Q&A: A former USPSTF member’s thoughts on state of the task force

Key takeaways:

• USPSTF is being prevented from releasing recommendations it drafted for cervical cancer and perinatal depression screening, a former member said.
• Members are rotating off as usual but not being replaced.

The U.S. Preventive Services Task Force’s state of uncertainty is threatening preventive health care in the country, according to a former member.

Under the Trump administration, the USPSTF has published significantly fewer recommendations — with their last being in August 2025 — and two meetings were canceled by HHS Secretary Robert F. Kennedy Jr.

A major question is whether USPSTF will undergo an overhaul of its members as the CDC’s Advisory Committee on Immunization Practices (ACIP) did.

Former task force members have warned that such a fate could have adverse implications for insurance coverage and clinical recommendations for high-risk groups.

Alex H. Krist, MD, MPH, a professor in the department of family medicine and population health at Virginia Commonwealth University and a former member of the USPSTF, talked to Healio about the challenges the task force is facing, how much longer it could be until there is a resolution and more.

Healio: How has** the task force changed during the Trump administration?**

Krist: The task force’s mission and the way it carries out its mission and its function hasn’t changed. They’re still focused on evaluating the evidence and making sure that Americans and clinicians understand what preventive services improve health outcomes, which ones should be recommended, which ones should not be recommended and which ones we do not have enough evidence to make a recommendation on.

The problem is that they’ve not been allowed to meet and they’ve not been allowed to carry out their function. Their July meeting last year, their November meeting last year, and I suspect their upcoming March meeting this year, have all been canceled, and they’ve also not been allowed to release their recommendations.

They have multiple recommendations that I’m fairly confident have moved through the pathway — draft recommendations on things like cervical cancer screening and screening and counseling for perinatal depression, for example. They finished up draft recommendations a long time ago, and they should have been able to release final recommendations on those topics, but they’ve not been allowed to do that.

Healio:** What are your biggest concerns right now about *USPSTF?*

Krist: What’s going on with the task force is catastrophic for the nation for prevention. The task force normally releases 20 to 25 recommendations a year, and they weren’t able to do that in 2025. I think they released five. This morning, I was seeing patients, and I’ll see patients this afternoon. I use the task force recommendations 100 times a day, and that’s not figurative. Every single person I see, there’s three to 10 preventive recommendations that I should be thinking about to make sure that they stay healthy. So, our clinicians are left rudderless without having good evidence-based guidelines that they can count on for prevention.

This affects our country economically as well. The task force guidelines are linked to the Affordable Care Act, and that means that payers are mandated to pay for preventive services recommended by the USPSTF. This is good for Americans because if there’s something that we know saves lives and improves health, and the task force recommends it, it means that it’s covered for people and they can get this preventive care that can improve their life. But it’s also important to identify preventive services that don’t work or that we don’t have enough data to know if they work. The payers rely on the task force to be able to say what things we shouldn’t be doing for prevention, because either it doesn’t help or we don’t really know if it works.

The USPSTF serves such a key function to our health care system and the day-to-day lives of clinicians and the patients seen in our primary care practices.

Healio:** How much longer do you envision this situation playing out for?**

Krist: I don’t think it can go on any longer. I’m concerned Kennedy is going to cancel the March meeting and disband the task force and reconstitute it with groups and members that will not be trusted by the primary care community. I’m concerned that will happen in March, but even if it doesn’t happen, he’s strangling the task force. Every year, members rotate off. At the end of 2025, five members rotated off. So, our body of 16 members is now down to 11. In the federal notice, there’s a public announcement about nominating new task force members, and that was posted in January of 2025. A bunch of people were nominated, but the task force wasn’t able to interview, identify and select and appoint new members. At the end of 2026, they’re going to go from 11 to eight members. You can see they’re just being killed.

The other thing that’s being killed, too, is if they’re not allowed to do the work that they do — the evidence-based practice centers that do these evidence reviews that the task force relies on, that gives us these systematic reviews that not just the task force but other specialty societies and other groups across the world look at — if they aren’t funded and aren’t continued to be funded, they’re going to be lost. Those people are going to get other jobs, and we’re going to lose this national expertise in evaluating the evidence and telling the world what prevention we should and shouldn’t do.

Healio:** Is what USPSTF experiencing *now *a better alternative to ***Kennedy replacing members?*

Krist: I can’t even begin to tell you how terrible that would be. The short answer here is the task force has been working for 40 years internationally. They’re referenced as guidelines that we can trust. The National Academy of Medicine wrote a report on guidelines we can trust, and they held the task force up as the poster child for good, evidence-based guidelines. Kennedy is messing up a system that is the gold standard on how to make preventive recommendations for the nation. He is screwing up something that is working extremely well, and it makes no sense. That’s a real problem.

I run our state’s primary care practice-based research network. I work with 526 different practices across the state. I know many of the primary care physicians in Virginia. No one listens to ACIP anymore, so primary care is not following their guidelines. They’re looking to American Academy of Pediatrics and the American Academy of Family Physicians. They’re looking to groups that are going to stick to the evidence, that are not giving biased information, that are going to be objective in looking at the data and telling us what we need to do.

If Kennedy does what he did to ACIP to the task force, primary care in the country is not going to listen to the task force anymore, and we’re going to lose that North Star for prevention.

Healio:** ***What, if anything, could be done to address these concerns?*

Krist: It’s a self-imposed problem that Kennedy has created. So, it’s a very simple problem to solve. Kennedy just needs to get out of the way and let the task force do the work that it’s so good at doing.

In addition to that letter from all the former task force members with which I was a part of, AcademyHealth organized different medical societies to sign a support for the task force as well. Within the span of 3 days, around 100 medical societies like AMA signed on to say they believe in, trust and want the task force in its current form. In 3 days, they did this, and it’s next to impossible to get medical societies and medical groups to agree to anything. So, the fact that AcademyHealth and AMA and others were able to get 100 medical organizations to buy on so quickly, there’s no question that the task force is doing a phenomenal job and should be allowed to continue to do the job that they’re doing. I just hope that people can realize the value of what’s there and the loss that they will suffer as a country if it goes away.

Healio: Anything else to add?

Krist: The task force is one of the rare medical bodies that is made up of PCPs making recommendations to PCPs to inform everyday care. As a PCP, this is our body that we should really be caring about and supporting and advocating for. I do think it’s important for clinicians to speak up and let people know that this is something that they value, that they trust, that they rely on, and that they want the task force to be able to do the work that it does and to be able to continue unimpeded. I think clinicians can be a strong and powerful voice to advocate for the task force, and that can improve the health of Americans.

For more information:

Alex H. Krist, MD, MPH*, *can be reached at [email protected].