Supreme Court ACA Challenge Threatens Hepatitis C Screening Mandate

The Affordable Care Act's preventive services mandate is facing a Supreme Court challenge with significant implications for hepatitis C screening and treatment in the U.S. This mandate requires health insurance plans to cover preventive services rated A or B by the U.S. Preventive Services Task Force, including a one-time hepatitis C screening introduced in 2020. If the mandate is eliminated, there is concern that insufficient screening rates will continue or worsen, delaying diagnosis and treatment of hepatitis C and increasing long-term health costs.

Hepatitis C is a major cause of liver diseases including cirrhosis and certain types of liver cancer. Advances in direct-acting antiviral treatments now cure approximately 95% of hepatitis C cases if diagnosed early. These treatments have proven cost-effective, saving billions in Medicaid healthcare costs by preventing severe liver conditions and need for transplants.

Experts from Michigan Medicine emphasize that early diagnosis through guaranteed no-cost screening is critical to offer cures and avoid progression of the disease. Hepatitis C is often asymptomatic until advanced stages, which complicates timely intervention. Current screening rates remain below recommended levels nationally, presenting a barrier to eliminating the disease.

The researchers highlight a national hepatitis C elimination plan that could save thousands of lives and billions in healthcare expenditures over the next decade. However, the potential repeal of the ACA preventive services mandate could hinder these efforts by removing coverage for no-cost hepatitis C screening, thereby limiting access to early detection and curative treatment.

This legal challenge originally targeted coverage for HIV-prevention medication but has broader implications for all ACA-covered preventive services. The outcome of this case could impact insurance plan obligations, regulatory compliance, public health objectives, and cost management strategies related to hepatitis C and other preventive health services under ACA guidelines.