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Supreme Court Upholds Coverage under the Affordable Care Act

Client Alert

On June 27, 2025, the U.S. Supreme Court issued a landmark decision upholding the authority of the U.S. Preventive Services Task Force (USPSTF) to make determinations about preventive services coverage mandated by the Affordable Care Act (ACA). The ACA mandates that group health plans and health insurance issuers provide coverage for over 100 preventive health services without cost-sharing.

Following the Supreme Court’s ruling, the USPSTF can continue issuing recommendations for services that must be covered by health insurers without cost-sharing.

In Kennedy v. Braidwood Mgmt. Inc., No. 24–316. (S.C. 2025), Braidwood Management (and others) argued that the USPSTF’s requirement to cover an HIV prevention medication violated its religious freedoms.

In its ruling, the Supreme Court reversed a Fifth Circuit decision that had found the delegation of authority to the USPSTF violated the Appointments Clause. The Supreme Court reasoned that USPSTF members are “inferior officers” of the Department of Health and Human Services (HHS) Secretary instead of “principal officers”, despite their independence in the Affordable Care Act context.

As a result, the USPSTF can continue to recommend coverage for preventive services using a grading system. Per the ACA, for covered services with an 'A' or 'B' rating, health plans and insurance issuers offering group or individual insurance coverage “shall, at a minimum, provide coverage for and not impose any cost sharing requirements” for the “evidence-based items or services that have in effect a rating of ‘A’ or ‘B’ in the current recommendations” of the USPSTF. Covered services with an 'A' or 'B' rating include certain cancer screenings, risk-reducing breast cancer medications, statin medications reducing the risk of heart disease and stroke, and physical therapy to help the elderly avoid falls.

The practical coverage provisions of the ACA remain in effect, meaning over 150 million Americans can continue to access a wide range of preventive health care services each year at no cost to them. For providers, this ruling maintains the status quo, ensuring providers can continue to provide screenings and resulting treatment paid for by insurance without having to chase patients for cost sharing amounts.  

The case is Kennedy v. Braidwood Mgmt. Inc., No. 24–316. (S.C. 2025).

To learn more about this ruling and the ACA’s coverage of preventive services, please contact BMD Healthcare Member Daphne Kackloudis at dlkackloudis@bmdllc.com or Attorney Jordan Burdick at jaburdick@bmdllc.com.


Planning for Wealth: Lessons from Athletes, Entertainers, and Executives

The financial challenges and strategies used by high-income earners like Donovan Mitchell, Taylor Swift, and Jamie Dimon are not just for the wealthy—they can apply to anyone managing significant assets. This article delves into essential wealth management techniques, from leveraging tax exemptions to navigating major liquidity events, providing valuable insights to help you achieve financial stability and preserve your wealth.

The Ohio Department of Medicaid Amends Fraud, Waste, and Abuse Rules

Ohio Department of Medicaid has updated definitions of fraud, waste, and abuse as well as given specificity and clarity to the list of examples.

Ohio Department of Medicaid Proposes Changes to Dental Reimbursement and Coverage Rule

The Ohio Department of Medicaid is proposing amendments to Ohio Administrative Code. There will be a hearing on the proposed rule changes August 12, 2024.

Will Division II and III Athletic Programs Survive the New Era of College Athletics?

The potential reclassification of student-athletes as employees presents major financial challenges for Division II and III sports programs, which may struggle to afford the costs and could be forced to cut or eliminate non-revenue-generating sports. Recent legal rulings, including the Alston case and Johnson v. NCAA, have challenged the NCAA's amateurism model and prompted a need for innovative solutions to sustain these programs.

Corporate Transparency Act: Business Owners Must Act Now

The Corporate Transparency Act requires all reporting companies to file their Beneficial Ownership Information (BOI) report by year-end to avoid penalties. Companies formed before January 1, 2024, have less than six months to comply. Learn more in a client alert by BMD Member Blake Gerney.