The U.S. Supreme Court agreed on Friday to review a Fifth Circuit decision that found the task force responsible for setting preventive care coverage requirements under the Affordable Care Act (ACA) unconstitutional. This sets the stage for a pivotal legal battle that could impact insurance coverage for critical screenings, such as those for colon and breast cancer.

The Court granted a petition for certiorari from the federal government, which sought to overturn the Fifth Circuit's ruling. While businesses and individuals who challenged the preventive care requirements also filed their own petition, the Supreme Court only granted review of the government’s request.

In June, the Fifth Circuit struck down a national injunction against the ACA’s preventive care rules, which had been imposed by U.S. District Judge Reed O'Connor in March 2023. However, the ruling maintained the block for religious individuals and businesses in Texas that had filed the lawsuit. Additionally, the Fifth Circuit agreed with the lower court that the U.S. Preventive Services Task Force (USPSTF) members who set these coverage requirements were unconstitutionally appointed, violating Article II of the U.S. Constitution.

The plaintiffs in the case, including Texas residents Joel Starnes and John Kelley, the owner of Kelley Orthodontics, and wellness center management firm Braidwood Management Inc., initially filed their suit in 2020. The government agencies involved in the case include the Health and Human Services, Labor, and Treasury departments.

The Supreme Court will address two key questions raised by the government. First, the Court will decide whether the Fifth Circuit erred in ruling that the structure of the task force violated the Constitution’s appointments clause. Secondly, the Court will consider whether the Fifth Circuit made an error by refusing to sever the provision of the ACA that created the appointments clause issue. If severed, this provision would allow the Secretary of Health and Human Services to approve preventive care services coverage requirements recommended by the USPSTF.

In the absence of Supreme Court action, the Fifth Circuit’s ruling leaves the door open for plaintiffs or other similar parties to seek a nationwide block on the preventive care coverage rules set by the task force.

This case has a lengthy history, with earlier rulings addressing claims that the preventive services requirements violated the Religious Freedom Restoration Act (RFRA). In September 2022, Judge O'Connor ruled that requiring Braidwood to cover PrEP (pre-exposure prophylaxis) to prevent HIV violated RFRA.

Representatives for the federal government and the plaintiffs did not immediately respond to requests for comment regarding the Supreme Court’s decision to review the case.

The case is Becerra et al. v. Braidwood Management Inc. et al., case number 24-316, in the U.S. Supreme Court.