On June 27, 2025, the Supreme Court upheld in Kennedy v. Braidwood that nongrandfathered group health plans must continue covering “A” and “B” recommendations made by the U.S. Preventive Services Task Force (USPSTF) without cost sharing.

What’s New? The question before the Supreme Court was about the constitutionality of the task force structure. “By a vote of 6-3, the justices ruled that members of the U.S. Preventive Services Task Force, an independent panel of 16 volunteer experts, were properly appointed by the Secretary of Health and Human Services [HHS] and did not need to be nominated by the president and confirmed by the Senate,” Amy Howe wrote on SCOTUSblog.

Why It Matters: Preventive services can help people stay well, treat chronic conditions and aid in the early detection of cancers and diseases, among other benefits. With this Supreme Court ruling, existing preventive services coverage remains in place, and the HHS Secretary’s authority over task force membership and preventive services recommendations was reinforced. The HHS Secretary could remove and reappoint new members, as occurred with a vaccine advisory committee in June. 

Key Takeaways: Group health plan participants’ access to preventive services without cost sharing will remain the status quo for now. The existing task force recommendations remain in place as of this writing. However, the Court’s holding that the HHS Secretary exercises at-will removal power over task force members and has the authority to review and block their recommendations may have implications for USPSTF operations going forward. A July 10, 2025 task force meeting was canceled (and hasn’t been rescheduled as of this writing), leading to speculation that membership changes might be underway to align with current presidential administration priorities.

Background

The Affordable Care Act (ACA) requires all insurers of nongrandfathered group health plans to cover certain preventive services without participant cost sharing (i.e., no deductible or copay). The preventive services coverage requirement was intended to ensure affordable access to preventive health care, which can lead to the early detection and treatment of medical conditions through services such as screenings for cancer, hypertension and depression, as well as pregnancy screenings.  

In Braidwood, the plaintiffs wanted coverage requirements for preventive services recommended by three bodies—the USPSTF, the Advisory Committee on Immunization Practices (ACIP), and the Health Resources and Services Administration (HRSA)—struck down. On March 30, 2023, the United States District Court for the Northern District of Texas struck down the recommendations of one of those three, the USPSTF, as unconstitutional. The case was appealed to the Fifth Circuit Court of Appeals, which ruled on June 21, 2024, in Braidwood v. Becerra, that the lower court had overreached when it struck down the ACA preventive services mandate nationwide. However, the Fifth Circuit panel agreed that the USPSTF didn’t have constitutional authority to issue recommendations; this issue was appealed to the Supreme Court.

Note: The Fifth Circuit agreed that PrEP HIV medication coverage, which was a USPSTF recommendation from 2019, violated the rights of the plaintiffs under the Religious Freedom Restoration Act. The Braidwood plaintiffs don’t have to cover HIV preventive medication or the other recommendations that they objected to, such as the human papillomavirus (HPV) vaccine as well as screenings and behavioral counseling for sexually transmitted disease and drug use. This wasn’t part of the appeal to the Supreme Court.

Question Before the Supreme Court 

In Kennedy v. Braidwood, the question before the Court was whether USPSTF members are inferior officers or principal officers under the Constitution’s appointments clause.

The opinion of the Court states, “The Court first concluded that Task Force members are inferior officers because their work is ‘directed and supervised’ by the HHS Secretary, a principal officer.” The Congressional Research Service’s summary states, “the Secretary directs and supervises Task Force members through ‘two main sources’ of authority: (1) ’the Secretary’s authority to remove Task Force members at will’ and (2) his authority ‘to review and block the Task Force’s recommendations before they can take effect.’” (Read the full summary for further discussion on these terms and clauses as well as relevant excerpts of the Supreme Court opinion.)

Preventive Health Care Items and Services

The Supreme Court reinforced that the HHS secretary oversees the USPSTF, the ACIP and HRSA and can influence recommendations.

Group health plan sponsors should watch for any guidance from the Department of Labor on the ACA preventive care requirement in light of this ruling on the USPSTF. Check with plan professionals and monitor future changes to task force membership, operations (i.e., regular meetings) and decisions on recommended items and services.

“Nongrandfathered group health plans must continue to cover ACA-mandated preventive services – according to the USPSTF, ACIP, HRSA recommendations and guidelines. However, a challenge to the authority of ACIP and HRSA . . . is still under review by the lower courts. Employers may want to monitor this litigation, but until those questions are resolved, the coverage requirement will remain in effect,” Katharine Marshall, principal, Mercer’s Law & Policy Group, said.

The Congressional Research Service’s summary further states, “Under the authority now recognized by the Supreme Court, the HHS Secretary could remove and replace Task Force members who, when requested by the Secretary, decline to modify or rescind a recommendation or to take up a recommendation proposal. Against the backdrop of the Secretary’s recent decision to exercise his removal power with respect to members of the Advisory Committee on Immunization Practices, whose vaccine recommendations form another part of the preventive-services coverage requirement, Braidwood affirms the Secretary’s ability to supervise the Task Force’s operation moving forward . . .  it was reported that HHS postponed a Task Force meeting scheduled to occur on July 10, 2025.”

What We’re Watching: Insurers and plan sponsors should monitor any decisions by the HHS secretary (or Congressional actions) regarding task force membership, operations and recommendations that would change preventive service coverage requirements under the ACA.

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Developed by International Foundation Information Center staff. This does not constitute legal advice. Please consult your plan professionals for legal advice.