Supreme Court Protects Preventive Care Coverage Under the ACA

The Supreme Court has long upheld the Affordable Care Act (ACA) over the past 15 years, and this week, it reaffirmed its commitment to the law by dismissing a challenge that threatened to weaken a key provision: coverage for preventive services at no cost to patients. These services include cancer screenings, cholesterol medications, and HIV prevention drugs.

The case, Kennedy v. Braidwood Management, centered on the structure of the US Preventive Services Task Force, an independent committee that recommends which health services should be covered under the ACA. To qualify, services must be rated “A” or “B” by the task force. The controversy arose over whether the members of this committee, appointed by the Secretary of Health and Human Services (HHS), are properly appointed without requiring Senate confirmation.

In a 6-3 decision authored by Justice Brett Kavanaugh, the Court ruled that task force members are appropriately appointed and do not need Senate approval. This decision safeguards numerous recommended services since the law’s inception, ensuring they continue to be provided free of charge.

The lawsuit was filed by opponents of the ACA, including Steven Hotze, a Texas-based activist and owner of Braidwood Management. Hotze argued that the preventive care mandate infringed on his religious freedoms, particularly concerning coverage for PrEP, a medication that prevents HIV. A federal judge initially exempted Hotze from the mandate but also questioned whether the task force members required Senate confirmation due to their significant authority.

The Biden administration appealed, asserting that HHS Secretary Robert F. Kennedy Jr. has the power to appoint and remove task force members at will. The Supreme Court upheld this view, emphasizing that the Secretary supervises the task force, and by extension, the recommendations remain valid.

Justice Clarence Thomas dissented, warning that the ruling shifts the task force from an independent body reporting directly to the President to one under the Secretary’s control, potentially undermining its independence. The decision reinforces the ongoing framework that ensures preventive healthcare services remain accessible and covered under the law.