Supreme Court upholds Affordable Care Act's preventive care mandate
The Supreme Court on Friday upheld a portion of the Affordable Care Act that requires health plans to provide free preventive care such as cancer screenings.
In a 6-3 decision, the justices ruled against a Christian-owned business and individuals who objected to being forced to offer medications intended to prevent the spread of HIV among at-risk populations. The plaintiffs contend the medications, which are administered before possible HIV exposure, “encourage and facilitate homosexual behavior” in conflict with their religious beliefs.
Health-care providers and nonprofit organizations say the case could have blocked critical health care for many Americans. A Stanford University study estimated nearly 40 million Americans use the act’s preventive services.
Friday’s ruling in Kennedy v. Braidwood was one of six opinions expected from the justices on the final day of the Supreme Court term.
The groups objected to the preventive care mandate on religious grounds, but their legal arguments before the high court involved a technical question about the expert panel that decides which measures health plans must cover.
They argued that members of the Preventive Services Task Force were improperly appointed because they were not approved by the Senate. The mandate, the challengers said, was therefore unenforceable. The high court rejected that argument.
The Constitution’s appointment clause requires the president to appoint and win Senate approval for principal officers such as Cabinet secretaries, federal judges and ambassadors, but allows Congress to vest authority in department heads and other officials to appoint “inferior officers.”
Jonathan Mitchell, an attorney for the challengers, said during oral arguments in April that the 16-member task force wields significant independent power and its appointees therefore should be considered principal officers.
Lawyers defending President Donald Trump in his classified documents case last year made a similar argument about special counsel Jack Smith, and convinced a federal judge appointed by Trump in his first term to toss the indictment.
In the preventive care case, some justices seemed skeptical of the idea.
“Your theory, I think, depends on us treating the task force as this massively important agency that operates with unreviewable authority,” Justice Brett M. Kavanaugh said. “Normally, before that kind of thing would happen, Congress would have provided stronger indications.”
The health and human services secretary has made appointments to the panel since 2023.
Hashim Mooppan, principal deputy solicitor general, told the justices that task force members are inferior officers since they serve at will under the secretary of the Department of Health and Human Services. The secretary also supervises the panel and decides when its recommendations take effect.
The preventive care mandate covers dozens of services—from statins for to preventing heart disease to screenings for hepatitis B and HIV.
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