By Amy Killelea, Justin Giovannelli, Madison Harden, and Abigail Knapp
The Affordable Care Act requires insurance plans to cover preventive services recommended by three federal expert bodies: the Advisory Committee on Immunization Practices (ACIP), the U.S. Preventive Services Task Force (USPSTF), and the Health Resources and Services Administration (HRSA). State and federal policymakers have also embedded their recommendations in laws and regulations governing insurance coverage and public health. However, recent events have cast doubt on whether these bodies can continue to be relied on to provide science-backed recommendations. In June of 2025, Health and Human Services Secretary Robert F. Kennedy Jr. fired ACIP members en masse and replaced them with several vocal vaccine critics. Since then, ACIP has moved to scale back its vaccine recommendations for measles, mumps, rubella, and varicella (MMRV), COVID-19, and hepatitis B. After the publication of our blog, HHS took further action to amend the entire pediatric vaccine schedule, moving several vaccines from a universal recommendation to a risk-based or shared decision making category Meanwhile, USPSTF has not met since last March amid news reports that the Secretary may fire its members.
These developments have prompted states to preserve scientifically backed services where they can: state-regulated private insurance plans, Medicaid, and public health programs. Some states have opted to tie their coverage and public health requirements to the specific federal recommendations that were in place at the end of the Biden administration. Others have granted non-federal entities the authority to issue recommendations for the state. As policymakers consider these decisions, they must determine how to move away from federal recommending bodies without further damaging trust in public health. In a recent article for the Commonwealth Fund, Amy Killelea, Justin Giovannelli, Madison Harden, and Abigail Knapp outline different state approaches to preserve access to preventive services. You can read the full article here.
