fb tracking

Braidwood Management Inc. v. Becerra

The Affordable Care Act (ACA) requires most insurance plans to cover certain preventive services without imposing cost-sharing, such as a copayment or deductible. Among the services subject to the cost-free coverage requirement are preventive-care measures that have been recommended by the U.S. Preventive Services Task Force, a body of volunteer experts. These measures include screenings that enable early detection and treatment of cancer and other life-threatening diseases, prenatal care measures that support healthy pregnancies, and medications that dramatically reduce the risk of contracting and transmitting HIV.

A group of individuals and businesses opposed to the ACA filed a lawsuit against the government in federal court in Texas, arguing among other things that the ACA’s incorporation of the Task Force’s recommendations was unconstitutional. Because these recommendations created legal duties under the ACA, the plaintiffs argued, the Task Force’s members were “officers of the United States” and so had to be either nominated by the President and confirmed by the Senate (which they had not been) or answerable to a constitutionally appointed officer (which, the plaintiffs argued, they were not). The district court agreed with the plaintiffs and held the ACA’s coverage requirement unconstitutional. Rather than remedying this supposed defect by allowing the Secretary of Health and Human Services—a constitutionally appointed officer—to ratify or override Task Force recommendations, the court eliminated the cost-free coverage requirement altogether for all services that received Task Force recommendations after the ACA’s March 23, 2010, enactment.

Public Citizen filed an amicus brief on appeal on behalf of itself and seven other nonprofit public-health organizations in support of the government’s motion asking the Court of Appeals to stay the district court’s ruling while the case is on appeal. The brief emphasizes that millions of Americans depend on the ACA’s guarantee of cost-free access to preventive care and argues that allowing the district court’s ruling to remain in effect during the appeal would cause irreparable harm to public health. The brief also explains that a vast body of research shows both that the preventive services subject to the district court’s ruling are effective in reducing serious illness and death and that even modest cost barriers decrease uptake of these services, particularly among economically vulnerable communities. As against the harms that will flow from the district court’s ruling, we argue, staying the ruling pending appeal will inflict no harm on either the plaintiffs or the public at large.

On May 15, 2023, the court of appeals issued an “administrative stay” of the district court’s decision, putting it on hold with respect to everyone other than the six plaintiffs but not making a definitive decision as to whether the stay would remain in place throughout the appeal. Therefore, the ACA’s requirements – including cost-free coverage of preventive care in accordance with the Task Force’s recommendations – remain in place for now.

Briefing of the merits of the appeal is now underway.