Background on USPSTF and AHRQ

The U.S. Preventive Services Task Force (USPSTF) is an independent panel of 16 experts appointed by the Secretary of Health and Human Services (HHS) that voluntarily provide recommendations on preventive services for adults and children provided in or referred from the primary care setting. According to the USPSTF procedure manual, the Task Force evaluates specific interventions and issues recommendation with a letter grade (A, B, C, D, or Insufficient [I] statement) based on the strength of existing evidence and the net benefits of a preventive service. Under the Affordable Care Act (ACA), services that receive a USPSTF Grade A or Grade B must be covered by Medicare and third-party insurance carriers without member cost sharing.

The Agency for Healthcare Research and Quality (AHRQ) convenes USPSTF, oversees evidence reviews, and disseminates its recommendations. AHRQ contracts Evidence-based Practice Centers (EPCs) to develop evidence reviews. EPCs develop the analytic framework and conduct the systematic evidence review that informs the USPSTF recommendation. Once a topic is prioritized, the topic team includes USPSTF members (including one USPSTF chair or vice chair), AHRQ staff members (including at least one AHRQ medical officer), and evidence review team members (including a lead investigator from the EPCs).

Proposed Budget Cuts and Stakeholder Response

In a letter sent to HHS Secretary Robert F. Kennedy Jr. in April 2025, 45 former USPSTF chairs, members, and scientific directors expressed grave concerns about the Trump administration’s FY 2026 budget proposal.  The proposal includes merging the AHRQ into a new Office of Strategy and cutting AHRQ’s budget by $129 million.

This reorganization under HHS risks undermining the USPSTF’s independence and its capacity to conduct rigorous, conflict-of-interest free reviews, which to date have been the benchmark for USPSTF preventive care recommendations. Additionally, because Task Force members serve on a voluntary basis, AHRQ—through its “Effective Healthcare Program”—provides essential resource support by overseeing and managing the EPCs that conduct the systematic evidence reviews informing USPSTF recommendations.

Signers warned that because the USPSTF relies heavily on AHRQ for scientific, administrative, and dissemination support, the proposed reorganization and workforce reductions could seriously jeopardize the Task Force’s ability to produce and distribute evidence-based preventive care recommendations—guidance that mandates insurance coverage without patient cost-sharing and contributes to the prevention of chronic disease through primary care.

A JAMA viewpoint article by former USPSTF Chair Alex Krist and colleagues echoed these concerns, emphasizing that AHRQ is the only agency authorized to advance primary care —despite receiving only a small portion of national health spending—and that the cuts threaten to undermine the administration’s own health promotion goals.

Additionally, the USPSTF faces potential legal challenges in the Supreme Court (see Kennedy vs. Braidwood Management Inc. ), related to its authority under the ACA to set coverage requirements for preventive services under the US Constitution and the Religious Freedom Restoration Act.

Meanwhile, the Task Force continues to develop new recommendations on emerging health issues, currently working on recommendations for topics such as tobacco cessation, vision screening in children, and others. Additionally, USPSTF has announced its intention to provide recommendations on obesity management drugs such as semaglutide and tirzepatide, underscoring its ongoing critical role in shaping US preventive care policy.

Next Steps

Avalere Health’s cross functional team is uniquely capable of supporting stakeholders navigating the evolving landscape of USPSTF recommendations and submission processes. Understanding the access landscape for screening requires a partner with strategic foresight and deep expertise in evidence, policy, and quality frameworks. Leveraging expertise in evidence generation and planning, market strategy, and policy shaping, Avalere Health can provide strategic recommendations that meet individual client needs. To learn more about how Avalere Health can assist you connect with us.