A federal appeals court ruled that a mandate under the Affordable Care Act is unconstitutional, but it decided not to halt the requirement.
On June 21, a panel from the U.S. Court of Appeals for the Fifth Circuit decided that the mandate requiring insurers to cover preventive services like cancer screenings and HIV prevention drugs is unconstitutional.
They argued that because the task force issuing these requirements wasn’t appointed by the president or confirmed by the Senate, the mandate lacks constitutional validity.
The Affordable Care Act, often referred to as Obamacare, mandates coverage for “preventive care” without specifying its definition. Instead, it requires coverage of preventive services and drugs that are rated A or B by the United States Preventive Services Task Force.
Members of the task force wield power akin to that of presidentially appointed officers but are not appointed by presidents. The task force is completely independent, issuing legally binding ratings without supervision, the panel found.
“The unreviewable power it wields—the power to issue preventive-care recommendations that insurers must cover by law—renders its members principal officers of the United States who have not been validly appointed under Article II of the United States Constitution,” U.S. Circuit Judge Don Willett wrote.
Health Secretary Xavier Becerra tried to resolve the constitutional issues by issuing a retrospective validation of the task force’s ratings. However, the memorandum has several flaws, and the new ruling states that the Affordable Care Act does not grant authority to the health secretary to review or amend the ratings.
Gene Hamilton, an attorney with America First Legal representing Christian businesses that sued over the law, said in a statement that the ruling “is a victory for the Constitution, the rule of law, and every American who does not want unelected bureaucrats making decisions about their healthcare coverage.”
The ruling only blocks the mandate for businesses that brought a lawsuit over the required coverage, although the case could ultimately lead to the coverage being struck down for all.
Judge Willett was joined in the unanimous decision by U.S. Circuit Judges Cory Wilson and Irma Carrillo Ramirez.
In 2019, the United States Preventive Services Task Force assigned an A rating to drugs that prevent HIV transmission. This decision prompted a lawsuit from Christian business owners and companies like Braidwood Management.
The plaintiffs argued that being mandated to cover these drugs violated their beliefs by “making them complicit in facilitating homosexual behavior, drug use, and sexual activity outside of marriage between one man and one woman.”
U.S. District Judge Reed O’Connor ruled in 2023 that the mandated coverage from the task force violated the religious freedom rights of the businesses. He blocked coverage recommended by the task force since the Affordable Care Act was enacted, not only for the plaintiffs but also nationwide.
The appeals court, which had earlier halted that decision, ruled on Friday that the judge should not have issued a nationwide injunction because the case does not fit within the specific categories the circuit has recognized as suitable for such extensive relief.
The ruling does not affect other healthcare coverage required under Obamacare, such as vaccines recommended by the U.S. Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices and services recommended by the U.S. Health Resources and Services Administration.
Judge O’Connor found those requirements valid, as the committee’s recommendations need to be accepted by the CDC, and the HRSA is a government agency under the supervision of the Department of Health and Human Services.
The appeals court judges, though, were unsure, noting plaintiffs had put forth “compelling and essentially unrebutted arguments” that indicate those recommendations may also suffer from constitutional problems.
The judges declined to rule on the matter, instead directing Judge O’Connor to consider them.
Share your thoughts by scrolling down to leave a comment.
