Supreme Court Reviews Constitutionality of HHS Preventive Services Task Force Appointment Power

The U.S. Supreme Court is considering legal challenges to the constitutionality of the U.S. Preventive Services Task Force's appointment structure. The Task Force, established under the Affordable Care Act, issues guidelines for preventive health services that private insurers must cover without cost-sharing, including recommendations like coverage of HIV prevention medicine PrEP.

The challenge comes from a group of individuals and small businesses opposing the insurance coverage mandate for PrEP on religious grounds, arguing the Task Force's members were not appointed in compliance with the Constitution's Appointments Clause. This clause requires principal officers to be appointed by the president and confirmed by the Senate.

Although lower courts found the Task Force's structure unconstitutional, the Biden administration defended it before the Supreme Court. The government stresses that the Department of Health and Human Services (HHS) Secretary has significant control over the Task Force, including appointing and removing members. Following oral arguments, the Supreme Court requested additional briefing on whether the HHS Secretary actually has the authority to appoint Task Force members.

In supplemental briefs, the Solicitor General argued that congressional delegation and related statutes effectively vest appointment power in the HHS Secretary, referencing precedent on inferior officers' appointments. Conversely, challengers argued that the law only directs the Agency for Healthcare Research and Quality (AHRQ) director to "convene" the Task Force without specifying appointment authority, meaning the Secretary lacks the power to appoint members, rendering the structure unconstitutional if Task Force members are principal officers.

The case interrogates the extent of executive appointment powers and statutory interpretation concerning federal health advisory bodies. A Supreme Court decision is anticipated by mid-2025, which will have implications on federal preventive services policy and insurance coverage regulations tied to such recommendations.