The Supreme Court upheld a key preventive services task force in a 6-3 ruling issued Friday morning.
The high court determined that members of the U.S. Preventive Services Task Force, which makes recommendations for coverage requirements under the Affordable Care Act, are selected within the bounds of the Constitution.
In the case, Braidwood Management, an employer, argued that the task force's recommendations were invalid because its members were selected in a way that violated the Appointments Clause, which determines how the president can name federal officials.
Braidwood and right-leaning organizations challenged the ACA's preventive services protections as they did not want to provide coverage for pre-exposure prophylaxis (PrEP) drugs for HIV due to religious reasons.
In the majority opinion (PDF), authored by Brett Kavanaugh, the justices said the plaintiff's argument against the appointments does not hold water, as Congress clearly vested the authority to the Department of Health and Human Services Secretary in the ACA.
The justices said there is a clear chain of command for the task force members that runs through the HHS secretary, which follows with the appointments clause—and that the secretary has the power to fire and appoint individual members at will, as well as block the task force's recommendations before they take effect.
In addition, Braidwood's arguments hinge on decades-old interpretations of statute, according to the opinion.
"This frozen-in-time reading finds no footing in statutory text or common sense," Kavanaugh wrote.
Alongside Kavanaugh, Chief Justice John Roberts and Justices Sonya Sotomayor, Elena Kagan, Amy Coney Barrett and Ketanji Brown Jackson joined the majority. Justice Clarence Thomas penned a dissent, which Justices Samuel Alito and Neil Gorsuch joined.
Court watchers had said that the discussion during oral arguments seemed to lean toward a win for the government. In the case. A federal district court and the Fifth Circuit Court of Appeals had both previously ruled that the task force's roster violated the Appointments Clause.
Patient advocacy groups cheered the ruling. Carl Schmid, executive director of the HIV+Hepatitis Policy Institute, said in a statement that "this is a great victory for healthcare in our country and for everyone who believes in prevention, including the Trump administration."
"This legal attack was initiated by extreme right-wing social conservatives who sought to make sure that gay men and others could not access PrEP to prevent HIV," Schmid said. "We are very pleased the Court upheld the coverage requirement."
"Now we must focus on making sure insurers comply with and regulators enforce the law, particularly with new, long-acting forms of PrEP," he said.
Schmid added that the ruling is notable as it comes during a time when the White House is seeking to defund HIV and hepatitis prevention programs.
"While we continue to oppose those proposed funding cuts, we can rest assured that at least for people with insurance, preventive services such as PrEP, HIV and hepatitis testing will be covered at no cost," he said.
Protect Our Care echoed the sentiment, calling the ruling a win but noting "preventive services are still in danger." Protect Our Care Senior Advisor Anne Shoup said in a statement that "the fight to protect affordable health care for all is far from over."
"But make no mistake—this is not over," Shoup said. "While today’s ruling protects preventive care for now, the Trump administration, including HHS Secretary RFK Jr., Republicans, and other far-right extremists, continue to try and weaken these protections and hand more power to insurance companies."
"We must remain vigilant to ensure access to science-backed preventative services are protected," Shoup said.
As patient orgs remained skeptical of insurers, AHIP said in a statement that the ruling has no immediate effect on coverage.
"Health plans have long supported affordable access to evidence-based preventive care to help people stay healthy—including coverage for recommended services with no cost sharing," AHIP said. "With this ruling, there are no impacts to existing coverage, and we will closely monitor the ongoing legal process."