The Impact of the ACA Preventive Services Mandate on Hepatitis C Treatment and Detection

The ongoing Supreme Court challenge to the Affordable Care Act's (ACA) preventive services mandate could significantly influence hepatitis C management in the United States. Recent research from Michigan Medicine highlights two potential scenarios: one where 90% of hepatitis C cases are cured within five years if current efforts are maintained, and another where insufficient screening and treatment worsen without ACA coverage protections.

Hepatitis C is a major cause of liver cirrhosis and cancers, but advancements like direct-acting antivirals (DAAs) have transformed treatment, offering a cure rate of about 95%. A 2022 study demonstrated that these medications have saved Medicaid approximately $15 billion by preventing costly complications.

Despite the availability of simple and highly effective cures, many infected individuals remain undiagnosed due to low screening rates—an issue exacerbated by potential policy changes. Dr. Anna S. Lok emphasizes that diagnosing hepatitis C early is crucial, as the cure is most effective before advanced liver damage develops. She warns that losing the preventive services coverage could reverse progress, leading to increased health burdens and economic costs.

The pending Supreme Court case, Kennedy v. Braidwood Management, Inc., challenges the ACA's requirement for insurance coverage of preventive services, including hepatitis C screening. While initially centered on HIV prevention medications like PrEP, the case threatens to remove coverage for other preventive services with high effectiveness ratings, such as the one-time hepatitis C screening recommended in 2020.

Given that hepatitis C remains the leading cause of serious liver disease, the importance of widespread testing and treatment cannot be overstated. The authors of recent research call for safeguarding the preventive services mandate to ensure continued progress toward hepatitis C elimination, which could save thousands of lives and billions of dollars in healthcare costs over the next decade.

For more details, see the study by Jordan Anders-Rumsey et al. in Gastro Hep Advances.

source: https://medicalxpress.com/news/2025-06-mandate-key-hepatitis-treatment.html