Obamacare: 15 years after it became law, the Affordable Care Act (ACA), also called Obamacare, is once again facing a serious legal challenge. This time, a Supreme Court case could take away the free preventive health services that millions of Americans have come to rely on. Services like cancer screenings, blood pressure checks, and diabetes tests are currently covered with no cost to patients but that could change.
At the center of the case is the U.S. Preventive Services Task Force, a group of health experts who decide which services insurance plans should cover for free. The new lawsuit says this task force has too much power because its members were not confirmed by the Senate, as the Constitution’s Appointments Clause requires.
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Two businesses in Texas brought the case. They argue they should not be forced to cover certain preventive services they disagree with, such as HIV medication. They believe the way the task force was created is not legal.
Preventive care health benefits provided at no cost to tens of millions of Americans since 2010 under a popular provision of the Affordable Care Act are in the balance Monday at the Supreme Court. https://t.co/J4V8wHPV9f
— ABC News (@ABC) April 21, 2025
“If the Supreme Court sides with the plaintiffs, recommendations issued by the task force since 2010 might no longer require mandatory coverage by insurance companies.” That means insurers could choose to stop paying for services that are now free, or they could start charging patients for them.
Health experts
Health experts say this change could hurt millions. People might stop going to the doctor for regular checkups and tests because of cost. That would mean more health problems might go unnoticed until they become serious.
“Americans will notice if these benefits disappear,” said Katie Keith of Georgetown University’s Health Policy Center. “If individuals start getting billed for routine preventive visits, it could signal a rollback to pre-ACA times” ET reports.
Before Obamacare, many people did not get preventive care. “Federal data showed that preventive care was utilized at less than half the recommended rate, largely due to cost barriers.”
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The free services rule has made a big difference. More people now get tested for illnesses early, which can save lives and lower medical costs in the long run.
Legal History
The ACA has faced many legal battles since it became law in 2010 under President Barack Obama. In fact, it has been challenged over 2,000 times in court. This new case started in Texas, where the court has ruled against ACA policies before.
The Fifth Circuit Court of Appeals partly agreed with the challenge, but its ruling only applied to the people who filed the lawsuit. Now the big decision is in the hands of the Supreme Court.
Trump Administration
The Trump administration is defending this part of the ACA, even though they tried to strike it down in the past. Now, government lawyers are saying the final decisions about which preventive services are covered should come from the Secretary of Health and Human Services.
Right now, that role is held by Robert F. Kennedy Jr. The administration argues that he can approve, delay, or stop any decision made by the task force. That means, in their view, the task force doesn’t have full control.
But the challengers disagree. They say, “the task force operates independently by design and that the Secretary lacks sufficient supervisory control to satisfy constitutional requirements.” They also say that even if the Secretary has some control, it’s not enough to make the system legal.
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