The U.S. Supreme Court
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The Supreme Court on Friday upheld a key provision of the Affordable Care Act, ensuring, at least for now, that some 150 million people will continue getting many free, preventive services under the act.
The vote was 6-3, with Chief Justice John Roberts, and Justices Amy Coney Barrett and Brett Kavanaugh joining the court’s three liberal justices in the majority.
Siding with the government on Friday, the court upheld the Affordable Care Act, allowing the U.S. Preventive Services Task Force to continue determining which services will be available free of cost to Americans covered by the Affordable Care Act.
At issue in the case was a lawsuit that sought to undo the preventive care provision by challenging the appointment process for members of a 16-person task force that determines which preventive services are to be provided for free under insurance policies. Two lower courts found that the appointments were unconstitutional, but on Friday, the Supreme Court disagreed.
More Supreme Court decisions from today:
More Supreme Court decisions today:
Writing for the court majority, Justice Kavanaugh said the Department of Health and Human Services has the power to appoint members of the task force.
“Task Force members are supervised and directed by the Secretary, who in turn answers to the President, preserving the chain of command in Article II,” Kavanaugh wrote.
The ACA’s preventive treatments have benefited millions of people since the health care law went into effect 11 years ago — a sufficiently long time for most people to take the free coverage for granted. Activists argued that if the court ruled for the groups challenging the law, the benefits could disappear.
Friday’s case arose when the preventive care task force classified pre-exposure prophylaxis (PrEP) drugs as essential to preventing HIV. Preventive PrEP coverage under the ACA includes not only HIV testing and medication, but also clinic visits and lab testing without added cost-sharing. Without ACA coverage, PrEP care would be astronomically expensive for most Americans.
The suit was brought by individuals and businesses with religious objections to the PrEP mandate—they claimed that providing PrEP coverage encourages “sexual behaviors and drug use” antithetical to their Christian beliefs.
Braidwood Management, the case’s named plaintiff, is led by Republican mega donor Steven Hotze who has referred to members of the LGBTQ+ community at different times as “morally degenerate,” “satanic,” and “termites.” Hotze, has challenged the ACA in at least two other federal lawsuits.
The court’s decision on preventive care likely will protect other existing preventive services under ACA, including treatment for blood pressure screenings, as well as birth control, breast and lung cancer screenings, immunizations, and more.
Prior to the court’s decision on Friday, proponents of the ACA’s existing preventive coverage had worried that without it, the financial burden of out-of-pocket expenses for these services would have discouraged people from getting care to prevent or detect disease at an early and treatable stage.
“I cannot think of another health policy that impacts more Americans than the preventive services provision,” said Dr. Mark Fendrick, a professor of medicine and public health at the University of Michigan.
Two lower courts in Texas found that the government violated the Appointments Clause of the Constitution because its task force members were appointed not by the president, but by the secretary of Health & Human Services.
The Supreme Court, however, disagreed, declaring that the task force was not composed of principal officers who must be appointed by the president and confirmed by the Senate. Rather, the court said, the advisory panel is composed of “inferior officers,” who may be appointed by a department head if that power is designated by Congress. Moreover, as the government pointed out in its briefs, the task force members are directly supervised by the HHS secretary, and members can be terminated at will.
