The Supreme Court on Friday upheld the constitutionality of an ObamaCare requirement that insurance companies cover certain preventive care recommended by an expert panel.
In a 6-3 decision authored by Justice Brett Kavanaugh, the justices upheld the panel’s authority, protecting access to preventive care for an estimated 150 million Americans.
The justices found the secretary of the Department of Health and Human Services (HHS) has the authority to appoint and fire members of the U.S. Preventive Services Task Force (USPSTF); their work is “directed and supervised” by the HHS Secretary so they do not need to be confirmed by the Senate.
In siding with the Trump administration, the court reinforced the ability of HHS Secretary Robert F. Kennedy Jr. to exert control over the panel’s recommendations.
The health law requires insurers to cover services the task force recommends with a “grade” of A or B, like cancer screenings and HIV-prevention drugs.
The task force is composed of medical experts who serve four-year terms on a volunteer basis. They are appointed by the HHS secretary and are supposed to be shielded from political influence. Congress designed the task force to be “independent and, to the extent practicable, not subject to political pressure.”
The case began when conservative Texas small businesses and individuals sued over the panel’s recommendation that pre-exposure prophylaxis (PrEP), medicine that is highly effective at preventing HIV, be included as a mandatory preventive-care service.
They said covering PrEP was against their religious beliefs, and would “encourage homosexual behavior, intravenous drug use, and sexual activity outside of marriage between one man and one woman.”
The plaintiffs argued the USPSTF mandates are unconstitutional because the task force’s members are “inferior officers” who aren’t appointed by the president or confirmed by the Senate.
They argued the panel is set up as independent, but since it is responsible for determining preventive health coverage for over 150 million Americans, its members should be confirmed.
In 2023, U.S. District Judge Reed O’Connor ruled that all preventive-care coverage requirements that the task force had imposed since the ACA was signed into law were invalid.
A federal appeals court in New Orleans last year agreed with O’Connor and ruled the task force was unconstitutional, though the ruling applied only to the challenger and was not enforced nationwide.
The Biden administration appealed to the Supreme Court. The Trump White House, though long antagonistic toward ObamaCare, surprisingly chose to continue the Biden administration’s defense of the law.
During oral arguments, Justice Department attorneys argued the HHS secretary has the power to fire task force members and reject its recommendations, even though that power has never been exercised previously.
After oral arguments, experts and court watchers felt the case was essentially a tossup.
