'Lackadaisical and negligent': RFK Jr. aims at overhaul of U.S. Preventive Services Task Force

The U.S. Preventive Services Task Force (USPSTF) is seeking new members — but how many and what exactly they will do, no one is sure yet.

Health and Human Services (HHS) Secretary Robert F. Kennedy, Jr., plans to overhaul the board that makes recommendations to primary care physicians about clinical preventive services, including screenings, counseling and preventive medications. Critics, including at least four Democratic physicians in the U.S. House of Representatives, said the Task Force is not broken, but it might get that way if Kennedy starts trying to fix it.

What is USPSTF?

USPSTF is a body of experts in prevention and evidence-based medicine that works to improve the health of Americans by making evidence-based recommendations about the effectiveness of clinical preventive services and health promotion. Those recommendations cover a broad range of services, including screening tests, counseling services, and preventive medications, and the Task Force makes its recommendations based on careful assessment of the available medical evidence.

The panel's work has direct financial consequences for patients. Under current law, insurers must cover USPSTF-recommended services without cost-sharing, making the Task Force critical to affordable preventive care access for Americans. In practical terms, that means a USPSTF recommendation can determine whether a physician's patient pays nothing for a mammogram or a colorectal cancer screening — or faces a significant bill.

The USPSTF is composed of members appointed by the Secretary of the U.S. Department of Health and Human Services. The Task Force operates independently, though administratively it works closely with the U.S. Agency for Healthcare Research and Quality (AHRQ). That agency is authorized to convene the USPSTF and to provide ongoing research, technical, administrative, and dissemination support for the USPSTF's operation. Members are volunteers who serve four-year terms, meeting three times a year for two days in the Washington, D.C. area and devoting approximately 250 hours a year outside of in-person meetings to their USPSTF duties.

Getting new members

In the last year or so, the nonpartisan USPSTF has not gotten anywhere near the attention of the Advisory Committee on Immunization Practices (ACIP), the government panel that considers evidence and makes recommendations on vaccine policy to the U.S. Centers for Disease Control and Prevention. Kennedy’s actions last year to fire the existing members and reconstitute the panel with new appointees have sparked a months-long national vaccine war of words, and some legal fights. Some medical groups and states now eschew ACIP declarations and have offered their own recommendations to physicians and patients.

Even so, health care sector observers have wondered about Kennedy’s approach to USPSTF. The Task Force itself has not met in more than a year and its latest news bulletin available online dates from August 2025.

Kennedy recently made no secret of his frustration with the task force in testimony before the House Ways and Means Committee on April 21.

"Screening for prevention is absolutely critical," Kennedy said. "We are reforming now the USPSTF, which is the committee that decides on new procedures and interventions that need to get CMS (Centers for Medicare & Medicaid Services) compensation. That committee has been lackadaisical and negligent for 20 years. Now, bringing new members on who have a clear mission, we're going to have much more frequent meetings. We're going to have, for the first time, transparency."

The remarks came in response to a question from Rep. Vern Buchanan, R-Fla., who cited personal experience with Alzheimer's disease and lung cancer in pressing Kennedy on the importance of expanding access to screening. Kennedy's comments signal that the overhaul is not merely administrative, but reflects a broader policy push within the administration of President Donald J. Trump to reorient the federal government's approach to chronic disease prevention.

A call for nominees (with an unusual deadline)

This spring, AHRQ began advertising for new nominations to USPSTF, according to an April 23 announcement in the Federal Register. The online nomination process remains open until May 23 for experts to be appointed starting in June. The compressed timeline, roughly a month from notice to deadline, is a departure from the panel's standard annual nomination cycle, which typically requires nominations to be received by March 15 of a given year to be considered for an appointment beginning in January of the following year.

The notice also specified that individuals nominated prior to April 23, 2026, who continue to have interest in serving should be renominated for consideration. It appears that could effectively wipe the slate clean and restart the selection process, though as of May 15, the USPSTF website includes the names, photos and biographies of the current 16 members.

