Pink ribbons won’t keep mammograms free. Here’s what will.

When an American woman turns 40, her doctor will likely recommend a mammogram. If she has private insurance, she’ll likely pay nothing for it. Few women know why. They can thank a panel of 16 volunteers that most people have never heard of.

Those 16 make up the U.S. Preventive Services Task Force. Since 1984, this panel has weighed the evidence on screenings, counseling and preventive medicines. When the panel gives a service an A or B grade, federal law requires most private health plans to cover it free of charge. More than 150 million people with private insurance rely on that rule.

The list of free healthcare services is long and practical. Mammograms every other year starting at 40. Colon cancer screening starting at 45. Blood pressure checks. Screening for diabetes. Help to quit smoking. I have spent more than 30 years studying the health of mothers and babies, and the panel protects them too. It recommends checking blood pressure throughout pregnancy to catch preeclampsia, and low-dose aspirin for women most likely to develop it. And it recommends counseling for women at risk of depression during and after pregnancy.

This system is now under strain. The panel normally meets three times a year. It hasn’t met since March 2025. The Department of Health and Human Services canceled the July 2025 meeting, the November meeting fell to the government shutdown, and the March 2026 meeting was postponed without explanation.

Last month, Health and Human Services filled eight open seats, half the panel, at once. That raises concerns about the panel’s independence. Seventeen senators wrote to the department on Oct. 5 to ask how the new members were chosen. The senators noted that the window for nominations had shrunk from about a year to one month, and that the Agency for Healthcare Research and Quality, which runs the panel’s evidence reviews, has lost about 80% of its staff. The agency asked Health Secretary Robert F. Kennedy Jr. to respond by Oct. 15.

The system for recommendations on preventive care protects every family. It is too important to be revised without clear and public deliberation.

Prevention works only if people use it. Decades of research show that even small copays lead people to skip care. When some Medicare plans began charging copays for mammograms in the early 2000s, fewer women got screened. For a family living paycheck to paycheck, a modest bill can mean putting off a crucial test. When screening is free, more people come in. When more people come in, we find disease early, at the point when treatment works best and costs least.

Here is what prevention can do when it reaches everyone. In 2009, Black members of Kaiser Permanente in Northern California were dying of colorectal cancer at far higher rates than white members: 54 deaths per 100,000, compared with 33. Kaiser had just begun mailing an at-home test each year to every member ages 50 to 75 who was due for screening. Over the next decade, screening rates doubled, from about 40% to about 80%. By 2019, death rates had fallen to 21 per 100,000 among Black members and 19 among white members. The gap had nearly closed. No new drug did that. Just a simple test, mailed to every member who needed it.

All of this rests on a chain of trust. Clinicians follow the panel because its reviews are careful and independent. Insurers cover what it recommends because the law requires it. Families accept the advice because they believe it is sound. If any link weakens, the whole chain weakens.

So here are four plain tests that any Task Force should meet, under any administration.

First, expertise in prevention. The core of the panel should be people trained in primary care, prevention and the science of weighing evidence. Specialists have long helped as advisors on the topics they know best. By contrast, five of the new members are specialists, and one is an expert in health finance — the sort of experts who would have been consulted in the past, rather than serving on the panel itself. The new members include accomplished physicians, and they deserve a fair chance to do this work, but the sudden and unexplained shift in appointments raises concerns about a system on which the health of millions depends.

Second, open books on conflicts of interest. Every panel member’s financial ties should be posted for the public to see. In early October, the panel’s conflict-of-interest page said only that it was “being updated.”

Third, obligate a fully staffed evidence review. The panel’s advice is only as good as the reviews behind it. The agency that supports that work must be rebuilt.

Fourth, insist on an open process and timely decisions. Draft recommendations should be posted for public comment, as they have been for years. Additionally, the panel should get back to meeting regularly, three times a year as it used to. Screening advice that sits untouched grows out of date, and patients pay the price.

Task Force members serve staggered four-year terms so that no single administration chooses the whole panel at once. That design reflects a simple idea that I hope we all share: What keeps our families healthy should not change with each election.

A woman turning 40 should not have to follow the news from Washington to know that her mammogram is covered and her doctor’s advice is sound. Keeping free prevention free, and keeping it trustworthy, is how we make sure she never has to.

Michelle A. Williams is professor of epidemiology and population health at Stanford University School of Medicine, former dean of the faculty at Harvard T.H. Chan School of Public Health and author of “The Cure for Everything.”