(LOOTPRESS) – The Supreme Court announced on Friday that it will review the constitutionality of the Affordable Care Act’s (ACA) no-cost coverage mandates for certain preventive care services. The case marks another high-stakes challenge to the landmark health care law, just as President-elect Donald Trump, who sought to repeal the ACA during his first presidency, prepares to return to the White House.
Although the case does not pose an existential threat to the ACA, it could jeopardize access to cost-free preventive treatments and services, such as HIV prevention medications, heart statins, and various cancer screenings. If overturned, the decision could lead to significant out-of-pocket costs for some preventive services, particularly impacting low-income Americans and potentially delaying early detection of life-threatening illnesses.
The Legal Challenge
The 5th U.S. Circuit Court of Appeals previously ruled that the ACA’s preventive care mandates, based on recommendations from the U.S. Preventive Services Task Force, violated the Constitution’s Appointments Clause. The court found that the task force members are not appointed by the president or confirmed by the Senate, as required for such decision-making authorities. This ruling specifically targeted no-cost coverage requirements implemented after the ACA’s passage in March 2010.
The appellate court’s decision directly affects only the plaintiffs—a Texas business and several individuals. However, both the Biden administration and the challengers agreed that the ruling could pave the way for broader lawsuits to block the mandates nationwide. They jointly petitioned the Supreme Court to review the case.
Potential Impacts
The 5th Circuit’s ruling puts at risk several preventive care mandates, including coverage for prenatal supplements, physical therapy to prevent falls among older Americans, and lung cancer screenings. According to the Biden administration, these services could save thousands of lives annually. Other mandates, such as well-baby visits, autism screenings, cervical cancer screenings, and vaccines for flu and other diseases, remain unaffected by the case.
Studies have shown that the ACA’s no-cost preventive care mandates have led to increased use of such services and reduced health disparities, particularly in communities of color. Experts warn that even small out-of-pocket costs could deter people from accessing preventive care.
“Even modest out-of-pocket costs mean that people don’t end up seeking out these services,” said Zachary Baron, a health policy expert at Georgetown University’s O’Neill Institute. “They end up pushing things off as they’re trying to juggle various bills.”
Government’s Argument
U.S. Solicitor General Elizabeth Prelogar urged the Supreme Court to overturn the 5th Circuit’s ruling, warning that it jeopardizes long-standing health care protections for millions of Americans.
“This Court’s review is warranted because the court of appeals has held an Act of Congress unconstitutional and its legal rationale would inflict immense practical harms,” Prelogar wrote. She emphasized that the decision could disrupt critical ACA provisions that millions rely on.
Challengers’ Position
The challengers, led by the Texas-based company Braidwood, argued that the 5th Circuit’s ruling was “well-reasoned and correct.” Braidwood opposes covering certain preventive services, such as HIV prevention medication (PrEP) and screenings for sexually transmitted diseases, on moral grounds. Representing the company is Gene Hamilton, a former Trump administration official, and Jonathan Mitchell, who has previously represented Trump in other legal matters.
The lawsuit, initially filed in 2020, began under the Trump administration, which defended the ACA’s requirements at the time.
What’s Next?
The Supreme Court’s decision to hear the case brings renewed focus to the ACA, a law that has faced repeated challenges since its enactment in 2010. The outcome could have far-reaching consequences for Americans’ access to preventive care and the broader health care landscape. Arguments in the case are expected later this year, with a ruling likely in 2025.