AHRQ's nomination page describes a wide range of desired expertise. The agency encourages nominations of physician specialists in anesthesiology/pain management, cardiology, endocrinology, family medicine, gastroenterology, hematology/oncology, internal medicine, obstetrics and gynecology, pediatrics, preventive medicine, radiology, and experts in health economics, and also seeks wide geographic representation and practice experience in diverse settings, including individuals with expertise in rural medicine.

To qualify, applicants must have no substantial conflicts of interest, whether financial, professional, or intellectual, that would impair the scientific integrity of the work of the USPSTF.

The meeting gap has gotten attention

Health care sector and government observers have noticed that the task force has not convened a formal meeting in more than a year.

That gap has real-world implications. Without regular meetings, the task force cannot update existing recommendations or issue new ones. If coverage requirements tied to USPSTF grades remain frozen, physicians and patients may not have updated clinical guidance on emerging screening tools or revised risk thresholds.

Lawmakers speak out

The overhaul has drawn sharp criticism from Democratic members of Congress, particularly those with clinical backgrounds. On May 8, Rep. Maxine Dexter, M.D. (D-Oregon), a pulmonologist and critical care physician, led more than 65 House members in formally objecting to what they characterized as an effort to politicize the panel's work.

“Americans depend on these experts not only to ensure preventive care is grounded in good science, but also to guarantee these lifesaving services are covered by insurance,” Dexter said in a news release. “Although I am heartened by recent comments that a scheduled July meeting will proceed as planned, it is unacceptable that USPSTF has not met in over a year.

“I refuse to stay silent as RFK Jr. undermines the work of this critical body in apparent service to his baseless ideological aims. Our communities deserve to know they can access the care they need, driven by science they can trust.”

Dexter and her colleagues called on HHS to immediately restore the Task Force's full operations, preserve its scientific independence, and halt any attempt to politicize preventive healthcare recommendations. The letter was signed by congressional physicians Rep. Raul Ruiz, M.D. (D-California), Rep. Ami Bera, M.D. (D-California), and Rep. Kim Schrier, M.D. (D-Washington).

Implications for primary care

For primary care physicians, USPSTF's recommendations are foundational to clinical workflow. Physicians rely on the task force's graded recommendations (A, B, C, D, or I for insufficient evidence) to guide conversations with patients about which screenings are appropriate and, crucially, which are covered without cost-sharing under the Affordable Care Act.

A period of prolonged inactivity or a shift in the panel's composition and direction could introduce uncertainty into those conversations. If new members pursue a different approach to evaluating evidence, existing recommendations could be revisited, altered, or delayed, affecting coverage determinations for services ranging from colorectal cancer screening and lung cancer low-dose computed tomography (CT) scanning to depression screening and statin use for cardiovascular disease prevention.

At the same time, Kennedy's stated goals of more frequent meetings and greater transparency could, if realized, address longstanding frustrations among clinicians who have argued that the task force moves too slowly to incorporate emerging clinical evidence.

For now, physicians should be aware that the makeup and priorities of one of the most influential bodies in American preventive medicine are in active flux. What’s more, the downstream effects on coverage, clinical guidelines, and patient conversations may not become fully clear for months.

Who they are

As of May 15, the USPSTF members are:

• Chair Michael Silverstein, M.D., M.P.H.
• Vice Chair John B. Wong, M.D., MACP
• Vice Chair Esa M. Davis, M.D., M.P.H.
• David Chelmow, M.D.
• Tumaini Rucker Coker, M.D., MBA
• Alicia Fernandez, M.D.
• Ericka Gibson, M.D., M.P.H.
• Carlos Roberto Jaen, M.D., Ph.D., M.S., FAAFP
• Marie (Tonette) Krousel-Wood, M.D., M.S.P.H.
• Sei Lee, M.D., M.A.S.
• Goutham Rao, M.D., FAHA
• John M. Ruiz, Ph.D.
• James Stevermer, M.D., M.S.P.H.
• Joel Tsevat, M.D., M.P.H.
• Sandra Millon Underwood, R.N., Ph.D.
• Sarah Wiehe, M.D., M.P.H.