The U.S. Supreme Court on Friday upheld a central component of the Affordable Care Act (ACA) that requires private insurers to fully cover certain preventive health services, rejecting a constitutional challenge brought by a group of Christian employers. The decision protects health coverage provisions that impact roughly 150 million Americans.
In a 6-3 decision, the court ruled in favor of maintaining how the federal government determines which medications and services must be fully covered under private insurance plans. These mandates are part of former President Barack Obama’s landmark healthcare legislation, commonly known as Obamacare.
Justice Brett Kavanaugh authored the majority opinion, while Justices Clarence Thomas, Samuel Alito, and Neil Gorsuch dissented.
The plaintiffs argued that the process used to decide coverage requirements violates the Constitution because it relies on recommendations from the U.S. Preventive Services Task Force—an independent panel of medical experts—whose members are not confirmed by the Senate. They contended that because these board members are not appointed through the traditional nomination and confirmation process, their authority to shape mandatory insurance coverage is illegitimate.
Despite having been critical of the ACA, former President Donald Trump’s administration defended the coverage mandate in court. The Department of Justice argued that Senate confirmation is not necessary because the health and human services secretary has the power to remove task force members.
The preventive services at stake included a range of critical treatments and screenings, such as statins for high cholesterol, HIV-prevention medication (PrEP), lung cancer screenings, and drugs that reduce the risk of breast cancer in women.
The legal battle reached the Supreme Court after the 5th U.S. Circuit Court of Appeals sided with Christian employers and Texas residents who objected to being required to cover certain services, including PrEP, which they opposed on religious grounds. The appellate court ruled that the mandate was unconstitutional because it was based on guidance from a group whose members were not confirmed by the Senate.
The plaintiffs were represented by Jonathan Mitchell, a conservative lawyer who previously defended Donald Trump in court over his eligibility to appear on the 2024 presidential ballot.
Although the appeals court decision threatened to dismantle parts of the ACA’s preventive care mandates, a 2023 report by the nonprofit KFF (Kaiser Family Foundation) noted that coverage for some services—such as mammograms and cervical cancer screenings—would likely have remained intact regardless of the ruling.
The Supreme Court’s decision preserves the current system for determining required preventive care and ensures continued access to a broad array of services without cost-sharing for millions of Americans.
Also Read:
Trump Seeks Supreme Court Approval to Proceed with Federal Workforce Cuts
