Kennedy v. Braidwood Management Inc.
Case Overview
The Supreme Court considers whether the Affordable Care Act's requirement that insurers cover preventive services recommended by the U.S. Preventive Services Task Force — including PrEP for HIV prevention — is constitutional. A Fifth Circuit ruling held that the mandate violated the non-delegation doctrine because the PSTF is a private entity not subject to presidential appointment and removal.
The Facts
The ACA requires most health insurance plans to cover preventive services rated A or B by the U.S. Preventive Services Task Force with no cost sharing. Braidwood Management, a Christian-owned Texas employer, challenged the mandate as applied to PrEP (pre-exposure prophylaxis for HIV prevention), arguing it facilitated conduct their faith considers sinful. The Fifth Circuit agreed that the PSTF's authority violated the Appointments Clause because PSTF members are not appointed by the President and do not occupy an 'Office' under the Constitution.
The Application
The Court applied the Appointments Clause by examining whether PSTF members function as "Officers of the United States," and found they do not: the PSTF merely recommends preventive services while the Secretary of Health and Human Services retains authority to set final coverage standards, making the panel's role advisory rather than decisional. Under the non-delegation doctrine, the Court found the ACA's delegation to the PSTF sufficiently bounded by intelligible principles—the statute itself establishes the governing standard—and analogized to similar delegations to expert bodies throughout federal administrative law. Reversing the Fifth Circuit's narrower conception of both doctrines, the Court upheld the constitutional validity of the preventive-care mandate without expanding non-delegation limits in ways that would threaten existing federal programs.
The Conclusion
**Decided June 27, 2025. The Court ruled 6-3 that PSTF members are not 'Officers of the United States' and the delegation is constitutionally permissible, reversing the Fifth Circuit.** The ACA's preventive care mandate survives. The Court declined to expand the non-delegation doctrine in ways that would threaten numerous existing federal programs.
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