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Braidwood Management Inc. v. Becerra: Is There a Violation of the Article II Appointments Clause?

Published online by Cambridge University Press:  30 December 2024

Gregory Curfman  and
Marcia M. Boumil
Gregory Curfman*
Affiliation:
JAMA Executive Editor, Solomon Center for Health Law & Policy, Yale Law School, Harvard Medical School
Marcia M. Boumil
Affiliation:
Tufts University School of Medicine
*
Corresponding author: Gregory Curfman; Email: [email protected]
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Abstract

Since 1984, the U.S. Preventive Services Task Force (USPSTF) has issued recommendations to the public regarding preventive health services. The recommendations have substantially benefited public health. With the passage of the Affordable Care Act in 2010, recommendations assigned the highest ratings (A and B) must be covered by most private health insurers without consumer cost-sharing. This statutory requirement has been challenged in Braidwood Management Inc. v. Becerra, a case centered on the plaintiffs’ argument that USPSTF members are officers of the United States but were not appointed in accordance with the Appointments Clause of the Constitution. The Appointments Clause requires that principal officers of the United States must be appointed by the President and confirmed by the Senate. This article contends that members of the USPSTF are not principal officers of the United States, but instead serve as advisors to Congress in making preventive health recommendations. Congress established the coverage policy, not the USPSTF members. On this basis, the defendants should prevail in the case, but if they do not, the court should apply severability to permit the Secretary of Health and Human Services to directly oversee the USPSTF in the assignment of ratings for preventive health recommendations. The important work of the USPSTF should not be abridged.

Keywords

Preventive MedicineU.S. Preventive Services Task ForceAffordable Care ActAppointments ClauseOfficers of the U.SSeverability
Type
Articles
Information
American Journal of Law & Medicine , Volume 50 , Issue 1-2 , July 2024 , pp. 11 - 23
Copyright
© 2024 The author(s). Published by Cambridge University Press on behalf of American Society of Law, Medicine & Ethics and Trustees of Boston University

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References

1 See Braidwood Mgmt. v. Becerra, 666 F. Supp. 3d 613 (N.D. Tex. 2023).

2 See id. at 617-18.

3 Id. at 618-20.

4 Id. at 620.

5 See Braidwood Mgmt. v. Becerra, 627 F. Supp. 3d 624, 639 (N.D. Tex. 2022).

6 See Brief for Defendant in Support of Response to Plaintiff’s Motion for Summary Judgment & Cross-Motion for Summary Judgment at 39-45, Braidwood Mgmt., 666 F. Supp. 3d 613 (No. 4:20-cv-00283-O), ECF No. 64 (arguing that members of the USPSTF are not “officers” for purposes of the Appointments Clause).

7 See About the USPSTF, U.S. Preventive Servs. Task Force, https://www.uspreventiveservicestaskforce.org/uspstf/about-uspstf [https://perma.cc/AY46-864E].

8 Complaint at 13, Braidwood Mgmt., 666 F. Supp. 3d 613 (No. 4:20-cv-00283-O), ECF No. 1.

9 See Braidwood Mgmt., 627 F. Supp. 3d at 652.

10 See id. at 632.

11 Affordable Care Act, 42 U.S.C. § 300gg-13(a) (requiring coverage, without cost-sharing requirements, of all “evidence-based items or services that have in effect a rating of ‘A’ or ‘B’ in the current recommendations of the United States Preventive Services Task Force”).

12 See First Amended Complaint at 13-18, 25, Braidwood Mgmt., 666 F. Supp. 3d 613 (No. 4:20-cv-00283-O), ECF No. 14.

13 Braidwood Mgmt., 627 F. Supp. 3d at 645-46.

14 Braidwood Mgmt., 666 F. Supp. 3d at 633.

15 42 U.S.C. § 299b-4(a)(1).

16 Id.

17 U.S. Preventive Services Task Force, Agency for Healthcare Rsch. & Quality (June 2021), https://www.ahrq.gov/cpi/about/otherwebsites/uspstf/index.html [https://perma.cc/7HWU-LF8H].

18 42 U.S.C. § 299b-4(a).

19 See U.S. Preventive Services Task Force, supra note 17; see also United States Preventive Services Task Force, JAMA Network, https://jamanetwork.com/collections/44068/united-states-preventive-services-task-force [https://perma.cc/VK2C-JBGX].

