The U.S. Supreme Court heard the debate on Monday in a case that could threaten Americans' access to free preventive health services under the Affordable Care Act, commonly known as Obamacare.
The issue is the constitutionality of the US Task Force on Preventive Services, which plays a key role in determining the preventive services that health insurance companies must cover patients without cost. A panel of 16 health professionals appointed by the Health Secretary without confirmation from the Senate, designates dozens of life-saving screenings and treatments as essential preventive care.
If a judge upheld a lower court decision, the Health Association said it would be subject to out-of-pocket and deductions with submissions, life-saving tests and cost-free treatments, and prevent many Americans from obtaining them.
The case represents the latest challenge in a long series of legal challenges to Barack Obama's Signature Health Care Act since its passage in 2010. Trump and his administration, who are major critics of the program during his first term, have taken over the case after the Biden administration first filed an appeal.
In the oral discussion, the judges raised acute questions as to whether the law gives HHS secretaries a more appropriate level of supervision than the task force. This includes the authority to influence recommendations and firefighters, or the group serves as largely independent government agencies where recommendations are effectively legal.
Jonathan Mitchell is a conservative lawyer representing plaintiffs who previously represented Trump in a voting access lawsuit, claiming that task force members are “primary officers” because “their precautionary obligations for preventive care are not directed or overseen by the Department of Health and Human Services Secretary.”
Mitchell's argument depends on interpreting the task force's “independence” and “statutory language that requires “to be protected from political pressures,” but he argues that it is incompatible with the supervision of a secretary.
Some justices who seemed skeptical of Mitchell's reading of law have questioned whether the council would create a board without Judge Elena Kagan appointing members.
The task force is made up of medical professionals who serve a four-year volunteer-based term. We review medical evidence and public feedback and issue recommendations on which preventive services are most effective in detecting diseases and dealing with diseases before the patient's condition worsens.
The task force identified a large number of preventive services as having high or moderate net benefits for patients that include screenings to detect diabetes and various types of cancer, statin drugs that reduce the risk of heart disease and stroke, and interventions that help patients quit smoking or unhealthy alcohol use.
The New Orleans-based 5th U.S. Circuit Court of Appeals ruled in 2024 that the task force structure violated the constitution, as the plaintiffs argued. The government's appeal against the Fifth Circuit decision was filed by the Biden administration before it was first addressed by Trump.
In a Supreme Court overview, the Trump administration argued that the Task Force's recommendations for preventive care cannot legally bind insurance companies without the permission of the HHS Secretary.
“Secretaries are free to remove them, and the threat of removal is the ultimate tool to control final decisions on recommendations,” wrote a Justice Department lawyer.
For this and other reasons, Justice Department lawyers argued that members of the task force should be considered so-called “supervisors.” This means that they can be legally appointed by an administrative chief, such as the HHS secretary, and do not require confirmation of the Senate under the Constitution.
The plaintiffs argued in a Supreme Court filing that the Affordable Care Act transformed the long-standing task force from advisory bodies to issue “orders” to insurers, adding that the HHS secretary has no power to stop the task force's recommendations from becoming binding laws.
They argued that the lack of oversight of the task force made members who must be appointed president “primary officers” and confirmed the Senate under the constitution.
Before the lawsuit was narrowed to the issue of appointment, the lawsuit contained religious objections to what is necessary to cover pre-exposure prevention for HIV. They argued that such drugs “promote and encourage homosexual behavior, prostitution, sexual prostitution, and intravenous drug use.”
The Fifth Circuit also rejected the government's request to remove certain problematic words from the Obamacare provisions in question (a process called cutting off) in order to make that part of the law constitutionality. That issue was also part of an appeal before the Supreme Court.
The Supreme Court's decision was expected by the end of June.
