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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.


Columbus, Ohio Ordinance Prohibits Employers from Inquiries into an Applicant’s Salary History

Effective March 1, 2024, Columbus employers are prohibited from inquiring into an applicant’s salary history. Specifically, the ordinance provides that it is an unlawful discriminatory practice to:

The Ohio Chemical Dependency Professionals Board’s Latest Batch of Rules: What Providers Should Know

The Ohio Chemical Dependency Professionals Board has introduced new rules and amendments, covering various aspects such as CDCA certificate requirements, expanded services for LCDCs and CDCAs, remote supervision, and reciprocity application requirements. Notable changes include revised criteria for obtaining a CDCA certification, expanded services for LCDCs and CDCAs, and updated ethical obligations for licensees and certificate holders, including non-discrimination, confidentiality, and anti-sexual harassment measures.

Governor Mike DeWine and The Ohio State University Introduce the SOAR Study on Ohio Mental Illness

On January 19, Ohio Gov. Mike DeWine and The Ohio State University announced a new research initiative, the State of Ohio Adversity and Resilience (“SOAR”) study, which will investigate all factors influencing Ohio’s mental illness and addiction epidemic.

CHANGING TIDES: Summary and Effects of Burnett et. al. v. National Ass’n of Realtors, et. al.

In April 2019, a class-action Complaint was filed in federal court for the Western District Court for Missouri arguing that the traditional payment agreements employed by many across the United States amounted to conspiracy resulting in the artificial increase in brokerage commissions. Plaintiffs, a class-action group comprised of sellers, argued that they paid excessive brokerage commissions upon the sale of their home as a result of the customary payment structure where Sellers agree to pay the full commission on the sale of their property, with Seller’s agent notating the portion of commission they are willing to pay to a Buyer’s agent at closing on the MLS or other similar system.

The Ohio Board of Pharmacy’s Latest Batch of Rules: What Providers Should Know

The Ohio Board of Pharmacy released several new rules and proposed amendments to existing rules over the past month that will significantly impact pharmacy operations. Topics range from updates to the Terminal Distributor of Dangerous Drugs license to mobile clinics to mandatory rest breaks for pharmacists of outpatient pharmacies. A summary of the proposed changes is below, along with instructions for commenting on the rules. Your BMD healthcare attorney can help write comment letters and submit the comments on your behalf as well.