The Supreme Court on Friday upheld a provision of the Affordable Care Act that requires insurance companies to offer some kinds of preventive care for free.
In a 6-to-3 decision, written by Justice Brett Kavanaugh, the justices ruled that a federal task force that determines which preventive health measures insurance companies must cover at no cost to the insured was constitutional.
The decision appears to safeguard coverage for tens of millions of Americans who receive some free health care services, including cancer and diabetes screenings, medications to reduce heart disease and strokes, and eye ointment for newborns to prevent infections causing blindness.
Justice Kavanaugh’s decision was joined by two other conservatives, Chief Justice John G. Roberts Jr. and Justice Amy Coney Barrett, as well as the three liberals: Justices Sonia Sotomayor, Elena Kagan and Ketanji Brown Jackson.
The court’s other three conservative justices — Clarence Thomas, Samuel A. Alito Jr., and Neil M. Gorsuch — dissented.
The case is the latest lawsuit targeting the Affordable Care Act, President Barack Obama’s central legislative achievement. The heath care law survived three previous major challenges at the Supreme Court, in 2012, 2015 and 2021. Chief Justice John G. Roberts Jr. cast the decisive vote to save the law in 2012, a crucial milestone in which the justices upheld the law’s core mandate that most employers provide health insurance for their workers.
This dispute centered on the U.S. Preventive Services Task Force, a panel of experts in the Department of Health and Human Services that recommends preventive medical services, including screenings and medications to prevent serious diseases.
The task force was devised to determine preventive health services that insurance companies are required to offer for free under the Affordable Care Act.
The challenge to the task force focused on the process for selecting its members. The task force is composed of 16 volunteers, all nationally recognized experts in prevention and primary care, including family medicine, geriatrics and obstetrics.
Members are appointed by the secretary of Health and Human Services to serve four-year terms.
At issue was whether these members are legally considered “inferior” or “principal” officers. Under the Constitution, “principal officers” must be appointed by the president and confirmed by the Senate.
Abbie VanSickle covers the United States Supreme Court for The Times. She is a lawyer and has an extensive background in investigative reporting.
Charlie Savage writes about national security and legal policy for The Times.
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