Supreme Court Issues Preventive Care Decision

July 9, 2025

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On June 27, the Supreme Court upheld Affordable Care Act (ACA) requirements for insurance coverage of preventive services recommended by the US Preventive Services Task Force (USPSTF), reversing the lower court’s decision. In a 6-to-3 decision written by Justice Brett Kavanaugh, the majority ruled that the appointment structure of the USPSTF, a panel of experts that recommends preventive health measures that, under the ACA, insurance companies must cover without cost-sharing, is constitutional.

The Court concluded that the USPSTF’s structure makes clear its members are inferior officers, whose appointments (and potential removal) by the Department of Health and Human Services (HHS) Secretary are consistent with the US Constitution’s Appointments Clause.

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June 19, 2026

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legislation

Bicameral Patients before Monopolies Act reintroduced

On May 13, bipartisan lawmakers in the House and Senate reintroduced the Patients Before Monopolies (PBM) Act (S.4509/H.R.8779), legislation that would prohibit common ownership of PBMs, insurers, and pharmacies. Sponsored by Sens. Warren (D-MA) and Josh Hawley (R-MO) alongside Reps. Diana Harshbarger (R-TN) and Jake Auchincloss (D-MA), the bill would require impacted organizations to divest […]
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June 10, 2026

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legislation

CMS announces ePA acceleration initiative, democrats seek to repeal WISeR Model

The Centers for Medicare & Medicaid Services (CMS) is advancing its electronic prior authorization (ePA) efforts through a newly established Electronic Prior Authorization Acceleration initiative to address key challenges and drive solutions ahead of 2027 requirements. To date, 29 health care organizations – including health systems, electronic health record developers, physician practices, networks, and digital health […]
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June 10, 2026

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