Work at the United States Preventive Services Task Force has been severely hampered under the current Trump administration for well over a year. Since USPSTF recommendations guide private and public insurer decisions on which preventive services and technologies to reimburse without patient cost-sharing, it’s possible that continued disruption could eventually lead to limits on which screenings are covered or more variation in coverage across payers.

Health and Human Services Secretary Robert F. Kennedy Jr. is overhauling the USPSTF. He has canceled four consecutive in-person advisory meetings and dismissed key leadership including the panel’s vice chairs. There are eight members left on the panel out of an original 16, with the roster in flux. And so, the future of operations at the USPSTF is in limbo.

Kennedy has framed the removals of task force members as a necessary measure to replace them with people who share a “clear mission.” It’s unclear what this means. But perhaps it relates to what the Wall Street Journal reported last year when the newspaper said Kennedy considered the task force “too woke,” apparently referring to past efforts by USPSTF to address “systematic racism” and health inequalities.

The USPSTF webpage lists “Recommendations in Progress,” which include cervical and prostate cancer screening, cardiovascular disease prevention, chronic kidney disease testing, tobacco cessation and cognitive impairment screening. These have been on hold for many months.

The group evaluates preventive healthcare services and technologies and subsequently issues and updates recommendations . Among the best known, these include mammograms and colonoscopies, HIV prevention (preexposure prophylaxis) medications, counseling on health behaviors related to weight management, alcohol and drug use, prenatal testing and statins for cardiovascular health. USPSTF recommendations serve as a guide to inform doctors and other healthcare providers. Importantly, they also determine what health insurers must cover.

For example, multiple cancer screenings have received strong recommendations from USPSTF. Among others, these include colonoscopy, Pap smears, human papillomavirus tests, lung cancer scans and skin cancer prevention counseling for some higher risk individuals.

The task force assigns letter grades to their recommendations: A, B, C or D grade based on the strength of the evidence and the benefits and harms of a preventive service. An A or B grade implies the panel strongly recommends the service or technology, as there is a relatively high certainty of a moderate or substantial net benefit to patients, respectively. Under a provision stipulated in the Affordable Care Act, those with an A or a B grade must be covered by health insurance in both the public and private sectors.

Two months ago, HHS said that the USPSTF’s July meeting had been postponed until “late August” because of an “unprecedented” number of nominations for new members. Reporting in the media this summer indicated HHS was preparing to announce eight new panel members and intended to have the reconstituted group meet. Kennedy has the authority to remove and replace USPSTF members at will. But as of early September, nothing is known publicly about new nominations or whether a meeting was convened in August.

The sacking of key leaders of the panel raises concern that the entire group may face a similar fate to what happened to the Advisory Committee on Immunization Practices in 2025. Its panel of 17 members was ousted by Kennedy in June of last year and replaced with hand-picked members, several of whom share similar vaccine-skeptic views. The ACIP evaluates vaccines and provides recommendations to the Centers for Disease Control and Prevention which then usually disseminates guidance to public health entities throughout the country. In turn, health insurers must take CDC advice into account in their coverage decisions.

Long before the dismissal of the two vice chairs in May of this year, former leaders of the task force expressed concern about the entity’s future in light of Kennedy’s moves. They’re particularly worried about the 42-year-old task force being able to maintain its independence and integrity, should a new panel be appointed that is “politicized.”

The USPSTF has provided recommendations on insurance coverage for preventive services and prescription drugs since 1984. Its members are unpaid experts in prevention and evidence-based medicine who serve four-year terms and have been vetted to ensure no conflicts of interest. They include independent doctors, nurses and public health experts who volunteer to regularly review scientific research about diseases ranging from cardiovascular conditions to cancer to HIV.

Removing independent experts raises the risk that recommendations issued by a restructured USPSTF could be shaped by ideology or special interests and not necessarily rigorous medical evidence. The former chair and vice chairs penned a piece saying they hope clinicians don’t lose trust in the task force.

Furthermore, public health experts have warned about the possible negative impact an upheaval at USPSTF could have on coverage of preventive care screenings by health insurers. Insurers could alter their coverage protocols, possibly removing previously covered items.

Payers may still decide to reimburse unrecommended items if they consider them medically necessary or because of the benefits they confer to enrollees. At the same time, in the absence of recommendations there could be increased variation across payer coverage decisions, depending on different priorities that insurers may attach to preventive care.