Supreme Court Upholds Obamacare Measure on Preventive Care

A federal appeals court previously ruled that the Preventive Services Task Force’s structure made it unconstitutional.

The Supreme Court in Washington on June 25, 2025. Madalina Kilroy/The Epoch Times

The U.S. Supreme Court on June 27 ruled that the structure of a federal panel under Obamacare that issues mandates requiring most health insurers to cover preventive medical services without cost to patients is constitutional.

The majority opinion in the 6–3 decision in Kennedy v. Braidwood Management Inc. was written by Justice Brett Kavanaugh.

The decision reverses a federal appeals court decision that held that the structure of the Preventive Services Task Force was unconstitutional and its mandates therefore invalid.

“The Executive Branch under both President Trump and President Biden has argued that the Preventive Services Task Force members are inferior officers and therefore may be appointed by the Secretary of [Health and Human Services]. We agree,” Kavanaugh wrote.

The task force comprises 16 members who serve four-year terms. Among the members, who are “nationally recognized experts in prevention, evidence-based medicine, and primary care,” are medical doctors, researchers, and professors who serve on a voluntary, unpaid basis, according to the task force. Preventive services “can help people avoid acute illness, identify and treat chronic conditions, prevent cancer or lead to earlier detection, and improve health.”

Task force members are subject to the secretary’s supervision, so under Article II of the Constitution and the court’s precedents, they are inferior officers, and Congress has given the secretary authority to appoint them. This means their appointments “are fully consistent with the Appointments Clause in Article II of the Constitution,” Kavanaugh wrote.

The task force structure, and the way its members are appointed, protects “the chain of political accountability that was central to the Framers’ design of the Appointments Clause,” Kavanaugh said.

The Supreme Court reversed the decision of the U.S. Court of Appeals for the Fifth Circuit and sent the case back to that court for further proceedings consistent with the opinion.

In the oral argument on April 21, the justices examined a provision in the Patient Protection and Affordable Care Act that allows the task force to make binding recommendations about preventive medical services, such as medications and screenings.

The act, also known as the Obamacare statute, was enacted in 2010.

The task force, part of the Department of Health and Human Services (HHS), has described itself as “an independent, volunteer panel of national experts in disease prevention and evidence-based medicine” that works “to improve the health of people nationwide by making evidence-based recommendations about clinical preventive services.”

Members of the task force are appointed by the health secretary, currently Robert F. Kennedy Jr.

Texas-based Braidwood Management sued the federal government over mandates that the task force approved, to which the company expressed religious objections.

The mandates cover a wide variety of treatments, including HIV prevention medicine and sexually transmitted disease screenings.

The U.S. Court of Appeals for the Fifth Circuit held in June 2024 that the task force’s mandates were invalid because the structure of the task force violates the Constitution’s appointments clause, according to the government’s September 2024 petition.

That clause provides that the president may appoint officers to assist him in carrying out his responsibilities.

Principal officers must be appointed by the president and confirmed by the Senate, but inferior officers may be appointed by the president alone, the head of an executive department, or a court.

The Fifth Circuit determined that the mandates could not be upheld because the task force members were not appointed by the president and confirmed by the Senate.

The federal district court was correct to block HHS from enforcing the mandates, the circuit court ruled, according to the petition.

Braidwood, which is being represented by a legal team that includes the America First Legal Foundation, had also urged the Supreme Court to take up the case.

In its brief, the company said that the statute “is of immense importance” and that the high court “should weigh in rather than leaving the constitutionality of [the law] and the appointments of the Task Force members to be resolved entirely by the court of appeals.”

Justice Clarence Thomas filed a dissenting opinion, which Justices Samuel Alito and Neil Gorsuch joined.

The appointments clause creates a default rule requiring that all executive branch officers have to be appointed by the president, subject to approval by the Senate. Congress may deviate from this default by authorizing a department head to name inferior officers, “but only if it does so expressly.”

“Everyone now agrees” that having a subordinate official within HHS appoint task force members, as had been the practice for years, “was unlawful,” and that no statute permits it, he wrote.

However, instead of accepting that the default method of appointment applies, the government “invented a new theory on appeal,” arguing that two loosely worded statutes from decades apart gave the health secretary authority to appoint members of the task force, he said.

“The Court today rushes to embrace this theory. I cannot,” Thomas wrote.

Congress has not spoken with the clarity required to ignore the default rule that the appointments clause established, he said. The court’s new ruling “distorts” the task force design intended by Congress, “changing it from an independent body that reports directly to the President to one subject to the control of the Secretary of HHS,” he said.