Kennedy v. Braidwood Management, Inc.: Understanding the Latest Challenge to the ACA

On June 27, 2025, the Supreme Court overturned the lower court ruling in Kennedy v. Braidwood Management, Inc.  in a 6–3 decision, in effect upholding the Affordable Care Act’s (ACA’s) preventive care mandate and protecting continued access to no-cost preventive care services. The Braidwood Management, Inc. case is just one in a long line of legal challenges aimed at dismantling the ACA. Over the past 15 years, the ACA has faced multiple high-profile cases and will likely face more challenges in the coming years. 

Braidwood Decision: 

In Justice Kavanaugh’s majority opinion, the Supreme Court held that members of the U.S. Preventive Services Task Force (USPSTF) are inferior officers under the Constitution’s Appointments Clause, meaning they can be appointed by the Secretary of Health and Human Services and are not required to be appointed by the President and confirmed by the Senate. This decision allows the Task Force to continue identifying critical preventative services.  

Insurance companies are required to cover any services that receive an A or B rating from the U.S. Preventive Services Task Force, with no cost-sharing for patients. Some examples of those services include: 

• • Screenings to detect lung, breast, cervical, and colorectal cancer;  

• • Risk-reducing medications for women at high risk of breast cancer;  

• • Nicotine patches for adults trying to quit smoking;  

• • Statin medications to reduce the risk of heart disease and stroke;  

• • Physical therapy to help the elderly avoid falls; and  

• • Diabetes screenings. 

Previous Challenges to the ACA 

While Braidwood was the first case directly questioning the constitutionality of the USPSTF, it is certainly not the first challenge to the ACA. Since its enactment in 2010, the ACA has faced and largely survived multiple challenges heard by the Supreme Court.   

• • National Federation of Independent Business (NFIB) v. Sebelius (2012)  was the first major ACA challenge heard by the Supreme Court. This case addressed whether Congress could require individuals to purchase health insurance and whether it could compel states to expand Medicaid by threatening to withhold existing federal funding. The Court upheld  the individual mandate, but ruled that states could not be required to adopt Medicaid expansion. The One Big Beautiful Bill Act most recently enacted additional significant changes aimed at the Medicaid expansion population. 

• • Burwell v. Hobby Lobby (2014) challenged the requirement that companies provide contraceptive coverage to their employees; the plaintiff argued that this requirement violated its religious rights under the Religious Freedom Restoration Act of 1993. The Court found for the plaintiff, holding that closely held for-profit corporations could opt out of this part of the ACA based on religious objections. The outcome of this case shed new light on religious exemptions, expanding the scope of freedom of religion protections to certain private corporations. 

• • Maine Community Health Options v. United States (2020) challenged a less prominent component of the ACA: reimbursement under the Risk Corridors program, a financial mechanism created to stabilize commercial insurance markets. Congress sought to withhold funding for the Risk Corridors program, but the ruling in this case reaffirmed the ACA’s statutory authority.