The Controversial Health Lawsuit Over ACA Preventive Services

In Kennedy v. Braidwood Management, Inc., the Supreme Court ruled 6–3 on June 27, 2025, that the U.S. Preventive Services Task Force is constitutionally structured, preserving the Affordable Care Act’s requirement that private insurers cover recommended preventive services with no out-of-pocket cost.¹ The decision kept no-cost coverage in place for roughly 100 million privately insured Americans, protecting access to cancer screenings, statins, HIV-prevention medication, and dozens of other services. But the reasoning the Court used to save the mandate also handed the executive branch a powerful lever over what the Task Force recommends in the first place, and that lever has already been pulled.

What the Case Was About

Section 2713 of the ACA requires private insurers and Medicaid expansion programs to cover, without cost-sharing, preventive services that receive an “A” or “B” rating from the U.S. Preventive Services Task Force.² Braidwood Management, a Texas company controlled by physician and Republican donor Steven Hotze, sued in 2020 to knock that requirement down.³

The lead constitutional argument was about who gets to appoint Task Force members. The plaintiffs said the panel wields serious government power by effectively deciding what insurers must cover, and that its members should therefore be nominated by the President and confirmed by the Senate under Article II’s Appointments Clause. Because Task Force members are instead appointed by the Secretary of Health and Human Services, the plaintiffs argued, every coverage requirement flowing from their recommendations was unconstitutional.²

The stakes were broad. A win for the plaintiffs would have let insurers begin charging for any preventive service the Task Force recommended after the ACA took effect on March 23, 2010, including lung, breast, and colorectal cancer screenings, statins for heart disease prevention, and pre-exposure prophylaxis (PrEP) for HIV.⁴⁵⁶⁷

How the Court Ruled

Justice Brett Kavanaugh wrote for a six-justice majority that included Chief Justice Roberts and Justices Sotomayor, Kagan, Barrett, and Jackson. The Court held that Task Force members are “inferior officers” who can be appointed by the HHS Secretary without Senate confirmation.¹

The reasoning turned on two features of the Secretary’s control over the panel. First, the Secretary can remove Task Force members at will, which the Court called a “powerful tool for control” that creates “here-and-now subservience.” Second, the Secretary can review and block Task Force recommendations before they take legal effect, because at least a year must pass between a recommendation’s issuance and its enforcement. Taken together, the majority said, these powers mean Task Force members “have no power to render a final decision on behalf of the United States” without the Secretary’s acquiescence.¹

The Court also rejected the argument that the statute’s description of the Task Force as “independent” shielded members from removal. Independence there refers to freedom from outside professional affiliations, the majority explained, not insulation from the Secretary.¹

Justice Thomas dissented, joined by Justices Alito and Gorsuch. Thomas argued that Congress never actually gave the HHS Secretary the power to appoint Task Force members, so that power still resides with the President, and the members are principal officers requiring Senate confirmation.⁸

What the Ruling Means for Your Coverage

If you have private insurance, the mandate you already relied on is intact. Insurers must continue to cover Task Force-recommended services rated “A” or “B” without charging you a copay, coinsurance, or deductible.⁹ Cancer screenings, cardiovascular medications, PrEP, and the other services the plaintiffs targeted remain covered at no cost. Plan sponsors have not been required to change their coverage.

One narrow carve-out survives. The district court’s earlier ruling that the PrEP mandate burdened the Braidwood plaintiffs’ religious exercise under the Religious Freedom Restoration Act was not appealed, so that injunction still applies to the named plaintiffs. It does not affect anyone else’s coverage.¹

What the Ruling Didn’t Settle

The Supreme Court decided only the Appointments Clause question about the Task Force. The plaintiffs had also raised Administrative Procedure Act claims about the Secretary’s ratification of recommendations from two other advisory bodies: the Advisory Committee on Immunization Practices (ACIP), which recommends vaccines, and the Health Resources and Services Administration (HRSA), which sets guidelines for women’s and children’s preventive services. Those claims went back to the district court, which entered a judgment in October 2025.¹⁰¹¹

What Has Happened Since

The Court’s insistence that the HHS Secretary controls the Task Force has proved consequential in ways separate from the coverage mandate itself. The same reasoning that saved the law also confirmed the Secretary’s authority to remove panel members and block their recommendations, and HHS Secretary Robert F. Kennedy Jr. has used both.

