Hep C Discussion Forum

Hello Iris!

I've been following this, too. While there have been a lot of changes in government. I think it's too early to panic. There seems to be a lot of waste uncovered and people that were simply drawing a paycheck and following instructions. While there are daily changes and upsets in government now, I'm optimistic about the future streamlining. The waste has been incredible. Let's wait and see what happens. I'm going to remain hopeful that we're going to see improvements, not the ruination of our healthcare system that so many news outlets are claiming. Here is what I've been able to find thus far. I'll keep my eye on it going forward. Thanks for your input!

Overview of the Relevant Supreme Court Case

The query likely refers to the ongoing U.S. Supreme Court case *Kennedy v. Braidwood Management, Inc.*, which challenges the Affordable Care Act's (ACA) preventive services mandate under Section 2713. This mandate, informed by the U.S. Preventive Services Task Force (USPSTF), requires private health insurers to cover certain preventive services without cost-sharing, including screening for Hepatitis B and Hepatitis C (as recommended by USPSTF and the Advisory Committee on Immunization Practices). The case originated in 2023 when Christian-owned businesses in Texas argued that covering pre-exposure prophylaxis (PrEP) for HIV prevention violated their religious freedoms under the Religious Freedom Restoration Act (RFRA). However, the broader implications extend to all preventive services, including Hepatitis C testing, which is crucial for early diagnosis and treatment of a virus affecting millions in the U.S.

Hepatitis C testing under the ACA has been a public health priority since 2012, when the CDC recommended universal screening for baby boomers (born 1945–1965), who account for about 75% of chronic cases. The mandate ensures no-cost access, helping reduce undiagnosed cases from ~70% in 2012 to ~50% today. A ruling against the mandate could limit access, potentially increasing infections, liver damage, and healthcare costs.

Current Status as of September 3, 2025 -

Oral Arguments: Heard on April 21, 2025. During arguments, justices appeared divided on the validity of the Task Force's structure and the scope of RFRA claims. The government defended the mandate as essential for public health, while challengers focused on religious objections to PrEP (not directly on Hepatitis C testing). -

Amicus Briefs: In February–March 2025, 20 HIV and hepatitis advocacy groups (including the HIV+Hepatitis Policy Institute, Hepatitis B Foundation, and Community Liver Alliance) filed a brief urging the Court to uphold the mandate. They emphasized that eliminating no-cost coverage for Hepatitis C testing would hinder linkage to curative treatments (direct-acting antivirals, effective >95% of cases), increase transmission, and undermine efforts to eliminate Hepatitis C by 2030, per the National Viral Hepatitis Strategy. The brief highlighted that testing identifies ~40% of undiagnosed cases, enabling curative care and preventing ~120,000 deaths if scaled. 

Decision Timeline: No decision has been issued as of September 3, 2025. The Court typically releases opinions by late June or early July for April arguments, but delays can occur. If not yet released, it may be pending or under revision. A final ruling is expected imminently if not already announced; check supremecourt.gov for updates. - 

Potential Outcomes

Uphold the Mandate: Preserves no-cost Hepatitis C testing for ~150 million insured Americans, supporting CDC goals to diagnose 90% of cases by 2030. -

Strike Down or Limit: Could allow opt-outs for religious reasons, leading to fragmented coverage. Lower courts (e.g., 5th Circuit) have already invalidated parts of the mandate, but the Supreme Court could affirm, narrow, or reverse. - 

Broader Impact A negative ruling might affect other services like cancer screenings and vaccinations, but Hepatitis C testing's inclusion stems from evidence-based USPSTF recommendations (Grade B for adults at risk).

Related Developments 

Legislative Efforts In June 2025, Senators Bill Cassidy (R-LA) and Chris Van Hollen (D-MD) introduced the Cure Hepatitis C Act (S.1941), proposing a $4.3 billion national elimination program over 7 years. It includes expanded testing in high-risk groups (e.g., prisons, Medicaid), a subscription model for treatments, and provider training. This complements the ACA by addressing gaps in diagnosis (~2.5–4.7 million infected, per CDC). - 

Surveillance Data (2023) CDC reports 4,966 acute Hepatitis C cases (rate: 1.5 per 100,000, stable since 2021) and 101,525 new chronic diagnoses (rate: 36.2 per 100,000). Deaths fell 13% to 2.5 per 100,000, but disparities persist (e.g., 3.3x higher in American Indian/Alaska Native populations). Testing uptake remains low; universal screening could save lives but requires ACA protections. - 

Prison Context: Lower courts have ruled denying Hepatitis C testing/treatment in prisons as "cruel and unusual" under the 8th Amendment (e.g., Estelle v. Gamble, 1976). Ongoing suits in states like Texas and Connecticut seek class-action relief, but no direct Supreme Court involvement. For the latest, monitor the Supreme Court's docket (No. 23-11227) or CDC's Viral Hepatitis Surveillance.