The Supreme Court ruled 6–3 to preserve the Affordable Care Act’s requirement that insurers cover preventive services—ranging from cancer screenings to HIV prevention medications—without cost-sharing, maintaining coverage for roughly 150 million Americans.
At a Glance
- The Court upheld ACA-mandated coverage of services recommended by the USPSTF.
- The ruling reverses a lower court’s decision that had struck down those requirements.
- Preventive measures covered include statins, lung cancer screenings, HIV-prevention drugs, and breast cancer medication.
- The decision affirms the Task Force’s appointment process as constitutional.
- Conservative dissenters accused the Court of overstepping its constitutional bounds.
The Ruling and Its Significance
In Kennedy v. Braidwood Management, the conservative Fifth Circuit Court had ruled that members of the U.S. Preventive Services Task Force (USPSTF) were unconstitutionally appointed and that their mandates violated the Appointments Clause. That decision endangered ACA provisions guaranteeing cost-free preventive care.
Now, in a 6–3 Supreme Court decision, Justice Brett Kavanaugh wrote for the majority that USPSTF members are “inferior officers” properly appointed under the ACA. The ruling preserves no-cost access to critical services like PrEP for HIV, breast cancer medications, statins, and lung cancer screenings.
Watch a report: Inside today’s ACA ruling
Broader Legal and Health Implications
The decision rebukes a lower court ruling that would have dismantled ACA preventive care mandates and raised out-of-pocket costs for tens of millions. Kavanaugh’s opinion emphasized the importance of stable, evidence-based public health protections, particularly those based on Task Force recommendations.
Dissenting justices Clarence Thomas, Samuel Alito, and Neil Gorsuch objected on constitutional grounds, accusing the majority of judicial overreach and politicizing healthcare—a critique that echoed broader conservative legal challenges to the ACA.
What It Means for Americans
The ruling preserves a linchpin of the ACA: free preventive services that help catch disease early and reduce long-term costs. Had the Court ruled otherwise, millions of Americans could have lost access to screenings and medications without cost-sharing—particularly vulnerable groups dependent on HIV prevention or chronic illness screening.
While the verdict reinforces ACA stability, legal experts warn that additional lawsuits targeting the structure of preventive mandates may still emerge. For now, Americans retain full access to screening, diagnostic, and prophylactic care—without the fear of financial penalty.
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