Most Americans haven't heard of the U.S. Preventive Services Task Force (USPSTF), but its impact on American healthcare is profound. The Task Force is an advisory board of the Department of Health and Human Services (HHS). Despite being little known, it wields considerable power and plays a significant role in American healthcare: recommendations made by the Task Force become covered requirements in insurance plans under the Affordable Care Act.
There's just one problem: the USPSTF is populated by far-Left woke ideologues and uses its power to push DEI into healthcare.
A Brief History of the USPSTF
The Task Force was established in 1984 as a five year appointment to "develop recommendations for primary care clinicians on the appropriate content of periodic health examinations" and was modeled after the Canadian Task Force on Preventive Health Care that was established in 1976. In 1989, the Task Force issued its report, the Guide to Clinical Preventative Services. In 1990, HHS reconstituted the Task Force to continue making recommendations. Those recommendations evaluate scientific and medical evidence to determine whether medical screenings, counseling, and preventive medications are effective for adults and children without symptoms.
The Task Force gives a letter grade to each of its recommendations. Grades "A" and "B" are recommended, with "high certainty that the net benefit is substantial" or "high certainty that the net benefit is moderate or there is moderate certainty that the net benefit is moderate to substantial," respectively.
The USPSTF and the Affordable Care Act
But it wasn't until 2010 and the passage of the Affordable Care Act (ACA) that the Task Force's recommendations gained statutory weight. Under the ACA, insurance providers are required to cover any recommendation that the USPSTF grades as an "A" or "B", regardless of the cost or how small the benefit actually is.
The ACA mandates that "a group health plan and a health insurance issuer offering group or individual health insurance coverage shall, at a minimum provide coverage for and shall not impose any cost sharing requirements for evidence-based items or services that have in effect a rating of 'A' or 'B' in the current recommendations of the United States Preventive Services Task Force."
This includes things like a recommendation for preventive prophylaxis for HIV, known as PrEP, for those at risk for HIV infections. The at-risk group is commonly sexually active, gay men, and the ACA mandate requires Christian employers to provide coverage of such medications, in conflict with their religious beliefs.
Recommended
The larger issue, of course, is the impact of mandating such recommendations without consideration of cost versus benefits. In 2021, Heritage reported the ACA led to a doubling of the cost of individual health insurance. Between 2013 and 2019, the average premium increased by 129 percent, and the recommendations of the USPSTF contributed to that.
Last year, The New York Times also reported higher costs for health care in 2025:
Weight-loss drugs. Cutting-edge gene therapies. In vitro fertilization. All are life-changing, but expensive, medical options that are helping to drive up health care costs next year for employers and their employees.
The annual open enrollment period for health benefits is now underway at many workplaces. According to surveys by industry groups and benefit consulting firms, employers expect the costs of those benefits to jump as much as 9 percent on average in 2025, after years of more modest increases. But workers probably won’t be asked to shoulder them all. In recent years, employers have assumed much of the cost increases, probably because of a tight job market, said KFF, a nonprofit health research group. And employers may take steps to rein in their costs.
KFF found that while employers have seen the total annual cost of premiums for family coverage rise 24 percent over the past five years, the amount that workers pay rose 5 percent, or less than $300 on average. Workers contribute about a quarter of the average $25,572 annual family premium, or about $6,300.
The Task Force and its recommendations drive healthcare costs and coverages for millions of Americans, with little oversight or transparency into the decision-making process.
The USPSTF and DEI
President Biden appointed every member of the Task Force, and it shows.
While the ACA gave the USPSTF statutory weight, DEI initiatives—many enacted during the aforementioned Biden administration—empowered it to use that weight to influence policy with a Left-leaning bent. This includes ending sex-specific references in favor of "gender-neutral language" such as "individuals with breasts." It recommends the use of "cisgender women" or "persons assigned female at birth" in breast cancer screening guidelines.
According to The American Conservative, the USPSTF also would "prioritize transgender and other populations of sexual minorities in selecting topics for research, as well as promising to hand over any relevant research and draft recommendations to gender activists for review and comment."
In 2023, the Task Force recommendations were given a preamble that focused on "health equity," as well as systemic racism and gender discrimination, and used that as a basis for claiming that being black is a risk factor due to "social inequities" and not biological reality.
These claims are often made without sufficient evidence to support them.
Calls for Reform
Over the summer, Republicans in Washington started pushing for an overhaul or the disbanding of the Task Force.
In July, three Senate Republicans backed a plan by Secretary Kennedy to reform the Task Force, citing its ideological motivations as proof that reforms are needed.
The "independent" task force is used to determine recommendations of what services health insurance companies in the United States have to cover for free, such as checking for cancer.
"Americans deserve to know health guidelines are based on real science, not radical wokeness. The Task Force needs to get back to its mission of giving clear, evidence-based recommendations people can trust," Sen. Jim Banks, R-Indiana, said in a statement.
The Wall Street Journal reported that Kennedy is considering removing members of the board, and the senators are saying they back any change to veer away from certain DEI tactics employed by the group currently, including the 2023 Report to Congress on High-Priority Evidence Gaps for Clinical Preventive Services and "social justice activism" by people in the group.
