Kennedy v. Braidwood Management, Inc.
The Affordable Care Act (ACA), passed in 2010, requires private insurers to include preventive care and treatments without cost sharing, which involves the out-of-pocket fees such as deductibles. The preventive care methods in this list are graded as either A or B by 3 agencies within the Department of Health and Human Services (HHS), and these are the US Preventive Services Task Force (USPSTF), the Advisory Committee in Immunization Practices (ACIF), and the Health Resources and Services Administrations (HRSA). Within the list of preventive treatments are a variety of cancer screenings and statins, as well as contraceptives, emergency contraceptives, and HIV prevention drugs. Pre-exposure prophylaxis (PrEP) is medication designed to help prevent HIV infections in those at risk, and is included in the list of preventive measures.
These requirements are now being challenged in Kennedy v. Braidwood Management, Inc. due to the belief of Braidwood Management along with a few other individuals that the recommendations violate the Religious Freedom Restoration Act (RFRA). RFRA, passed in 1993, prevents one’s free exercise from being substantially burdened even by generally applicable policies unless the government can prove both that there is a compelling state interest involved and that the law is the least restrictive means of accomplishing it. The plaintiffs, Christian-owned businesses in this case, have stated that the mandatory coverage for certain preventive services makes them “complicit in facilitating homosexual behavior, drug use, and sexual activity outside of marriage between one man and one woman.” They have cited both economic harm for unwanted yet enforced health plans, as well as religious harm for being forced to include services they believe combat their religious beliefs.
In 2022, the District Court decided that the preventive services requirement did in fact violate RFRA, and also appointing members to the USPSTF violated the Appointments Clause of the Constitution. The Appointments Clause requires all officers of the state to be appointed by the president with the consent of the Senate, yet is not entirely clear on who all falls under that category or how much authority they must have in order to be considered an officer. Judge O’Connor cited Hobby Lobby in his argument that since “the government did not show that it could not simply provide PrEP to those unable to obtain it from a plan due to an employer’s religious objection…it is not the least restrictive means of reducing the spread of HIV.” The 5th Circuit Court of Appeals decided in 2024 that the decisions in this case only applied to the plaintiffs and was not a “nationwide remedy.”
The Supreme Court has actually decided to narrow its focus on this case to whether or not the structure of the USPSTF violates the Appointments Clause since members are not appointed by the president, and will not be examining whether or not the ACA violates the First Amendment.
There are some precedents playing into how this case will be determined, one of which is Burwell v. Hobby Lobby Stores, Inc. That case determined RFRA prevented the HHS from requiring closely held corporations provide coverage for contraceptives that contradict their owners’ beliefs. It also set the standard for closely held corporations to be classified as persons, as RFRA was originally written to apply to persons.
This case shows an overlap between the authority of government agencies, the right to free exercise of religion, and issues regarding public health. There is a compelling state interest in providing access to many health services, as well as preventing the spread of infectious diseases. Challenging the ACA leads to a genuine concern on the impact to cancer treatment as well as preventive treatments for HIV. It can also lead to questioning who has the authority to determine what takes top priority and will be legally enforced, and what means may they take in order to impose such regulations.
The plaintiffs are only arguing against the treatments that directly violate their religious beliefs, so while there is risk of a slippery slope to further requests, it is not enough to negate the exemptions they are looking for. The government has not proven that the requirements within the ACA for private insurers are the only way to ensure people have access to treatment, nor has it clarified how the USPSTF has the constitutional authority to implement such regulations; therefore, the Supreme Court should follow the precedent set by Hobby Lobby and side with the plaintiffs. While the government may have the “desire to promote public health and gender equality…the government has provided exceptions for churches, non-profit religious organizations… and businesses that employ 50 people or fewer.” The right to free exercise allows exemptions in policies where possible, even if alternatives still need to be found.
Sources:
https://www.oyez.org/cases/2024/24-316
https://fedsoc.org/events/courthouse-steps-oral-argument-kennedy-v-braidwood-management-inc
https://www.ca5.uscourts.gov/opinions/pub/23/23-10326-CV0.pdf
https://ncdoj.gov/wp-content/uploads/2025/02/Kennedy-v.-Braidwood-Mgmt.-IL-Merits-Amicus-PDF-A.pdf
https://firstamendment.mtsu.edu/article/burwell-v-hobby-lobby-stores-inc/
https://www.congress.gov/bill/103rd-congress/house-bill/1308
https://constitution.congress.gov/browse/essay/artII-S2-C2-3-1/ALDE_00013092/
https://firstamendment.mtsu.edu/article/burwell-v-hobby-lobby-stores-inc/
https://www.law.cornell.edu/wex/closely_held_corporation
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