Washington – The defenders of public health won a big case before the Supreme Court on the last day of this year’s mandate, but the victory came with an asterisk.
The decision ended a threat to preventive services, without cost – of cancer and diabetes screening for statins and vaccines – used by more than 150 million Americans who have health insurance.
But that did so by empowering the first vaccine of the nation: the secretary of health and social services Robert F. Kennedy Jr.
Losing would have been “a terrible result,” said Washington lawyer Andrew Pincus. Insurers would have been free to stop paying medication, projections and other services that have proven to be effective in saving lives and money.
But winning means that “the secretary has the power to put aside” the recommendations of medical experts and to suppress approved drugs, he said. “His actions will be submitted to the exam in court,” he added.
The new legal fight has already started.
Last month, Kennedy cited a “public confidence crisis” when he withdrew the 17 members of a separate vaccination advisory committee. Its replacements included vaccine skeptics.
Vaccines recommended by this committee are included as preventive services that insurers must provide.
On Monday, the American Academy of Pediatrics and other medical groups continued Kennedy for withdrawing the COVVI-19 vaccine as a recommended vaccination for pregnant women and healthy children. The trial called this an “arbitrary” and “baseless” decision which violates the law on administrative procedure.
“We take legal action because we think children deserve better,” said Dr. Susan J. Kressly, president of the Academy. “It was not only the touch of science. It is an attack on the very foundation of the way we protect families and children’s health. ”
Kennedy postponed a planned meeting on the US preventive services which was at the center of the case on Wednesday.
“Obviously, many projections related to chronic diseases could face changes,” said Richard Hughes IV, lawyer and Washington law professor. “A large concern is the coverage of HIV preparation”, a preventive drug that was challenged in the Texas trial which came to the Supreme Court.
From a measure, the 6-3 decision of the Supreme Court was a rare victory for the Liberals. The judges canceled a decision by the Judges of Texas who would have canceled the popular benefit which came with Obamacare. The 2012 law forced insurers to provide preventive services that have been approved as very effective.
But conservative criticism had spotted what they saw a defect in the affordable care law. They noted that the working group of unpaid medical experts who recommend the best and profitable preventive care has been described in law as “independent”.
This word was sufficient to lead the five -year legal battle.
Steven Hotze, a Texas employer, had continued in 2020 and said that he had opposed religious reasons for the supply of HIV drugs, even if none of his employees consumed these drugs.
The trial brought before the American district judge Reed O’Connor to Fort Worth, who in 2018 had canceled Obamacare as unconstitutional. In 2022, he reigned for the Texas employer and canceled the preventive services required on the grounds that the members of the working group on American preventive services made legally binding decisions even if they had not been appointed by the president and confirmed by the Senate.
The 5th short circuit suspended its decision, but confirmed its decision according to which the work of the working group on the preventive services was unconstitutional because its members were “free from any supervision” by the president.
Last year, the Biden administration asked the Supreme Court to hear the case of Xavier Becerra against Braidwood Management. The appeal said that Texas’ decision “ends the health protections that have been in place for 14 years and that millions of Americans are currently enjoying.”
The court agreed to hear the case and, at the time of the oral argument in April, the Trump administration had a new secretary in HHS. The case was now Robert F. Kennedy Jr. against Braidwood Management.
The six conservatives of the Court believe that the Constitution gives the President the executive power to control the government and to put its officials in charge. But they separated on what it meant in this case.
The Constitution indicates that the president can appoint ambassadors, judges and “all other officers in the United States” with the approval of the Senate. In addition, “the congress may, by law, refer the appointment of these lower officers” in the hands of the president or “the heads of department”.
Option two made more sense, said Brett judge Mr. Kavanaugh. He spoke for the Court, notably the chief judge John G. Roberts and judge Amy CONEY BARRETT, and the three liberal judges of the Court.
“The executive power of President Trump and President Biden argued that the members of the working group of preventive services are lower officers and can therefore be appointed by the secretary of HHS. We agree,” he wrote.
This “preserves the political responsibility chain. … The members of the working group are removable at will by the secretary of the HHS, and their recommendations are revisable by the secretary before taking effect. ”
The decision was a clear victory for Kennedy and the Trump administration. He said that medical experts are not “independent” and can be easily replaced by RFK Jr.
He did not win the three judges on the right. Judge Clarence Thomas wrote a 37 -page dissent.
“Under our constitution, the appointment by the president with confirmation of the Senate is the rule. The appointment by a head of department is an exception that the congress must consciously choose to adopt,” he said, joined by judges Samuel A. Alito and Neil Mr. Gorsuch.