"In particular, the USPSTF departed from its proper activities in its December 2023 Health Equity Framework. The framework criticizes ‘equal access to quality health care for all’ as an inadequate goal of public health and announces that the Task Force will instead use equity as ‘a criterion of the ‘public health importance’ of a topic’ for consideration," the letter added.
On August 20, Congresswoman Diana Harshbarger (R-TN) and GOP Doctors Caucus Co-Chair Congressman Greg Murphy (R-NC) announced the GOP Doctors Caucus in calling for an overhaul of the USPSTF, saying it "has strayed from its mission of saving lives through evidence-based preventative care and instead drifted into divisive political territory." In a letter addressed to Secretary Kennedy, they wrote:
As Members of Congress with medical backgrounds and hands-on experience translating scientific literature into practical healthcare solutions, we write to express our strong support in altering the makeup of the U.S. Preventive Services Task Force (USPSTF). We believe the Task Force should prioritize placement of practicing non-biased clinicians who can effectively balance rigorous, scientific evidence with real-world clinical application, while ensuring preventive guidelines rooted in science are published in a timely manner to address pressing public health needs.
The USPSTF is tasked with systematically reviewing the evidence of effectiveness and developing recommendations for clinical preventive services. In 2010, the Affordable Care Act expanded the authority of the USPSTF and tied coverage recommendations to Task Force determinations. However, since the USPSTF’s authority was expanded, the rate of incidence of preventable chronic disease in the United States has only climbed. Notably, adult obesity rates have increased 5% since2010,1and incidences of Type 2 diabetes increased nearly 20% from 2012 to 2022,2highlighting the urgent need for this body to focus on more effective preventive strategies.
Rather than maintaining focus on its core mission of preventive care recommendations, the Task Force has allocated substantial attention to divisive social issues, including race and gender identity considerations that extend beyond traditional clinical parameters. Too frequently, the Task Force concludes that recommendations cannot be made due to insufficient evidence, resulting in delayed or altogether canceled guidance on critical preventive services.
The letter noted that, since the ACA granted the USPSTF statutory authority, health outcomes have declined. This includes a 5 percent increase in adult obesity rates and a 20 percent increase in incidences of Type 2 diabetes.
It also notes that there's no requirement that the USPSTF include members from any medical specialty; the Task Force assigned a "D" grade to prostate cancer screenings without any input from urologists. This led to an increase in diagnoses of the disease at later stages. We have to wonder if, given the fact that men get prostate cancer, this was a decision based on woke ideology and not medical science. This would be unsurprising, as the Task Force has made biased recommendations in the past.
In 2024, it gave a "B" grade to a recommendation for clinicians to screen all women of childbearing age about intimate partner violence (IPV), but it refused to give such a recommendation that men be screened for IPV, even though the Task Force's own data showed a near-equal number of men and women faced IPV, 44 percent to 47 percent, respectively.
Such calls for reform were met with resistance from some groups, including the American Medical Association (AMA), which was "deeply concerned" about reported changes. In a letter to Secretary Kennedy, the AMA wrote, "[The] USPSTF plays a critical, non-partisan role in guiding physicians’ efforts to prevent disease and improve the health of patients by helping to ensure access to evidence-based clinical preventive services. As such, we urge you to retain the previously appointed members of the USPSTF and commit to the long-standing process of regular meetings to ensure their important work can continue without interruption."
More Than Woke
Despite tremendous power and influence, the Task Force has little public accountability or transparency — a contrast to other federal advisory committees. Although it is a volunteer-based committee, it is subject to influence from D.C. lobbyists, and there are no federal regulations or published procedures to act as guardrails for the Task Force.
The current decision-making process is unclear and updates to the Task Force Procedure Manual are not public. Neither are the meetings; attendance is by invitation only, and public comments on draft materials are kept confidential
Many current members of the Task Force are also affiliated with universities, and those institutions are often dependent on research grants from D.C., creating a conflict of interest.
These opaque and questionable practices must end.
As Part of MAHA, Secretary Kennedy Needs to Overhaul the Task Force
The only solution to fix the Task Force is a complete overhaul. All members should be dismissed and replaced with a more diverse body of medical experts, patient advocates, and business experts who can explain the economic impact of the Task Force's recommendations.
In June of this year, the Supreme Court ruled in Kennedy v. Braidwood Mgmt. that Secretary Kennedy has the authority to remove and replace the entire Task Force:
The Secretary of HHS has the power to appoint (and has appointed) the Task Force members. And no statute restricts removal of Task Force members. Therefore, there can be no doubt that the Secretary may remove Task Force members at will.
A return to science- and evidence-based practice is the only way to restore even a modicum of public trust and integrity to the Task Force, and it must be rebuilt from the ground up.
In addition to replacing Task Force members, Secretary Kennedy should push for reforms to practices, including greater public transparency of recommendations and guidelines, the incorporation of cost considerations into recommendations, and the elimination of DEI-driven "woke" practices and policies.
At a time when Obamacare is in the news and health insurance premiums are about to jump, thanks to the Democratic Party's policies, efforts to restrain price hikes from Task Force recommendations would be a political win for HHS, Republicans, and the Trump administration as well.
Secretary Kennedy has the authority to do all of this, and it would dovetail perfectly into his MAHA agenda.
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