Kennedy Moves to Add Specialists to Preventive Care Task Force; Experts Warn Against It

On Thursday, a notice appeared in the Federal Register asking for nominations to the US Preventive Services Task Force, the HHS panel that decides which screenings and preventive services Americans can get at no cost. The notice specifically encourages anesthesiologists, cardiologists, oncologists, radiologists, obstetricians and other specialists to apply. HHS expects the new members to begin serving in July.

The move comes less than a year after Health and Human Services Secretary Robert F. Kennedy Jr. remade the agency's most visible vaccine advisory group. The task force, created in 1984, has historically been made up of primary care doctors. It recommends screenings for cancer, diabetes, heart disease, sexually transmitted infections and more. Its influence reaches household budgets directly: under the Affordable Care Act, insurers must cover any service the panel grades A or B without charging patients.

What Kennedy intends is not yet clear. The notice does not say whether new members would fill the five seats whose terms expired at the end of last year, replace the remaining 11 members, or enlarge the panel. An HHS spokesperson, senior press secretary Emily Hilliard, did not answer CNN's question about how many members Kennedy plans to add. She said in a statement that a mix of primary care experts and specialists helps ensure recommendations are broadly applicable and based on the latest, high-quality science, and that specialists would bring prevention expertise from their fields.

Kennedy has repeatedly criticized the panel. Testifying to a House committee this week, he called it lackadaisical and said it has not been doing its job. Some of its advocates argue he has already sidelined it. The task force has not met in more than a year, and work under review or in development has stalled, including recommendations on autism spectrum disorder screening, breast cancer medication, chronic kidney disease screening and behavioral counseling for sexually transmitted infections. It also did not send Congress its annual report last year, which identifies research gaps and helps guide grant decisions at the National Institutes of Health.

Experts question the specialist plan. Dr. Aaron Carroll, a pediatrician and CEO of the nonprofit AcademyHealth, noted that the panel weighs evidence across 92 topics, from cancer screening to maternal health. No single specialist, he said, has deep expertise across all of them, which is why generalist primary care clinicians have traditionally filled the seats. He also pointed to the wording of the new solicitation. Earlier calls sought expertise in patient care and preventive medicine; this one refers to the ability to review scientific evidence on the effectiveness, appropriateness and cost-effectiveness of preventive services. Carroll called that a substantially lower and broader bar, and said it could admit members who are analytically capable but lack grounding in what happens when a recommendation reaches a patient and doctor.

Dr. Alex Krist, a Virginia Commonwealth University family medicine professor and former task force chair, said specialists tend to know the most about treating conditions rather than preventing them, and that too much of a treatment perspective could upset the balance of a prevention recommendation. Primary care doctors, he said, better understand whether recommendations can be put into practice. He added that members rely on evidence, not opinion, and already consult specialty societies while drafting. Experts also raised the possibility of financial incentives: a radiologist, for example, could benefit from more imaging screening recommendations. Carroll said he worries an overhaul could be aimed at weakening the Affordable Care Act, which the Trump administration has long tried to curtail through administrative actions.

The concern reaches into Kennedy's own party. Sen. John Barrasso, a Wyoming Republican and orthopedic surgeon, praised the panel's 40-year history of independent, evidence-based recommendations at a Senate Finance Committee hearing Wednesday. Kennedy promised not to undermine its functions, calling its role critical in securing compensation for approved interventions. He said specialists would ensure everybody is represented and that he plans more meetings and greater transparency.

The precedent is the Advisory Committee on Immunization Practices, whose members Kennedy replaced entirely last year. The new panel voted to drop universal hepatitis B vaccination for newborns, restricted a combined chickenpox, measles, mumps and rubella shot, and, for the first time, declined to universally recommend Covid-19 vaccines. What to watch now is whether the task force is expanded or replaced, and whether the looser expertise standard changes what insurers must cover.