In a 6–3 decision, the US Supreme Court ruled in Kennedy v Braidwood Management, Inc to uphold the constitutionality of the Affordable Care Act (ACA) provision mandating that insurers cover certain preventive services without cost sharing.¹ The ruling reaffirms the authority of the US Preventive Services Task Force (USPSTF), the Advisory Committee on Immunization Practices (ACIP), and the Health Resources and Services Administration (HRSA) in determining the scope of covered services.1
The case stemmed from a lawsuit brought by four individuals and two Christian-owned businesses in Texas, who objected to providing insurance that covers services such as HIV prevention medication (PrEP), the HPV vaccine, and contraceptives. The plaintiffs argued that the mandate violated their religious beliefs and that the USPSTF’s volunteer-led structure breached the Constitution’s Appointments Clause.²
The US Court of Appeals for the Fifth Circuit previously held that the USPSTF’s structure was unconstitutional and restricted the federal government from enforcing its recommendations. The Supreme Court reversed that ruling, reinstating the ACA’s full preventive services requirement.²
What You Need To Know
The Supreme Court upheld the ACA’s requirement that insurers cover preventive services without cost sharing, affirming the authority of USPSTF, ACIP, and HRSA.
The ruling ensures continued access to preventive care like HIV prevention, cancer screenings, and immunizations despite challenges based on religious and constitutional grounds.
Carl Schmid highlighted that the decision protects affordable access to HIV prevention and urged collective efforts to maintain coverage for all preventive health services.
In response, Carl Schmid, executive director of the HIV+Hepatitis Policy Institute, issued a statement supporting the decision, stating, “This is a great victory for healthcare in our country and for everyone who believes in prevention... We are very pleased the Court upheld the coverage requirement.”¹
He emphasized the continuing need for oversight and compliance, particularly with the expansion of long-acting forms of HIV PrEP, and expressed concern about proposed federal budget cuts to CDC prevention programs.¹
The HIV+Hepatitis Policy Institute, along with 19 other public health organizations, filed an amicus brief supporting the federal government’s position. Their brief highlighted the public health significance of routine screenings and preventive medications, including their role in identifying infectious diseases and linking individuals to treatment.¹
The ACA, passed in 2010, delegates to USPSTF, ACIP, and HRSA the authority to define which services must be covered at no cost by private insurers. Since then, these bodies have recommended coverage for services such as PrEP (2019), the HPV vaccine (2007), and contraceptives (2011).²
The ruling ensures that insured individuals nationwide will continue to have access to preventive services such as HIV testing, cancer screenings, immunizations, and contraceptive care without cost-sharing requirements.
March 2025 Interview with Carl Schmid
In our interview, Schmid discussed the ongoing Supreme Court case Kennedy v Braidwood Management, which challenges the Affordable Care Act’s preventive services coverage requirement. Schmid emphasized the critical role this mandate plays in ensuring access to HIV prevention tools like PrEP, as well as testing for HIV and hepatitis, all at no cost to insured individuals.
Read the full interview: The Case for HIV Prevention and Screening: Pay Today or Pay Tomorrow
He explained that without this requirement, insurers might stop covering these services, especially newer, long-acting PrEP treatments that are expected to come to market soon. Schmid noted, “The beauty of the preventive services requirement from the Affordable Care Act is that they not only have to cover the drug… and then the second aspect of the law is that it has to be at no cost to the consumer.”
Schmid also highlighted the broader implications for public health, pointing out that these preventive services reduce long-term healthcare costs by preventing infections and linking people to care early. He urged a unified approach beyond just HIV prevention to maintain coverage for all preventive health services, emphasizing collaboration among advocacy groups.
References
1.Supreme Court upholds preventive services coverage requirements. June 27, 2025. Accessed June 27, 2025. https://hivhep.org/press-releases/supreme-court-upholds-preventive-services-coverage-requirements/
2.Kennedy v. Braidwood Management, Inc. (n.d.). Oyez. Retrieved June 27, 2025, from https://www.oyez.org/cases/2024/24-316
