The U.S. Supreme Court signaled on Monday that it may uphold a central element of the Affordable Care Act (ACA) related to preventive health services. The case under review challenges whether the current method for determining required insurance coverage for preventive care is constitutional.
A majority of justices including two conservatives and the court’s three liberal members expressed skepticism toward arguments that the ACA’s approach is flawed due to the composition of the body recommending these services. The challenge focuses on the United States Preventive Services Task Force, a volunteer panel of medical experts whose recommendations form the basis for insurance mandates covering certain preventive treatments and screenings without cost-sharing.
The legal dispute hinges on claims that the Task Force lacks constitutional legitimacy because its members were not nominated by the president or confirmed by the Senate. Opponents of the provision also raised religious and procedural concerns, objecting to coverage requirements for specific services, such as HIV prevention drugs.
Attorneys defending the law maintained that Senate approval is unnecessary since the task force members can be removed by the Secretary of Health and Human Services. Justices Brett Kavanaugh and Amy Coney Barrett appeared to agree, suggesting that the task force does not possess the kind of authority that would trigger the need for Senate confirmation.
Justice Elena Kagan added that the court’s precedent typically does not support expanding the scope of independent federal agencies. Meanwhile, Justices Samuel Alito and Clarence Thomas appeared more sympathetic to the plaintiffs’ arguments.
The case could affect preventive care coverage for approximately 150 million Americans. At stake are services such as statins for heart disease prevention, lung cancer screenings, breast cancer risk-reduction medications, and PrEP for HIV prevention.
Although some justices floated the possibility of sending the case back to a lower court for further review, such a move would leave some aspects of the law’s coverage requirements in a state of uncertainty.
The case originated after a lower appeals court struck down parts of the ACA’s preventive care mandate, siding with Texas residents and religious employers who argued that they should not be compelled to provide coverage for certain treatments.
Despite the legal challenge, not all preventive services are at risk. According to a 2023 policy review, several screenings such as mammograms and cervical cancer tests—would likely remain covered without cost-sharing under other provisions of the ACA.
For more political updates, visit DC Brief.
