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Politico

a day ago

The Supreme Court has preserved the provision of the Affordable Care Act that requires insurance companies to cover preventive health services like colonoscopies and HIV prevention drugs at no cost to patients.
It's the fourth time in the past 13 years that the high court has rejected major challenges to the 2010 health law. This time around, the vote was 6-3, with Justice Brett Kavanaugh writing the majority opinion for a cross-ideological majority. Three of the court's conservatives dissented.
The case centered on a panel of experts known as the U.S. Preventive Services Task Force. The Affordable Care Act authorized the task force to specify health screenings and other preventive services that insurers must cover without charging patients copayments, deductibles or other cost-sharing. Tens of millions of Americans rely on those services, including cancer screenings, heart disease medications and the drug, known as PrEP, that prevents the transmission of HIV.
Opponents of the ACA who object to the HIV drug argued that the task force — which is chosen by the secretary of Health and Human Services — was unconstitutionally appointed. The task force members, the opponents argued, wield so much power that they amount to 'principal officers' under the Constitution's appointments clause and must be appointed by the president and confirmed by the Senate.
The Supreme Court rejected that argument, reasoning that the members are not principal officers because the health secretary can ignore their recommendations, fire them and replace them.
'Task Force members issue preventive-services recommendations of critical importance to patients, doctors, insurers, employers, healthcare organizations, and the American people more broadly. In doing so, however, the Task Force members remain subject to the Secretary of HHS's supervision and direction, and the Secretary remains subject to the President's supervision and direction,' Kavanaugh wrote for the majority. 'The structure of the Task Force and the manner of appointing its officers preserve the chain of political accountability that was central to the Framers' design of the Appointments Clause.'
Justices Clarence Thomas, Samuel Alito and Neil Gorsuch dissented.
The Trump administration surprised many when it revealed earlier this year that it would continue the Biden administration's defense of the Obamacare provision. But it shifted the focus of the federal government's legal argument. The Biden Justice Department had argued in lower courts that free preventive care was crucial for the health of millions of American patients. The Trump DOJ, on the other hand, focused during oral arguments before the Supreme Court in April on preserving executive power and fending off judicial and legislative encroachments.
Health policy experts and patient advocates who expressed relief that the Trump administration opted to defend Obamacare remain concerned that HHS Secretary Robert F. Kennedy Jr. and other officials will now deploy that power to reshape what services must be covered by insurance without copays.
'They really pointed out how much authority they think their Secretary wields, which is kind of foreboding given who the Secretary is and his ideas about science and health,' said Andrew Twinamatsiko, the director of the Health Policy and the Law Initiative at Georgetown University's O'Neill Institute. 'Somebody could be fairly concerned that there could be weaponization of the task force.'
And, while this case focused solely on the U.S. Preventive Services Task Force, the decision could also empower Kennedy to overhaul other advisory panels at HHS.