Kennedy v. Braidwood Management Inc.: Why every American should be concerned about this case before the U.S. Supreme Court
- mstnsly
- May 26
- 3 min read
An ounce of prevention is worth a pound of cure...right?
Numerous studies have shown that insurance companies’ historical cost-sharing tactics, such as co-pays and co-insurance, created additional barriers to preventive healthcare services. This was especially true for women, particularly women of color, LGBTQ+ individuals, and those in lower socio-economic groups. The Affordable Care Act (AKA “ACA” or “Obamacare”) addressed this barrier by requiring that expert-recommended preventive services be covered without cost-sharing. Congress went one step further and enacted a provision specifically around women’s preventive healthcare needs. Examples of preventive care protected by the ACA include screenings for cancer, diabetes, and depression, vaccinations, and well-child visits. Add-ons for women include well-woman visits and contraceptives, breast and cervical cancer screenings, and pregnancy-related services such as prenatal and postpartum diabetes and depression screenings, and breastfeeding services and supplies.
Experts with the Advisory Committee on Immunization Practices (ACIP), the United States Preventive Services Task Force (Task Force), and the Health Resources and Services Administration (HRSA) develop recommendations for preventive services coverage under the Secretary of Health and Human Services’ supervision, who ratifies their recommendations before they become legally required. In this latest attempt to undermine important provisions of the ACA, challengers claim that only “principal” officers nominated by the President can make such recommendations. This argument overlooks the Appointments Clause, which allows for “inferior” officers whose recommendations are subject to review and removal by a duly appointed and confirmed principal officer.
District Court Judge Reed O’Connor continued his anti-ACA agenda by ruling in September 2022 that the Task Force’s structure is unconstitutional because it violates the Appointments Clause, but spared ACIP and HRSA. He further ruled that the federal government could not require insurance plans to provide no-cost coverage of preventive services recommended by the Task Force after the enactment of the ACA in 2010, effectively denying access to crucial preventive services for more than 150 million Americans. Because of the devastating impact to preventive services access, the government appealed the case to the Fifth Circuit Court of Appeals, securing a pause in Judge O’Connor’s ruling and restoring access to preventive services. Not to be deterred, ACA opponents also appealed to the Fifth Circuit, hoping to overturn Judge O’Connor’s rejection of their Appointments Clause challenges to ACIP and HRSA.
The Fifth Circuit issued its decision on June 21st, 2024, affirming the district court’s 2022 finding that the Task Force’s structure is unconstitutional, but called Judge O’Connor’s block of prior Task Force recommendations an error because the plaintiffs had failed to bring a claim under the Administrative Procedures Act. Rather than deny the request to block recommendations from ACIP and HRSA, the Fifth Circuit punted it back to the district court.
The case was escalated to the U.S. Supreme Court in September 2024, but the Supreme Court only agreed to consider whether the Fifth District’s decision regarding the Task Force’s structure was correct. If the Supreme Court upholds that decision, the ACA’s preventive services provision will be invalidated, shattering years of progress toward health equity.
The decision at hand will potentially impact more than 150 million Americans who benefit from coverage of preventive services without cost and could open the door for decisions to strip away other critical preventive services, such as those based on ACIP and HRSA recommendations. While the Supreme Court will likely reject this challenge to the ACA provisions, this case opens the door for the Secretary of Health and Human Services to enact changes. This is worrisome, given Robert F. Kennedy’s ideals and actions thus far in the office.
Research has shown significant increases in screenings, vaccination rates, and contraceptive use since the advent of ACA protections from cost-sharing; resulting in earlier detection and treatment of chronic conditions and cancer, decreased maternal death and unplanned pregnancies, and overall improved health outcomes. Keeping these provisions in place is crucial to increasing access to preventive care and supporting equitable health care delivery to all Americans.
Source:
National Women’s Law Center (2025) Kennedy v. Braidwood Management Inc.: The latest Affordable Care Act attack before the U.S. Supreme Court threatens access to preventive health care services for over 150 million people [Fact Sheet]
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