Federal Appeals Court Declares Obamacare Preventive Care Mandate Unconstitutional


A federal appeals court has declared an Affordable Care Act (ACA) mandate requiring insurers to cover certain preventive services unconstitutional, but has not blocked the requirement. The decision focuses on the appointment process of the task force responsible for these mandates.

Why It Matters

This ruling underscores the importance of ensuring that federal mandates and regulations are created and enforced by constitutionally appointed officials, protecting the rule of law and individual freedoms.

Who It Impacts

The ruling primarily affects businesses and insurers, particularly those challenging the ACA mandates on religious and constitutional grounds.

In a significant legal decision, the U.S. Court of Appeals for the Fifth Circuit has ruled that a key mandate of the Affordable Care Act (ACA), requiring insurers to cover preventive services, is unconstitutional. The decision, issued on June 21, revolves around the appointment process of the United States Preventive Services Task Force, which is responsible for determining the preventive services insurers must cover.

The ACA, often referred to as Obamacare, mandates that insurers cover “preventative care” but does not clearly define what this entails. Instead, it relies on the ratings provided by the United States Preventive Services Task Force. This task force, which operates independently and without presidential appointment or Senate confirmation, has significant authority in issuing legally binding recommendations.

U.S. Circuit Judge Don Willett, writing for the court, stated, “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.” The court found this lack of presidential oversight unconstitutional, affecting the legality of the task force’s mandates.

Health Secretary Xavier Becerra attempted to address these constitutional concerns by retroactively approving the task force’s recommendations. However, the court found this effort inadequate, noting that the ACA does not permit the Health Secretary to review or amend the task force’s ratings. Gene Hamilton, representing America First Legal and the Christian businesses challenging the mandate, hailed the decision as a victory for constitutional governance and individual freedoms.

The court’s ruling only applies to the businesses involved in the lawsuit, potentially setting the stage for a broader legal battle that could impact the mandate’s application nationwide. Judges Cory Wilson and Irma Carrillo Ramirez joined Judge Willett in the unanimous decision, highlighting the judicial consensus on the constitutional issues at play.

The lawsuit initially gained traction when the United States Preventive Services Task Force gave an A rating to drugs preventing HIV transmission in 2019. This recommendation sparked a lawsuit from Christian business owners, including Braidwood Management, who argued that the mandate violated their religious beliefs by forcing them to cover services they morally opposed.

U.S. District Judge Reed O’Connor previously ruled in favor of the plaintiffs, stating that the mandated coverage violated their religious freedom rights. His decision to block the mandate nationwide was partially overturned by the appeals court, which argued that such broad relief was not justified under the circumstances.

The ruling does not affect other preventive service mandates under the ACA, such as vaccines recommended by the CDC’s Advisory Committee on Immunization Practices and services endorsed by the U.S. Health Resources and Services Administration (HRSA). Judge O’Connor upheld these mandates, noting they involved proper governmental oversight.

However, the appeals court indicated potential constitutional issues with these mandates as well, remanding the matter to Judge O’Connor for further consideration. This ongoing legal scrutiny highlights the complex interplay between healthcare policy and constitutional law.

The ruling emphasizes the importance of adhering to constitutional processes in the appointment and oversight of federal bodies. Ensuring that mandates and regulations are enacted by properly appointed officials is crucial in maintaining the integrity of the law and protecting individual rights.