The Supreme Court considers a challenge that could dismantle a cornerstone of the ACA’s preventive health care provisions.
At a Glance
- The U.S. Supreme Court is evaluating the constitutionality of ACA’s no-cost preventive care requirement.
- Kennedy v. Braidwood Management involves religious objections to mandatory coverage of preventive services.
- The Department of Justice argues the appointments of the U.S. Preventive Services Task Force are constitutional.
- Significant impacts on coverage for essential services like cancer screenings and HIV prevention are at stake.
Constitutional Challenge to the ACA
The U.S. Supreme Court is set to hear Kennedy v. Braidwood Management, a pivotal case challenging the constitutionality of the Affordable Care Act (ACA)’s mandate for insurers to provide no-cost preventive care to patients. At the heart of the case is the opposition of conservative Christian employers to the ACA’s Section 2713, which requires coverage for services as diverse as contraceptives, vaccines, and HIV prevention medications. The outcomes of this case could reshape how preventive services are accessed and financed across the country.
Religious objections are being voiced against covering these services, arguing they infringe on religious freedoms. Historically, such provisions have played an essential role in improving public health outcomes and reducing racial disparities. Stripping them away could mean adding significant financial burdens on Americans seeking preventative care services.
A Battle of Ideals
The ACA’s Section 2713 mandates most private health plans to offer over 50 preventive services without cost-sharing, benefitting an estimated 232.6 million Americans. The Department of Justice defends this provision, asserting that the U.S. Preventive Services Task Force’s (USPSTF) recommendations, while deemed constitutional, have been instrumental in shaping coverage. Some critics, however, take aim at the appointment process for the USPSTF, claiming the task force’s members are “inferior officers.” The case fundamentally highlights the friction between religious rights claims and public health benefits.
“The answer is straightforward: Task Force members are inferior officers, because the Secretary of HHS — a quintessential principal officer — remains responsible for final decisions about whether Task Force recommendations will be legally binding on insurance issuers and group health plans.” – DOJ brief
Should the ruling favor the ACA’s opponents, insurers may gain the autonomy to decide which preventive services are covered, potentially leading to increased out-of-pocket costs. For many, such changes could create barriers to accessing essential services, with individuals electing to forgo preventive measures when faced with new expenses.
Ripple Effects and Future Implications
Currently, the Biden administration appeals to the Supreme Court to uphold the ACA provision, emphasizing its critical role in maintaining Americans’ access to affordable, preventive health care. This case, if decided against the ACA, can embolden restrictions on services that have become a staple in public health strategy—such as cancer screenings and immunizations. A decision here has the potential to undermine decades of progress in preventive health, by forcing Americans to once again contend with access disparities and financial barriers.
If the justices determine that religious objections override the ACA’s preventive mandates, it could signal a seismic shift, where insurers may diverge on providing no-cost preventive services. This inconsistency threatens to erode the foundation of health care access, throwing individuals back into a system fraught with inequities and obstacles.
