Last week, the U.S. Supreme Court issued decisions in two cases that affect important health care rights, and in which the Center for Medicare Advocacy participated as an amicus party.
In Kennedy v. Braidwood, the Court upheld the Affordable Care Act’s requirement that insurers cover preventive health care services recommended by the U.S. Preventive Services Task Force without any cost to patients. The Task Force, a panel of experts housed within the Department of Health and Human Services, has recommended coverage for many critical services, such as cancer and diabetes screening. As explained in the amicus brief joined by CMA, the preventive care coverage requirement promotes both individual and systemwide health by helping Americans avoid chronic disease.
In Braidwood, employers with religious objections wanted to offer health insurance that excludes coverage for certain preventive services, including for pre-exposure prophylaxis medicines (PrEP), that are highly effective at preventing HIV. The employers claimed that the members of the Task Force were unconstitutionally appointed. The Supreme Court rejected that argument. It found that the Secretary of Health and Human Services has “significant control” over the Task Force, including the ability to remove and replace its members, and to disregard its recommendations. This makes Task Force members “inferior officers,” who do not have to be appointed by the President and confirmed by the Senate.
CMA is pleased with the result of Braidwood while mindful of the continuing threat to preventive services that remain from actions that could politicize, weaken, or override evidence-based standards for essential health care.
In Medina v. Planned Parenthood South Atlantic, the Court made it significantly harder for individuals to enforce important rights under federal law, including essential health care protections. The Court held that beneficiaries do not have the right to challenge a state’s decision to exclude providers from its Medicaid program, even if the exclusion may be unlawful.
Much of the media coverage has focused on the Court effectively greenlighting states’ exclusion of Planned Parenthood as a Medicaid provider for general health care services like annual check-ups and cancer screenings (Medicaid funding for abortion care was already prohibited.) But the decision has potentially wider ramifications.
The Court ruled that Medicaid’s “free choice of provider” provision does not create an individual right that beneficiaries can enforce under Section 1983, a statute that allows people to sue state actors for violating their federal rights. CMA was proud to join an amicus brief in Medina, underscoring that Congress did intend for the “free choice of provider,” and other protections, to be individually enforceable. Unfortunately, the Court rejected this argument.
CMA is concerned that Medina jeopardizes the ability of individuals, especially those most vulnerable, to protect rights that Congress clearly intended to guarantee, such as the right to their free choice of provider and other vital health care protections. The Medina decision also appears inconsistent with the Court’s reasoning just two Terms ago in Health and Hospital Corporation of Marion County v. Talevski, which upheld individuals’ ability to bring suit to protect rights under federal programs such as Medicaid.
CMA will continue to work for meaningful enforcement of health care rights and to ensure that these critical protections do not become hollow promises.
July 3, 2025 – A. Bers