On June 27, the U.S. Supreme Court issued its decision in Kennedy v. Braidwood Management Inc., affirming the authority of the U.S. Preventive Services Task Force (USPSTF) to issue preventive care recommendations. As a result, the Affordable Care Act (ACA) mandate requiring employer-sponsored group health plans to cover certain preventive services without cost-sharing remains in effect.
Background
Kennedy v. Braidwood Management Inc. challenges the constitutionality of the USPSTF, whose recommendations for preventive care with an “A” or “B” rating – including services such as screenings, counseling, vaccinations, and preventive medications – must be covered by most group health plans (and in all marketplace health insurance plans) under the ACA without cost-sharing. The central issue in the case was whether the USPSTF has the constitutional authority to issue binding recommendations that require employer-sponsored health plans to cover these services without copayments or coinsurance.
Initially, U.S. District Court for the Northern District of Texas decided that the USPSTF had no constitutional authority to mandate that private insurance cover different preventive services, which led to several appeals before the Supreme Court took up the case in February 2025. The core of the argument rested on the Appointments Clause, which requires that officers of the United States who make decisions that would affect the public be appointed by the President and confirmed by the Senate. The members of the USPSTF, however, were not appointed through this process. That said, the Supreme Court narrowly examined whether the structure of the USPSTF violated the Constitution’s Appointments Clause.
Kennedy v. Braidwood Management Inc. Decision
In the landmark decision, the Supreme Court upheld the ACA’s preventive services mandate, affirming that group health plans must continue to cover preventive services without cost-sharing. The Court ruled that the USPSTF operates constitutionally, with its members properly appointed as “inferior officers” by the Secretary of Health and Human Services (HHS). The Supreme Court emphasized that these members are removable at will and that their recommendations are subject to review by the Secretary before taking effect, ensuring both accountability and oversight.
Justice Thomas, joined by Justices Alito and Gorsuch, dissented, arguing that the Secretary lacked proper statutory authority to appoint USPSTF members and that the USPSTF operates with too much independence to be considered subordinate.
Employer Takeaways
As a result of the Supreme Court’s decision, there are no changes to the preventive service mandates required under the ACA. Meaning, employer-sponsored group health plans must continue to provide coverage for certain preventive services without cost-sharing. While the status quo remains in place for plan sponsors and insurers for now, Sequoia will continue to monitor any future developments and communicate updates, as applicable.
Additional Resources
Connect with a Sequoia consultant to learn how Sequoia’s compliance services are integrated in our benefits services and tailored solutions. And if you’re already a Sequoia client, stay on top of your employer obligations with your Compliance Checklist that highlights important compliance dates, action items, and resources.
The information and materials on this blog are provided for informational purposes only and are not intended to constitute legal or tax advice. Information provided in this blog may not reflect the most current legal developments and may vary by jurisdiction. The content on this blog is for general informational purposes only and does not apply to any particular facts or circumstances. The use of this blog does not in any way establish an attorney-client relationship, nor should any such relationship be implied, and the contents do not constitute legal or tax advice. If you require legal or tax advice, please consult with a licensed attorney or tax professional in your jurisdiction. The contributing authors expressly disclaim all liability to any persons or entities with respect to any action or inaction based on the contents of this blog. © 2025 Sequoia Consulting Group. All Rights Reserved.
