access and make these life-saving services unaffordable for many. The court’s ruling was appealed to the Fifth Circuit Court of Appeals, and, in June 2024, the Appeals Court issued a ruling agreeing with the District Court ruling but limited the scope only to the parties who filed the lawsuit. That decision has now been appealed to the Supreme Court, and oral arguments are expected to begin in April. The Supreme Court could issue its ruling as early as June.
“By striking the requirement that insurers cover certain preventive care measures, the district court’s judgment ensures that fewer people will have access to these preventive care measures. That outcome will be devastating,” Komen continued.
More than 150 million Americans rely on preventive care services that are in jeopardy because of the courts’ rulings. In 2025 alone, nearly 320,000 women and men will be diagnosed with breast cancer and 43,000 will die from it.
“It is undeniable that the preventive care covered by the ACA has made a meaningful difference in the lives of people throughout the country. Komen respectfully submits that the Court should overturn the circuit court’s decision and the district court’s conclusion that preventive care recommendations are unlawful and unenforceable,” Komen concluded.
