Seyfarth Synopsis: In a closely watched decision, the Supreme Court has upheld the authority of the U.S. Preventive Services Task Force (Task Force), preserving the Affordable Care Act's (ACA) requirement that health plans cover preventive services–such as HIV prevention medication–without cost sharing. The ruling ensures continued access to a wide range of preventive care for millions of Americans.
Background: The Role of the Task Force
The Task Force, originally established by the Department of Health and Human Services (HHS) and later codified by Congress in 1999, is a panel of volunteer experts appointed by the HHS Secretary. Its mission is to issue evidence-based recommendations on preventive health care.
When Congress passed the ACA in 2010, it leveraged off of the existence of the Task Force by requiring health plans to cover its recommended preventive services without any cost-sharing requirements. One such service is Apretude for pre-exposure prophylaxis (known as PrEP), a medication used to prevent HIV. However, some employers have objected to covering certain services –like PrEP–arguing that they prevent health conditions that those sponsors believe result from life styles that are in conflict with their religious beliefs.
The Braidwood Challenge
One such employer, Braidwood Management, Inc., served as lead plaintiff challenging the ACA's preventive care mandate in Kennedy v. Braidwood Management, Inc. The plaintiffs argued that the Task Force members were unconstitutionally appointed because they were not nominated by the President and confirmed by the Senate. They claimed that this invalidated the Task Force's recommendations, and, by extension, the ACA's preventive care requirements.
The U.S. District Court for the Northern District of Texas and the Fifth Circuit Court of Appeals agreed with the plaintiffs, ruling that the Task Force members were improperly appointed under the Constitution's Appointments Clause.
Despite the change in administration, the current Trump administration continued to pursue the appeal of the Fifth Circuit decision to the Supreme Court, defending the ACA's preventive care provisions and appealed to the Supreme Court.
The Supreme Court's Decision
The Supreme Court reversed the Fifth Circuit's decision, holding that Task Force members are "inferior officers" whose appointments by the HHS Secretary are consistent with the Appointments Clause. The Court clarified that only "principal officers" must be appointed by the President with the advice and consent of the Senate. Congress may allow inferior officers to be appointed by department heads, which it did in this case.
The Court also emphasized that the Task Force operations are under the supervision of the HHS Secretary, who retains the authority to review, block or remove members and their recommendations.
What This Means for Employers and Insurers
The ruling preserves the ACA's preventive care mandate, meaning employer-sponsored health plans must continue to cover Task Force-recommended services without cost sharing. Notably, however, there may still be exemptions from ACA mandates for employers with sincerely held religious beliefs. For plan sponsors, it's business as usual—no immediate changes are required to plan design or coverage.
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