Earlier this Summer, the US Supreme Court ruled that the Affordable Care Act’s requirement to cover certain preventive care services at no cost is constitutional. As a result, employers must continue to provide first-dollar coverage for all preventive care services that receive an “A” or “B” rating from any of three organizations: the U.S. Preventive Services Task Force (clinical services for all populations), the Advisory Committee on Immunization Practices (vaccines) and the Health Resources and Services Administration (for services specific to women and children).
The original challenge was built on the argument that Preventive Services Task Force members are not constitutionally appointed officers of the United States and therefore may not exercise the authority granted to them by Congress under the Affordable Care Act. Two lower courts ruled in favor of this argument, but the Supreme Court recently rejected it on a vote of 6-3, which leaves the mandate in place for employers.
The ruling eliminates some uncertainty for employer-sponsored health plans, although many employers said they would have continued to cover most preventive services at no cost regardless. It is also important to note the Supreme Court ruled that the mandate does not violate the appointments clause because the duly appointed Secretary of Health and Human Services can block recommendations and remove USPSTF members at will. This may have implications for future recommendations. In fact, HHS Secretary Kennedy has already replaced all 17 members of the Advisory Committee on Immunization Practices.
A comprehensive summary of no-cost sharing preventive care services can be found here.