A federal appeals court ruled Friday that the Preventive Care Task Force established under the 2010 health care law is unconstitutional, but stopped short of blocking 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 suit, a group of Texas businesses that have religious objections to preventive health care requirements imposed after passage of a 2010 law that includes coverage for the HIV-prevention drug PrEP.
Other examples of this care include lung cancer screening and medications to lower the risk of breast cancer.
“There is no reason to support relief that goes beyond what is necessary to compensate plaintiffs for their injuries,” wrote Judges Don Willett and Corey Wilson, both appointees of President Trump, and Judge Irma Carrillo Ramirez, a Biden appointee.
The companies argued that the U.S. Preventive Services Task Force, which was created to recommend preventive care that insurers must cover at no out-of-pocket cost to patients, should not make binding decisions because that is not a congressionally authorized position.
The Fifth Circuit Court of Appeals agreed. 43-page ruling The Task Force’s “unreviewable authority” makes its members “principal officers of the United States not validly appointed under Article II of the United States Constitution.”
The court also rejected efforts by Health and Human Services Secretary Xavier Becerra to “solve” these problems by approving the task force’s recommendations. “The Secretary has no statutory authority to review, revise, or issue preventive health care recommendations on his own,” the court wrote.
The case raises concerns about the future of preventive care services, which more than 100 million Americans receive services covered by the mandate each year, according to the health research organization KFF.
Laurie Sobel, deputy director of women’s health policy at KFF, said Friday’s ruling means that, at least for now, millions of Americans will have protected access to preventive health care.
“Right now, only plaintiffs are allowed to not provide insurance without cost sharing,” Sobel said. “For everyone else, nothing has changed.”
But the case is likely to continue for a long time, she added.
“We have a long way to go,” she said. The case could be appealed to the 5th Circuit Court of Appeals and ultimately all the way to the Supreme Court.
In March 2023, Judge Reed O’Connor of the U.S. District Court for the Northern District of Texas issued a nationwide injunction invalidating parts of a 2010 law that required insurers to provide preventive health services at no cost to patients.
But three months later, judges on the 5th Circuit Court of Appeals agreed that the requirement to provide free coverage for preventive health services would not be affected if a lawsuit challenging the mandatory enrollment proceeded.
“There is no basis for a blanket injunction,” the 5th Circuit Court of Appeals said in a ruling Friday.
“Because the district court erred in invalidating all agency actions taken to enforce the preventive care mandate, there is no reason to uphold relief in excess of that necessary to compensate plaintiffs,” the court wrote. “It would be an abuse of discretion to seek blanket injunctive relief after already granting plaintiffs complete relief.”
The court also did not rule on similar advisory bodies, the Advisory Committee on Immunization Practices and the Health Resources and Services Administration, saying that “if left unconsidered, could lead to an erroneous result with respect to plaintiffs’ constitutional claims,” and remanded the matter back to Judge O’Connor.
Judge O’Connor dismissed the plaintiffs’ challenges to ACIP and HRSA. The appeals court declined to take up the issue, stating that it “will not decide questions of particular importance or constitutional significance without full explanation.”
“We believe it prudent for the district court to consider these arguments rather than decide these difficult issues for itself, without a considered decision in the lower court or meaningful responses from the government on appeal,” the court wrote.
The case is Braidwood Management Inc. v. Becerra.
