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July 4, 2025 13 mins

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Kennedy v. Braidwood Management, Inc.

In 1984, the Department of Health and Human Services (HHS) created the U. S. Preventive Services Task Force, a body that formulates evidence-based recommendations regarding preventive healthcare services. Congress codified the Task Force’s role in 1999, establishing it as an entity within the Agency for Healthcare Research and Quality (AHRQ) in HHS’s Public Health Service. The Task Force currently consists of 16 volunteer members appointed by the Secretary of HHS to staggered 4-year terms. Before 2010, Task Force recommendations were purely advisory. The Affordable Care Act of 2010 changed this by requiring most health insurers and group health plans to cover without cost sharing those preventive services that receive “A” or “B” ratings from the Task Force. The Act also amended the governing statute to describe the Task Force as “independent” and to provide that members and their recommendations “shall be independent and, to the extent practicable, not subject to political pressure.” 42 U. S. C. §§299b–4(a)(1), (6). Plaintiffs, individuals and small businesses who object to the Affordable Care Act’s preventive-services coverage requirements, sued in federal court. Lead plaintiff Braidwood Management runs a health and wellness center offering insurance coverage to its approximately 70 employees through a self-insured plan. Plaintiffs argued that Task Force members are principal officers under the Appointments Clause who must be appointed by the President “with the Advice and Consent of the Senate,” Art. II, §2, cl. 2, not by the Secretary. The District Court agreed, recognizing that Task Force members are removable at will by the Secretary but concluding they are principal officers because they “have no superior” who supervises and directs them. 627 F. Supp. 3d 624, 646. While the Government’s appeal was pending, the Secretary in June 2023 ratified existing appointments made by the AHRQ Director and began personally appointing Task Force members. The Fifth Circuit affirmed the District Court, holding that while Task Force members are removable at will, they are not inferior officers because they cannot be “ ‘independent’ ” and “free from ‘political pressure’ ” while simultaneously being supervised by a political appointee. 

 Held: Task Force members are inferior officers whose appointment by the Secretary of HHS is consistent with the Appointments Clause. 

Read by RJ Dieken. 

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