20 See Gregory Curfman & Kirsten Bibbins-Domingo, US Preventive Services Task Force Challenged in Federal Court, 329 JAMA 1743, 1743 (2023).

21 See id.

22 Patient Protection and Affordable Care Act, Pub. L. No. 111-148, § 2713, 124 Stat. 131 (2010) (codified as amended at 42 U.S.C. § 300gg-13).

23 42 U.S.C. § 300gg-13.

24 See id. § 300gg-13(a).

25 Id.

26 See Patient Protection and Affordable Care Act, Pub. L. No. 111-148, § 2713, 124 Stat. 131 (2010) (codified as amended at 42 U.S.C. § 300gg-13).

27 Id.

28 AHRQ’s Support of the USPSTF, U.S. Preventive Servs. Task Force, https://www.uspreventiveservicestaskforce.org/uspstf/about-uspstf/task-force-resources/ahrqs-support-uspstf [https://perma.cc/8QKR-LEH2] (last updated February 2021).

29 Patient Protection and Affordable Care Act, Pub. L. No. 111-148, § 4003(a)(6), 124 Stat. 541 (2010) (codified as amended at 42 U.S.C. § 299b-4).

30 42 U.S.C. § 299b-4(a)(6).

31 Our Members, U.S. Preventive Servs. Task Force, https://www.uspreventiveservicestaskforce.org/uspstf/about-uspstf/current-members [https://perma.cc/3DQ6-RPMJ].

32 See 42 U.S.C. § 300gg.

33 Grade Definitions, U.S. Preventive Servs. Task Force, https://www.uspreventiveservicestaskforce.org/uspstf/about-uspstf/methods-and-processes/grade-definitions [https://perma.cc/Y36R-QB94] (last updated June 2018).

34 Id.

35 Id.

36 Id.

37 Id.

38 USPSTF: An Overview, U.S. Preventive Servs. Task Force, https://www.uspreventiveservicestaskforce.org/uspstf/about-uspstf/task-force-resources/uspstf-overview [https://perma.cc/9SVD-5CWT] (last updated Apr. 2021).

39 Affordable Care Act, 42 U.S.C. § 299b-4(a)(2)(F).

40 See id. § 300gg-13(a).

41 About PTAB, U.S. Patent & Trademark Off., https://www.uspto.gov/patents/ptab/about-ptab [https://perma.cc/85NN-6PBP].

42 Id.

43 See discussion infra Section I.A.

44 U.S. Const. art. I, § 2, cl. 2.

45 Id. art. I, § 2.

46 See Braidwood Mgmt., 627 F. Supp. 3d at 639.

47 Id.

48 U.S. Const. art. I, § 2, cl. 2.

49 Officers of the United States Within the Meaning of the Appointments Clause, 31 Op. O.L.C. 73, 73 (2007) [hereinafter Meaning of the Appointments Clause].

50 Id.

51 Lucia v. SEC, 585 U.S. 237, 241-45 (2018).

52 Meaning of the Appointments Clause, supra note 49, at 77.

53 See About the USPSTF, supra note 7.

54 Meaning of the Appointments Clause, supra note 49, at 115.

55 Id. at 74-75.

56 See Our Members, supra note 31.

57 Procedure Manual Section 1. Overview of U.S. Preventive Services Task Force Structure and Proces, U.S. Preventive Servs. Task Force, https://www.uspreventiveservicestaskforce.org/uspstf/about-uspstf/methods-and-processes/procedure-manual/procedure-manual-section-1 [https://perma.cc/DH2G-E2MW]; Meaning of the Appointments Clause, supra note 49, at 77.

58 Meaning of the Appointments Clause, supra note 49, at 77.

59 Id. at 78.

60 USPSTF: An Overview, U.S. Preventive Servs. Task Force (2021), https://www.uspreventiveservicestaskforce.org/uspstf/sites/default/files/inline-files/uspstf-overview-fact-sheet-2021.pdf [https://perma.cc/5BFE-2XLV].

61 Brian Schilling, Hitting the Copay Sweet Spot, The Commonwealth Fund, www.commonwealthfund.org/publications/newsletter-article/hitting-copay-sweet-spot [https://perma.cc/H8MZ-7TXZ].

62 Affordable Care Act, 42 U.S.C. § 300gg-13.

63 Opening Brief for the Federal Defendants at 14, Braidwood Mgmt. Inc. v. Becerra, No. 23-10326 (5th Cir. June 20, 2023).

