In a case with significant implications for the future of HIV prevention, the US Supreme Court ruled 6-3 to uphold a provision of the Affordable Care Act that determines which preventive services insurance companies must cover at no extra cost.
Justice Brett Kavanaugh wrote the opinion in the case, Kennedy v. Braidwood, which focused on the constitutionality of the US Preventive Services Task Force (USTPS), a powerful advisory body responsible for issuing recommendations on which screening tests or preventive medications should be covered under the Affordable Care Act. That same task force has already determined that PrEP, the HIV prevention medication, must be covered by insurance companies. Other covered services include cancer screenings, heart medication, and more.
The case rose to the Supreme Court after former President Joe Biden’s secretary of Health and Human Service, Xavier Becerra, appealed a decision by the US Court of Appeals for the Fifth Circuit. The Fifth Circuit held that the US Preventive Task Force was unconstitutionally created because its members were not nominated by the president and confirmed by the US Senate.
The Supreme Court said otherwise, with Justices John Roberts, Amy Coney Barrett, Sonia Sotomayor, Elena Kagan, and Ketanji Brown Jackson joining Kavanaugh in the majority.
“Task force members are supervised and directed by the secretary, who in turn answers to the president, preserving the chain of command in Article II” of the US Constitution, Kavanaugh wrote. “As a result, appointment of task force members by the secretary of HHS is consistent with the appointments clause.”
The members of the task force are appointed to four-year terms by the secretary of Health and Human Services.
“Today the Court has made the right decision to reject this assault, upholding essential protections for preventive services and affirming that prevention and early detection of diseases save lives, improve health outcomes, and reduce long-term health outcomes,” the statement noted. “We applaud this outcome and express our gratitude to all stakeholders and advocates who raised the visibility of a case that evolved from an attack on LGBTQ+ healthcare into a threat to the well-being of Americans from all walks of life. This case began with plaintiffs objecting to PrEP, claiming it “promotes homosexuality” and offends their religious beliefs.”
However, the authors of that statement warned that the ruling gives HHS Secretary Robert F. Kennedy Jr. more “tools to exert significant control over what have historically been independent, science-driven health recommendations.”
“If misused and unchecked, this authority risks transforming objective medical guidance into a politicized tool susceptible to partisan interference, potentially undermining public trust in preventive care,” they said. “The secretary’s expanded grip on the USPSTF could open the door to abuses, enabling administrations to sideline medical experts, shape recommendations to match political agendas, and jeopardize evidence-based healthcare for millions of Americans.”
