Supreme Court Preserves Free Preventive Health Care in Kennedy v. Braidwood Management
On June 27, 2025, the U.S. Supreme Court issued a landmark ruling in Kennedy v. Braidwood Management, Inc., preserving a key part of the Affordable Care Act (ACA) that requires insurance companies to cover preventive health services — including HIV prevention medications like PrEP — at no cost to patients.
In a 6–3 majority opinion written by Justice Brett Kavanaugh, the Court upheld the legal authority of the U.S. Preventive Services Task Force (USPSTF) to continue making coverage recommendations. For LGBTQ+ Nebraskans and others who rely on access to cost-free screenings, medications, and checkups, the decision was a major win.
What Was at Stake in Kennedy v. Braidwood?
The plaintiffs in this case challenged the ACA provision that requires insurers to cover services recommended by the USPSTF. They claimed the Task Force’s members were appointed unconstitutionally — that because they were not nominated by the President or confirmed by the Senate, their recommendations could not be binding under the Appointments Clause of the Constitution.
If the Court had sided with the plaintiffs, insurers could have stopped covering dozens of preventive services, including:
PrEP (Pre-exposure prophylaxis for HIV prevention)
Cancer screenings
Mental health screenings
STI tests and other routine care
That would have drastically increased out-of-pocket costs for many patients — particularly LGBTQ+ people, individuals living with chronic conditions, and communities that already face systemic health care barriers.
What the Supreme Court Decided
The Court ruled that USPSTF members are “inferior officers” and can legally be appointed by the Secretary of Health and Human Services (HHS) — currently Robert F. Kennedy Jr. Because the Secretary has direct oversight, appointment, and removal authority over the Task Force, the Court found no constitutional violation.
As a result, the ACA’s requirement that insurers cover all USPSTF-recommended services graded “A” or “B” remains in effect. That includes:
PrEP for HIV prevention
Depression and anxiety screenings
Breast cancer mammograms
STI and cholesterol screenings
Statin therapy for certain adults
And importantly, all of this care must remain available at no cost to patients.
Why This Ruling Matters for the LGBTQ+ Community
This is more than a technical constitutional question. For many LGBTQ+ people, preventive health care is often shaped by discrimination, affordability issues, and access gaps. Tools like PrEP have dramatically reduced the risk of HIV — but only if people can afford and access them.
By preserving the ACA’s preventive services mandate, the Court’s ruling helps keep essential care free and accessible, especially for marginalized groups that already face higher health disparities.
As an LGBTQ+ attorney in Nebraska, I know this isn’t theoretical. I’ve worked with clients navigating denied coverage, provider discrimination, or uncertainty around health insurance benefits. This ruling affirms protections that directly support LGBTQ+ health and dignity.
What Comes Next: More Power for HHS, and More Scrutiny
One other important takeaway from the decision: the HHS Secretary now has greater authority to review and influence USPSTF recommendations. While that offers a layer of federal oversight, it also introduces the possibility of political interference in what has traditionally been a science-driven process.
For LGBTQ+ individuals and others who rely on sensitive or stigmatized services — like gender-affirming care, STI screening, or mental health treatment — we’ll need to keep a close eye on how future HHS leadership wields that influence.
Your Rights Under the ACA (as of now)
Thanks to this ruling, your right to no-cost preventive care under the ACA remains protected — including access to PrEP, cancer screenings, depression checks, and more.
If your insurer tries to deny you coverage for these services, or if you face barriers in accessing them, you have the right to challenge that denial and advocate for your care.
Frequently Asked Questions
Does my insurance still have to cover PrEP?
Yes. Under the ACA and following the Supreme Court’s decision in Kennedy v. Braidwood, private insurance plans must cover PrEP (pre-exposure prophylaxis) at no cost to patients if it is recommended by the USPSTF — which it is.
What is the U.S. Preventive Services Task Force (USPSTF)?
The USPSTF is an independent panel of health experts that reviews scientific evidence and issues recommendations on preventive services, such as screenings, medications, and counseling. Their “A” and “B” graded services are required to be covered by insurers under the ACA.
Can the HHS Secretary now change or block USPSTF recommendations?
Yes. The ruling clarified that the HHS Secretary has supervisory authority, which means they can review or block Task Force decisions. This adds a political dimension to what has historically been a scientific process.
What if I’ve been denied coverage for a preventive service?
You have the right to appeal insurance denials and demand compliance with ACA protections. If you’re unsure how to challenge a denial, or you’ve been denied PrEP or other preventive care, a Nebraska health care attorney can help you assert your rights.
Does this ruling apply nationwide?
Yes. The Supreme Court’s ruling applies across all states, including Nebraska. All insurers subject to the ACA must continue providing no-cost coverage for USPSTF-recommended services.