🏛️ U.S. Supreme Court Upholds ACA Preventive Care Mandate
📅June 27, 2025 — In a landmark decision, the U.S. Supreme Court upheld a central provision of the Affordable Care Act (ACA), affirming that health plans and issuers must continue covering the full range of recommended preventive care services without cost sharing.
⚖️ The Case: Kennedy v. Braidwood Management, Inc.
The ruling reverses a previous decision by the 5th Circuit Court and affirms that the ACA’s preventive care mandate is constitutional. As a result, health plans and issuers must continue offering free preventive services—including immunizations and screenings—as long as they’re provided by in-network providers.
💡 Reminder: These services must be offered without deductibles, copayments, or coinsurance.
🩺 What’s Included in Preventive Care Coverage?
Under the ACA, non-grandfathered health plans are required to cover:
✅ Services rated A or B by the U.S. Preventive Services Task Force (USPSTF)
💉 Immunizations recommended by the Advisory Committee on Immunization Practices
👶 Preventive care and screenings for infants, children, and adolescents per HRSA guidelines
👩⚕️ Preventive services for women supported by HRSA
🧑⚖️ Background of the Legal Dispute
A group of individuals and businesses in Texas challenged the ACA’s mandate on religious and constitutional grounds. In 2023, the U.S. District Court for the Northern District of Texas sided with the plaintiffs and ruled that the USPSTF’s authority violated the Constitution’s Appointments Clause—since its members are not nominated by the president or confirmed by the Senate.
That decision led to a nationwide injunction against enforcing part of the ACA’s mandate.
🧭 What This Means Going Forward
Thanks to the Supreme Court’s decision, the preventive care mandate remains fully in effect across the country. Health insurers and plan sponsors should continue complying with the ACA’s requirements and ensure coverage remains up to date with the latest USPSTF and HRSA recommendations.
📞 Questions?
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