Early signs say Supreme Court likely to preserve preventive care mandate
Early signs indicate that the Supreme Court of the United States is likely to preserve the preventive care mandate in the Affordable Care Act, according to reports published Monday.
SCOTUS on April 21 started hearing oral arguments in the high-profile case that could impact cost-free access to CT screening for lung and colorectal cancer. The case in question is Braidwood Management Inc. et al v. Robert Kennedy Jr. et al (formerly v. Becerra).
Two years ago, a U.S. District Court in Texas ruled that insurers do not have to cover the full cost of such preventive services, a decision that was upheld in June by an appeals court. The case has now made its way to the nation’s highest court, with a decision expected by the end of June.
Christian business owners and individuals who filed the lawsuit in 2020 claim the ACA requirement violates their religious rights by forcing them to cover preventive drugs for HIV. Plaintiffs also have contended that members of the U.S. Preventive Services Task Force act as officers of the country but were not properly selected in accordance with the Constitution’s Appointments Clause.
Conservative justices Brett Kavanaugh and Amy Coney Barrett—alongside the court’s three liberals—on Monday appeared skeptical that the process for deciding which services should be covered is unconstitutional, the AP reported.
"Your theory depends on us treating the task force as this massively important agency that operates with unreviewable authority to make really critical decisions that are going to affect the economy and without any supervision or direction by the secretary," Kavanaugh told Jonathan Mitchell, the attorney representing the Christian businesses, according to ABC News. "Normally, before that kind of thing would happen, Congress would have provided stronger indications that this task force is enormously important in the American economy and would have treated it such. And I just don't see indications of that."
Conservative justices Samuel Alito, Clarence Thomas and Neil Gorsuch, meanwhile, appeared more sympathetic to the plaintiffs, according to ABC.
Despite President Donald Trump’s criticisms of the ACA, his administration is defending the landmark 2010 law before the Supreme Court, the AP noted. Plaintiff attorneys argue that ACA requirements to cover cancer screenings and other services are unconstitutional because USPSTF appointments are not approved by the Senate. The Justice Department, meanwhile, contends that members don’t require such approval because they can be removed by the appointed HHS secretary, the AP noted.
Experts emphasized that not all preventive care services are threatened by the case, according to the report. A 2023 analysis from the Kaiser Family Foundation indicated that a win in favor of the plaintiffs only would apply to services endorsed by the USPSTF after March 2010. This would spare cost-free mammography and cervical cancer screenings in the case. However, the task force recommended both CT-based lung and colorectal cancer screenings in 2021.
Breast care advocacy organization Susan G. Komen last month urged SCOTUS to preserve access to these critical services.
“It is undeniable that the preventive care covered by the ACA has made a meaningful difference in the lives of people throughout the country,” SGK wrote in a March amicus brief. “Komen respectfully submits that the court should overturn the circuit court’s decision and the district court’s conclusion that preventive care recommendations are unlawful and unenforceable.”
Radiology policy expert Tom Greeson also penned a blog on Monday to mark the start of oral arguments, noting the outcome could impact access to preventive care for over 150 million Americans.
Marty Stempniak has covered healthcare since 2012, with his byline appearing in the American Hospital Association's member magazine, Modern Healthcare and McKnight's. Prior to that, he wrote about village government and local business for his hometown newspaper in Oak Park, Illinois. He won a Peter Lisagor and Gold EXCEL awards in 2017 for his coverage of the opioid epidemic.