On June 27, 2025, the U.S. Supreme Court issued its decision in Kennedy v. Braidwood Management, Inc., rejecting a constitutional challenge to the Affordable Care Act’s (ACA) preventive services mandate. The Supreme Court upheld the authority to rely on the U.S. Preventive Services Task Force (USPSTF) when requiring most group health plans to cover certain preventive services without cost sharing (e.g., deductibles, copays, coinsurance). The decision does not change existing law — it preserves the status quo, resolves significant legal uncertainty and confirms that employer-sponsored group health plans must continue to comply with the ACA’s no-cost preventive care coverage requirements. Plan sponsors should take note of the decision and continue maintaining ACA-compliant preventive service coverage.
Background on the ACA’s Preventive Services Mandate
The ACA requires most group health plans to cover preventive services without cost sharing if those services receive an “A” or “B” rating from the USPSTF. Created by the Department of Health and Human Services (HHS) in 1984 and codified by Congress in 1999, the USPSTF issues evidence-based recommendations for clinical preventive care. Under the ACA, these recommendations become binding after a minimum one-year delay, during which the HHS secretary can review or block them.
Summary of the Supreme Court’s Ruling
In Kennedy v. Braidwood Management, Inc., a group of Texas individuals and businesses challenged the ACA’s reliance on the USPSTF, arguing that its members were not properly appointed under the U.S. Constitution’s Appointment Clause. The appellate court agreed, ruling that the USPSTF members required presidential nomination and Senate confirmation under the Appointments Clause.
However, the Supreme Court disagreed. The Supreme Court found the USPSTF appointments constitutional and reaffirmed the legal foundation of the preventive services mandate.
What This Means for Employer Group Health Plans
Employers do not need to make any changes to their group health plans because of this ruling. The Supreme Court’s decision leaves the ACA preventive services mandate fully intact. Employer-sponsored group health plans must continue to cover preventive services recommended by the USPSTF, such as cancer screenings, certain immunizations, diabetes screenings and more.