64 See U.S. Const. art. I, § 2, cl. 2.

65 Federal Defendants’ Response and Reply Brief at 17, Braidwood Mgmt., No. 23-10326 (5th Cir. Sept. 29, 2023).

66 Id. at 25-28, 49.

67 Id. at 26.

68 See Memorandum Opinion & Order at 23, Braidwood Mgmt. Inc. v. Becerra, 627 F. Supp. 3d 624 (N.D. Tex. 2022) (No. 4:20-cv-00283-O).

69 Braidwood Mgmt., 627 F. Supp. 3d at 641, 645-48.

70 Federal Defendants’ Response and Reply Brief, supra note 65, at 2, 25.

71 Brief of Appellees/Cross-Appellants Braidwood Management Inc., et al. at 17, Braidwood Mgmt., No. 23-10326 (5th Cir. Aug. 7, 2023).

72 Id. at 20-23.

73 Affordable Care Act, 42 U.S.C. § 300gg-13(b).

74 Braidwood Mgmt., 627 F. Supp. 3d at 646 (alteration in original).

75 Id.

76 Id. at 644.

77 Id. at 641 (citing Consumer Fin. Prot. Bureau v. Gordon, 819 F. 3d 1191 (9th Cir. 2016)).

78 U.S. Const. art. I, § 2, cl. 2.; 42 U.S.C. § 202.

79 Constitutional Avoidance, Legal Info. Inst., https://www.law.cornell.edu/wex/constitutional_avoidance [https://perma.cc/5DRS-YUWX] (last updated Aug. 2022).

80 Ashwander v. Tenn. Valley Auth., 297 U.S. 288, 347 (1936) (Brandeis, J., concurring).

81 Id.

82 Patient Protection and Affordable Care Act, Pub. L. No. 111-148, § 4003, 124 Stat. 543 (2010) (codified as amended 42 U.S.C. § 299b-4).

83 Healthcare Research and Quality Act of 1999, Pub. L. No. 106-129, § 915, 113 Stat. 1659-60 (codified as amended at 42 U.S.C. § 299b-4).

84 See id.

85 Federal Advisory Committee Act, Pub. L. No. 92-463, § 5(b)(3), 86 Stat. 771 (1972).

86 Public Health Service Act, H.R. 5961, 117th Cong. (2022).

87 E.g., Patient Protection and Affordable Care Act, Pub. L. No. 111-148, § 4003(a)(6), 124 Stat. 543 (2010) (codified as amended 42 U.S.C. § 299b-4(a)(6)).

88 Brief of Appellees/Cross-Appellants Braidwood Management Inc., et al., supra note 71, at 6-7.

89 Affordable Care Act, 42 U.S.C. § 299b-4(a)(6).

90 See discussion supra Section I.B.

91 42 U.S.C. § 299b-4(a)(6).

92 Id.

93 United States v. Bonilla-Romero, 984 F.3d 414, 418 (5th Cir. 2020) (citing Seila Law LLC v. Consumer Fin. Prot. Bureau, 140 S. Ct. 2183, 2209 (2020)).

94 United States v. Arthrex, Inc., 141 S. Ct. 1970 (2021).

95 About PTAB, supra note 41.

96 Arthrex, Inc., 141 S. Ct. at 1978.

97 Id. at 1986-87.

98 Leahy-Smith America Invents Act, Pub. L. No. 112–29, §7, 125 Stat. 313 (2011) (codified as amended at 35 U.S.C. § 6).

99 35 U.S.C. § 6(c).

100 Arthrex, Inc., 141 S. Ct. at 1987.

101 H.R. 5961.

102 Id. at § 299b-4(a)(6).

103 See United States ex rel. Accardi v. Shaughnessy, 347 U.S. 260, 266-67 (1954) (Board of Immigration Appeals); Snead v. Barnhart, 360 F.3d 834, 838 (8th Cir. 2004) (Social Security Administrative Law Judges).

104 Memorandum Opinion & Order, supra note 68, at 23 (quoting Little Sisters of the Poor Saints Peter & Paul Home v. Pennsylvania, 140 S. Ct. 2367, 2380 (2020)).

105 Id. at 23-24.

106 Braidwood Mgmt. v. Becerra, 104 F.4th 930 (5th Cir. 2024).