The Supreme Court (SCOTUS) ruled on the legality of federal preventive healthcare mandates issued by a federal task force under the Affordable Care Act (ACA). In a 6–3 decision on June 27, 2025, the Court upheld the mandate in Kennedy v. Braidwood Management, preserving requirements that insurers cover services like HIV prevention and cancer screenings without cost-sharing.
What We Know:
- The U.S. Preventive Services Task Force (PSTF), which recommends mandatory no-cost health coverage under the ACA, was deemed constitutionally authorized.
- Plaintiffs argued the task force was not properly appointed under the Constitution and that its recommendations should not carry binding legal weight.
- The Court ruled the PSTF members are “inferior officers” and may be lawfully appointed by the Secretary of Health and Human Services.
- This preserves the ACA’s requirement for insurers to cover PSTF-recommended services — including HIV prevention drugs like PrEP — without cost-sharing.
Deeper Dive:
The case was brought by Christian-owned businesses, including Braidwood Management, which objected to providing insurance coverage for PrEP on religious grounds. They also challenged the legality of the Preventive Services Task Force (PSTF) itself, claiming it had excessive, unaccountable power to set binding healthcare regulations.
In a 6-3 decision, Justice Brett Kavanaugh authored the majority opinion, joined by Justices Roberts, Sotomayor, Kagan, Barrett, and Jackson, with the dissenting opinion delivered by Justice Clarence Thomas, joined by Justices Alito and Gorsuch. The majority opinion reaffirmed the constitutionality of the task force’s structure, emphasizing that Congress provided an “intelligible principle” guiding the agency’s work and that the HHS Secretary retains supervisory authority, satisfying constitutional requirements for executive delegation.
The ruling means insurers must continue covering a wide range of preventative services at no cost to patients — including contraception, STI screenings, cancer tests, and more — benefiting millions, particularly in communities with limited access to preventive care.
More Quotes from the Opinion:
Majority Opinion – Justice Kavanaugh:
Task Force members issue preventive-services recommendations of critical importance to patients, doctors, insurers, employers, healthcare organizations, and the American people more broadly. In doing so, however, the Task Force members remain subject to the Secretary of HHS’s supervision and direction, and the Secretary remains subject to the President’s supervision and direction. So under Article II and this Court’s precedents, Task Force members are inferior officers, and Congress may vest the power to appoint them in the Secretary of HHS.
Dissenting Opinion – Justice Thomas:
Under our Constitution, appointment by the President with Senate confirmation is the rule. Appointment by a department head is an exception that Congress must consciously choose to adopt. The Framers established this rule to ensure that the President is accountable for the selection of officers in the Executive Branch. And, it is the law, whether we agree with it or not. Had the Court taken seriously this rule, it would not have rushed to rule on the Government’s new theory, much less adopted it. I respectfully dissent.
Why This Matters:
Kennedy v. Braidwood Management protects the ACA’s preventive services requirement — a cornerstone of equitable healthcare access in the U.S. If the Court had ruled the other way, it would have opened the door for religious employers, and other entities, to deny coverage for essential preventive care, setting back decades of public health progress.
Instead, the Court preserved a system that helps millions avoid chronic illness, maintain reproductive autonomy, and catch life-threatening conditions early — all without out-of-pocket costs.
