The U.S. Supreme Court issued its long-awaited decision in Kennedy v. Braidwood Management, Inc., holding that members of the United States Preventive Services Task Force (USPSTF) are inferior officers (not principal officers, as the plaintiffs argued) whose appointment does not violate the Constitution’s Appointments Clause.
The USPSTF is an entity within the Department of Health and Human Services (HHS) that issues public recommendations on preventive healthcare services (e.g., cancer and diabetes screenings). Under the Affordable Care Act (ACA), preventive services must be covered by non-grandfathered group health plans without any cost sharing (i.e., no deductibles, copays or coinsurance) to plan participants.
Under the Appointments Clause, principal officers must be appointed by the president of the United States “with the Advice and Consent of the Senate.” In Braidwood, the plaintiffs argued that the members of the USPSTF are principal officers and thus were unconstitutionally appointed. As a result, they argued, the ACA’s preventive care coverage mandates cannot be enforced.
The Supreme Court disagreed and found that the USPSTF members are inferior officers because their work is “directed and supervised” by the Secretary of HHS, a principal officer, through two main sources of authority; therefore, the appointment of the USPSTF members was constitutional.
Going forward
This decision means that employer-sponsored group health plans must continue to cover evidence-based items or services with an A or B rating recommended by the USPSTF, with no out-of-pocket costs to participants.