Court of Appeals calls preventive care task force unconstitutional

A federal appeals court ruled Friday that the preventive care task force created under the 2010 health care law is unconstitutional, but did not block access to preventive care for millions of Americans.

The New Orleans-based 5th U.S. Circuit Court of Appeals ruled that relief should go to the plaintiffs in the case — a group of Texas businesses with religious objections to the due diligence requirements imposed after the law passed in 2010, which include coverage of the HIV preventive drug PrEP.

Other examples of such care include lung cancer screenings and medications to reduce the risk of breast cancer.

“We have no reason to uphold more extensive relief than is necessary to remedy the plaintiffs’ injuries,” wrote Justices Don Willett and Cory Wilson, Trump appointees, and Irma Carrillo Ramirez, a Biden appointee.

The businesses argued that the United States Preventive Services Task Force — created to recommend preventive care that should be covered by insurers without patient cost-sharing — should not make binding decisions because they are not positions confirmed by Congress. .

The 5th Circuit agreed, writing in a 43-page decision that the task force’s “unbridled power” makes its members “principal officers of the United States not validly appointed under Article II of the Constitution of the United States”.

The court also rejected efforts by Department of Health and Human Services Secretary Xavier Becerra to “cure” those issues by ratifying the task force’s recommendations. “The Secretary does not have the statutory authority to even review, revise, or issue preventive care recommendations on his own,” the court wrote.

The case has caused anxiety about the future of preventive services coverage. More than 100 million Americans receive services each year covered under the preventive services mandate, according to KFF, a health research organization.

Friday’s decision means access to preventive care will be preserved for millions of Americans, at least for now, said Laurie Sobel, an associate director for women’s health policy at KFF.

“Right now, only plaintiffs are allowed to not offer coverage without cost sharing,” Sobel said. “For everyone else, nothing has changed.”

But, she added, the case is likely to drag on for a long time.

“We’ve come a long way,” she said.

In March 2023, Judge Reed O’Connor of the U.S. District Court for the Northern District of Texas issued a statewide order and struck down parts of the 2010 law that required insurers to cover preventive health care services without cost to the patient.

But three months later, a judge on the 5th U.S. Circuit Court of Appeals agreed that a request for free coverage of preventive health care services should not be affected while the lawsuit challenging the mandatory coverage was pending.

The 5th Circuit Court of Appeals wrote in its opinion Friday that there was “no basis for the universal injunction.”

“The district court erred in vacating all agency actions taken to implement the preventive care mandates, so we have no reason to uphold more extensive relief than is necessary to remedy the plaintiffs’ injuries,” the court wrote. “It was an abuse of discretion to enter a universal injunctive relief after already providing full relief to the plaintiffs.”

The court also did not rule on similar advisory bodies—the Advisory Committee on Immunization Practices and the Health Resources and Services Administration—but remanded the case to O’Connor, stating that “if left without consideration, it could lead to an incorrect result with respect to plaintiffs’ unconstitutional challenges.”

O’Connor had rejected the plaintiffs’ challenges to ACIP and HRSA. The appeals court declined to take the case, saying it was “disinclined to decide questions without sufficient briefing, especially those of high interest and constitutional importance.”

“Rather than decide these tantalizing questions on our own without the benefit of any judgment below or any meaningful response by the government on appeal, we think it prudent for the district court to consider these arguments,” he wrote. court.

The case is Braidwood Management Inc. against Becerra.