Supreme Court Upholds Key ACA Preventive Care Coverage Rule

The U.S. Supreme Court upheld a crucial component of the Affordable Care Act (ACA) preventive healthcare coverage requirements, ruling 6-3 against a challenge from Christian employers concerning the validity of a federal process determining which medications and preventive services private insurers must cover fully.

The court ruled that the expert panel responsible for recommendations operates under the authority of the Secretary of Health and Human Services (HHS), who has removal power over panel members, thus meeting constitutional standards without the need for Senate confirmation.

This ruling ensures continued access to no-cost preventive care for approximately 150 million Americans, including services like cholesterol-lowering statins, lung cancer screenings, HIV prevention medications, and breast cancer risk reduction drugs. The legal challenge arose from the Fifth Circuit Court, which sided with some employers objecting to coverage mandates, arguing the advisory group lacked appropriate appointment by the president and Senate confirmation as required by the Appointments Clause of the Constitution. Despite dissent from three justices citing the lack of Senate approval for the panel members as unconstitutional, the majority emphasized the Secretary's control over the task force.

The decision impacts payer-provider compliance and regulatory adherence under the ACA, reinforcing federal authority over preventive service coverage benchmarks. Advocacy groups acknowledged the decision’s significance for patient access while cautioning about potential future politicization of the advisory panel. The ruling delineates key boundaries for administrative agency authority in health insurance mandates and confirms the sustainability of ACA preventive care provisions amidst ongoing legal scrutiny.