The Affordable Care Act of 2010 requires private insurance to cover preventive benefits endorsed by the USPTF. The legitimacy of the USPSTF to set such requirements was challenged, and the challenge "won" in district court and federal appeals court. However, the USPSTF authorities were preserved on June 27 2025, in a 6-3 decision. Thomas, Gorsuch, and Alito dissented.
Find coverage at NYT here.
Find the actual decision here, Braidwell case. The case is 86 pages, with the dissent beginning on page 49. The main point is whether the USPSTF members are inferior officers subject to management, or, if not, are they indeed "principal" officers who should require Senate confirmation.
Separate topic - How the administration funds, staffs, or controls USPSTF is "TBD."
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AI CORNER
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Summary for Health Policy Experts and Legal Audiences:
In Kennedy v. Braidwood Management, Inc., the Supreme Court ruled (6–3) that members of the U.S. Preventive Services Task Force (USPSTF) are inferior officers under the Appointments Clause and thus lawfully appointed by the Secretary of HHS, rather than requiring presidential nomination and Senate confirmation.
The case centered on the ACA’s provision mandating that health insurers cover preventive services graded “A” or “B” by the USPSTF at no cost to patients. The plaintiffs, including Braidwood Management, objected to covering certain services and argued that USPSTF members were principal officers—with legally binding power but no clear supervision—rendering their appointments unconstitutional.
Lower Court Victories for Braidwood:
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Both the district court and the Fifth Circuit agreed with Braidwood, finding that USPSTF members were not meaningfully supervised and thus principal officers, improperly appointed under Article II.
Supreme Court Reversal:
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Justice Kavanaugh, writing for the majority, reversed the Fifth Circuit. The Court held that Task Force members are inferior officers because:
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They are removable at will by the Secretary of HHS.
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The Secretary has statutory authority to review and block recommendations before they take legal effect (under ACA provisions like 42 U.S.C. §300gg-13(b) and §202).
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Their authority is non-final without the Secretary’s approval—thus preserving executive chain-of-command accountability as required by Edmond v. United States.
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Key Legal Finding:
The majority reasoned that “independent” in the statute (42 U.S.C. §299b–4(a)(6)) does not imply for-cause removal or insulation from review. Instead, “independent” refers to freedom from external stakeholder influence, such as hospitals or academic affiliations.
Dissenting Opinion (Thomas, joined by Alito and Gorsuch):
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The dissent strongly objected to the majority’s interpretation, arguing that the USPSTF holds binding policymaking authority without genuine oversight.
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It rejected the idea that mere removal or post-hoc review powers constitute “supervision” under Article II.
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The dissent warned that this decision blurs the distinction between principal and inferior officers and invites future constitutional abuse by allowing politically consequential decisions to be made by officials not confirmed by the Senate.
Policy Implications:
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The decision preserves the ACA’s preventive services mandate infrastructure, avoiding immediate disruption to insurance coverage requirements.
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It sets a clearer boundary for what constitutes sufficient executive supervision to qualify federal officers as “inferior” under the Constitution.
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It may limit future constitutional challenges to similar advisory or expert panels—so long as a cabinet-level officer retains power to remove members and review their output before legal force attaches.
Bottom Line:
Despite initial wins in the district and appeals courts, Braidwood’s challenge to the USPSTF structure ultimately failed at SCOTUS. The Court reaffirmed a broad view of executive supervision sufficient to satisfy the Appointments Clause—while the dissent viewed this as a dangerous dilution of constitutional safeguards.
“Remand for further proceedings” is a common legal phrase, and yes, it’s important—but not dramatic.
In this context, the Supreme Court reversed the lower courts’ rulings (which had struck down the USPSTF appointments) and sent the case back (“remanded”) to the lower courts to apply the Supreme Court’s new decision and handle any remaining issues.
Here's what it means:
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"Reversed": The Supreme Court disagreed with the Fifth Circuit and district court, ruling that Task Force members are not principal officers.
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"Remanded": The case goes back to the lower court to clean up the details, implement the ruling, and resolve any leftover matters (e.g., how exactly the injunctions are lifted or narrowed).
Is it important?
Yes, but mostly procedural now:
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It confirms that Braidwood doesn’t win on the Appointments Clause claim.
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But the remand allows the lower court to finalize what this means for the actual injunction and the parties (for example, what remains under the Religious Freedom Restoration Act claim, which was not appealed and still stands in part).
In short: The big question is settled, but the paperwork’s not done.
