Supreme Court Reviews ACA Preventive Care Coverage Mandate

The U.S. Supreme Court is reviewing Kennedy v. Braidwood Management, a case challenging the constitutionality of preventive health service mandates under the Affordable Care Act (ACA). The crux of the case involves whether the U.S. Preventive Services Task Force (USPSTF), which sets the list of preventive services insurers must cover at no cost, operates with proper constitutional authority since its members are not presidential appointees confirmed by the Senate.

Plaintiffs, including Braidwood Management, argue that certain mandated coverages, notably pre-exposure prophylaxis (PrEP) for HIV prevention, violate their religious beliefs and challenge the legitimacy of the USPSTF's authority. Analysts note the case's potential to affect coverage for nearly 50 preventive services rated "A" or "B" by the USPSTF, which impact over 200 million Americans across private insurance, Medicaid, and Medicare plans.

Oral arguments suggested the Supreme Court may uphold the USPSTF's constitutional validity and its recommendations, but some observers highlight the possibility of remanding the case for lower court reconsideration. The case also raises considerations about the future ability of the HHS Secretary, recently Robert F. Kennedy Jr., to influence preventive coverage policies.

Although the court's final ruling is expected by mid-2025, ongoing litigation and policy debates around preventive care access and insurer mandates appear likely. Advocacy experts highlight the significant public health implications, noting that introducing cost-sharing for these services could reduce their utilization and affect population health outcomes, especially since many Americans delay care due to cost.

The Trump administration's defense of the case in court may influence conservative justices towards maintaining no-cost coverage for preventive services. Overall, this pivotal legal proceeding could shape how preventive care mandates are enforced, insurer compliance, and the regulatory framework governing preventive health benefits at the national level, impacting insurers, employers, and patients alike.