The Vaccine Committee Overhaul

On June 9, 2025, Kennedy fired all 17 voting members of ACIP and installed a reconstituted committee.¹²¹³¹⁴

In January 2026, Acting CDC Director Jim O’Neill signed a decision memo stripping “universally recommended” status from seven childhood vaccines: rotavirus, meningococcal disease, hepatitis A, hepatitis B, influenza, COVID-19, and respiratory syncytial virus.¹² Fourteen state attorneys general and the Governor of Pennsylvania sued in February 2026 to block the changes.¹⁵ On March 16, 2026, a federal court stayed both the new ACIP appointments and the January decision memo, restoring the June 2024 childhood immunization schedule while the litigation continues. The court found that at least six of the new ACIP members lacked vaccine-related expertise and three others had only tangential experience, and that the committee failed the Federal Advisory Committee Act’s balanced-membership requirement.¹³

Removal of Task Force Leadership

In May 2026, Kennedy removed the Task Force’s chair, Dr. John Wong of Tufts Medical Center, and vice chair, Dr. Esa Davis of the University of Maryland School of Medicine. Kennedy called the panel “lackadaisical and negligent for 20 years” and faulted it for not recommending early Alzheimer’s screening.¹⁶ The official termination letters, dated May 11, 2026, described the action as “administrative in nature” and unrelated to performance.¹⁷ The removals left the Task Force with eight sitting members out of a possible 16, and the panel had not met for over a year.¹⁸

How States Are Responding

Several states have moved to lock in preventive-care rules regardless of what happens federally. Colorado enacted SB 25-196 in May 2025, empowering its insurance commissioner to adopt preventive-service guidelines as they existed in January 2025, or to follow a state advisory task force if federal standards weaken.¹⁹ Maine authorized its health department to set vaccine policy independently of ACIP. Massachusetts used executive authority to require state-regulated plans to cover vaccines recommended by the state’s public health department. Groups of states in the Northeast and West announced regional frameworks to preserve science-based vaccine guidance.²⁰

These state protections have an important limit. They generally cannot regulate self-funded employer health plans, which cover most working adults and are governed exclusively by federal law. If your coverage comes through a self-funded employer plan, a state fix will not reach you. Separately, the insurance industry trade group AHIP said its members would voluntarily maintain no-cost coverage for vaccines recommended as of September 2025 through the end of 2026, though coverage for vaccines placed in a “shared decision-making” category is less certain.²⁰

Where Things Stand

As of mid-2026, the ACA’s preventive-services mandate is still law and still enforceable. What has shifted is the machinery that feeds into it. The Task Force is operating at half strength and has not met in more than a year, so new or updated screening recommendations are effectively frozen. The reconstituted ACIP’s changes to the childhood vaccine schedule are on hold under court order. The remaining APA claims about HRSA and ACIP have reached a district court judgment, and further litigation is ongoing.¹¹ For now, check your plan documents or your insurer’s preventive-services list before any screening or vaccination if you want to confirm no-cost status, particularly for services that have recently been reclassified as “shared clinical decision-making.”

1
Supreme Court of the United States. Kennedy v. Braidwood Management, Inc., No. 24-316
2
KFF. Explaining Litigation Challenging the ACA’s Preventive Services Requirements
3
Mother Jones. The Controversial Figures Behind the Supreme Court Case Targeting Obamacare
4
George Washington University. Kennedy v. Braidwood Management, Inc.
5
National Center for Biotechnology Information. Impact of Braidwood on Colorectal Cancer Screening
6
KFF. Kennedy v. Braidwood: The Supreme Court Upheld ACA Preventive Services but That’s Not the End of the Story
7
AIDSVu. One Question: Braidwood Becerra
8
Harvard Law Review. Kennedy v. Braidwood Management, Inc.
9
Segal. SCOTUS Upholds ACA Preventive Care Recommendation Process
10
KFF. ACA Preventive Services: Supreme Court Kennedy Braidwood
11
Georgetown Law Litigation Tracker. Braidwood Management Inc. v. Becerra
12
Arizona Attorney General. Attorney General Mayes Leads Multistate Lawsuit Challenging Kennedy Vaccine Schedule
13
Georgetown University Center for Children and Families. Court Order Presses Pause on New ACIP Committee and Changes to Childhood Vaccination Schedule
14
Chemical & Engineering News. CDC Advisers Endorse Changes to MMR Vaccination
15
Maryland Attorney General. Attorney General Brown Joins Multistate Lawsuit Challenging the Kennedy Vaccine Schedule
16
Politico. RFK Jr. Fires USPSTF Preventive Care Task Force Leaders
17
STAT News. Kennedy Fires Vice Chairs of US Preventive Services Task Force
18
CNN. RFK Jr. Fires Preventive Services Task Force Leaders
19
Colorado General Assembly. SB25-196: Insurance Coverage Preventive Health-Care Services
20
Georgetown University Center for Children and Families. Preventive Services at Risk: Federal Instability and State Responses