Kennedy v. Braidwood Mgmt., Inc., 2025 WL 1773628 (U.S. 2025)
Available at https://www.supremecourt.gov/opinions/24pdf/24-316_869d.pdf
The U.S. Supreme Court has ruled on the validity of the preventive health services mandate, holding that the United States Preventive Services Task Force (USPSTF) operates under proper constitutional authority. As background, the Affordable Care Act (ACA) requires group health plans and insurers to provide specified preventive services without cost-sharing, including items and services recommended by the USPSTF with an “A” or “B” rating. In 2022, a federal trial court held that the members of the USPSTF were unconstitutionally appointed by the Secretary of HHS and thus lacked the authority to determine the preventive services that must be covered under the ACA. The court later vacated as unlawful all agency actions taken on or after March 23, 2010, to implement or enforce the USPSTF-recommended preventive care coverage requirements, and the agencies were blocked nationwide from implementing or enforcing coverage requirements in response to the USPSTF ratings. On appeal, the Fifth Circuit affirmed that the USPSTF’s members were not validly appointed under the Constitution but reversed the trial court’s decision to vacate agency actions and narrowed the scope of the injunction to only the parties that filed the lawsuit. In early 2025, the Supreme Court agreed to hear the case.
Reversing the Fifth Circuit, the Supreme Court held the USPSTF members were validly appointed by the Secretary of HHS. The Court explained that whether the appointment was constitutional turns on whether the members are “principal officers” or “inferior officers.” (Principal officers must be nominated by the President and confirmed by the Senate, whereas inferior officers may be appointed by department heads, such as the Secretary.) The Court held that USPSTF members are inferior officers because they are supervised and directed by the Secretary, removable at will by the Secretary, and their recommendations are reviewable and may be revoked by the Secretary. The Court concluded that, because Congress has the authority to vest the power to appoint inferior officers in the Secretary (and has done so), the Secretary’s appointment of members pursuant to that grant of authority is valid under the Constitution. The case was returned to the trial court for further proceedings.
EBIA Comment: The Supreme Court’s decision affirms the constitutional authority of the USPSTF to shape the ACA preventive health services mandate. Employer-sponsored health plans generally should not require any immediate action since the Fifth Circuit decision was put on hold pending appeal and the coverage requirements remained in effect during the litigation. For more information, see EBIA’s Health Care Reform manual at Section XII.C (“Coverage of Preventive Health Services”) and EBIA’s Group Health Plan Mandates manual at Section XIV.C (“Required Preventive Health Services Coverage”). See also EBIA’s Self-Insured Health Plans manual at Section XIII.C.1 (“Preventive Health Services”).
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