On April 21, 2025, the U.S. Supreme Court agreed to hear a case challenging the Affordable Care Act's (ACA) mandate that insurers cover certain preventive services at no cost to patients. The case questions the constitutionality of the U.S. Preventive Services Task Force (USPSTF), whose members are appointed by the Secretary of Health and Human Services (HHS) without Senate confirmation. The Court's decision could significantly impact Americans' access to cost-free preventive health services.

The ACA, enacted in 2010, requires most private health plans to cover a range of preventive services recommended by the USPSTF without imposing deductibles or copayments on patients. These services include cancer screenings, behavioral counseling, and medications for disease prevention. The USPSTF is a panel of volunteer experts appointed by the HHS Secretary to evaluate and recommend preventive services based on scientific evidence.

The plaintiffs in this case, including Texas-based Christians and small businesses, argue that the USPSTF's structure violates the Appointments Clause of the U.S. Constitution. They contend that the task force's members are "principal officers" who require presidential appointment and Senate confirmation. In 2024, the 5th U.S. Circuit Court of Appeals ruled that the USPSTF's structure is unconstitutional, agreeing with the plaintiffs' argument. The Biden administration appealed this decision, leading to the Supreme Court's agreement to hear the case.

The Department of Justice maintains that USPSTF members are "inferior officers" who do not require Senate confirmation. They argue that the HHS Secretary has sufficient oversight over the task force, including the authority to remove members and control the implementation of their recommendations.

If the Supreme Court upholds the lower court's ruling, millions of Americans could lose cost-free access to preventive services such as cancer screenings, behavioral counseling, and HIV prevention medications. This could lead to decreased utilization of these services and potentially worse health outcomes. The American Public Health Association has warned that limiting access to these preventive services could have devastating consequences for public health and the well-being of communities.

The Supreme Court's decision, expected by June, will have significant implications for the ACA's preventive services mandate and could affect the cost-free access to a range of preventive services currently available to Americans.