A federal appeals court on Friday ruled that the preventive care task force created under the 2010 health care law is unconstitutional, but stopped short of blocking access to preventive care for millions of Americans.

The New Orleans-based 5th U.S. Circuit Court of Appeals held that relief should be targeted to the plaintiffs in the case — a group of Texas businesses with religious objections to the preventive care requirements imposed after the law passed in 2010, which include covering the HIV preventative drug PrEP.

Other examples of such care include lung cancer screenings and medications to lower the risk of breast cancer.

“We have no reason to uphold relief broader than what is necessary to redress the plaintiffs’ injuries,” wrote judges Don Willett and Cory Wilson, Trump appointees, and Irma Carrillo Ramirez, a Biden appointee. 

The businesses argued that the United States Preventive Services Task Force — created to recommend preventive care that must be covered by insurers at with no patient cost-sharing — should not make binding decisions because they are not congressionally confirmed positions.

The 5th Circuit agreed, writing in a 43-page ruling that the task force’s “unreviewable power” makes its members  “principal officers of the United States who have not been validly appointed under Article II of the United States Constitution.”

The court also rejected Department of Health and Human Services Secretary Xavier Becerra’s efforts to “cure” those issues by ratifying the task force’s recommendations. “The Secretary does not have the statutory authority to either review, revise, or issue the preventive-care recommendations himself,” the court wrote.

The case has caused anxiety over the future of preventive services coverage. More than 100 million Americans receive services each year covered under the preventive services mandate, according to KFF, a health research organization.

The ruling Friday means access to preventive care will be safeguarded for millions of Americans, at least for now, said Laurie Sobel, an associate director for women’s health policy at KFF.

“Right now, only the plaintiffs are allowed to not provide coverage without cost-sharing,” Sobel said. “For everyone else, nothing has changed.”

But, she added, the case is likely to continue for a long time.

“We’re on a long road,” with the case potentially being appealed back to the Fifth Circuit and maybe eventually making it to the Supreme Court, she said. 

In March 2023, Judge Reed O’Connor of the U.S. District Court for the Northern District of Texas issued a nationwide injunction and invalidated the portions of the 2010 law that required insurers to cover preventive health care services at no cost to the patient.

But three months later, a judge in the 5th U.S. Circuit Court of Appeals agreed that a requirement for free coverage of preventive health care services should not be impacted as the lawsuit challenging mandatory coverage moved forward.

The 5th Circuit Court of Appeals wrote in its opinion Friday that there was “no basis for the universal injunction.”

“The district court erred in vacating all agency actions taken to enforce the preventive-care mandates, so we have no reason to uphold relief broader than what is necessary to redress the plaintiffs’ injuries,” the court wrote. “It was an abuse of discretion to enter universal injunctive relief after already providing complete relief to the plaintiffs.”  

The court also did not rule on similar advisory bodies — the Advisory Committee on Immunization Practices and the Health Resources and Services Administration — but sent the issue back to O’Connor, stating that “if left unconsidered, could lead to an incorrect result with respect to the plaintiffs’ unconstitutional challenges.”

O’Connor had rejected the plaintiffs’ challenges to ACIP and HRSA. The appeals court declined to take up that issue, saying it was “disinclined to decide questions without sufficient briefing, particularly ones of high stakes and of constitutional import.”

“Rather than decide these heady questions ourselves without the benefit of any considered judgment below or any meaningful response from the Government on appeal, we think it prudent for the district court to consider these arguments,” the court wrote.

The case is Braidwood Management Inc. v. Becerra.