Over 20 million women between the ages of 50 and 64 could lose access to cost-free mammograms if a court ruling striking down requirements for payers to cover preventive care at no cost is upheld, according to a report from the Robert Wood Johnson foundation.
U.S. District Judge Reed O'Connor struck down portions of the ACA in a March 30 ruling. The judge ruled employers cannot be required to cover preventive services recommended by the U.S. Preventive Services Task Force after 2010 with no-cost sharing.
Mr. O'Connor's decision applies to certain cancer screenings, statins, and HIV prevention drugs. Mammograms were recommended by the preventive services task force before 2010, but Robert Wood Johnson Foundation analysts said the guidelines have been updated since 2010, making it unclear if the ruling applies to these screenings.
According to an update added to the report May 18, the Consolidated Approprations Act of 2023 requires insurers to cover mammograms and other breast cancer preventive services at no cost, regardless of the outcome of the case, through 2025.
On May 9, the task force proposed lowering the recommended age to begin screenings from 50 to 40.
The Biden administration is appealing Mr. O'Connor's ruling.
According to the analysis, published May 10, 22.2 million women in the U.S. between the ages of 40 and 64 were enrolled in private health insurance in 2018. Of these women, 13.4 million reported receiving a mammogram in the past two years.
The average cost of a 2D mammogram without insurance is $400, according to the report. The researchers wrote that if cost-sharing for the screening increases, this will likely widen existing disparities in mammogram use by income and education level.
Payers have said beneficiaries should not expect any immediate impacts on care as a result of the court decision.