WASHINGTON: The Supreme Court seemed likely to uphold a key preventive-care provision of the Affordable Care Act in a case heard Monday.
Conservative justices Brett Kavanaugh and Amy Coney Barrett, along with the court’s three liberals, appeared skeptical of arguments that Obamacare’s process for deciding which services must be fully covered by private insurance is unconstitutional.
The case could have big ramifications for the law’s preventive care coverage requirements for an estimated 150 million Americans. Medications and services that could be affected include statins to prevent heart disease, lung cancer screenings, HIV-prevention drugs and medication to lower the chance of breast cancer for high-risk women.
The plaintiffs argued that requirements to cover those medications and services are unconstitutional because a volunteer board of medical experts that recommended them should have been Senate- approved. The challengers have also raised religious and procedural objections to some requirements.
The Trump administration defended the mandate before the court, though President Donald Trump has been a critic of the law. The Justice Department said board members don’t need Senate approval because they can be removed by the health and human services secretary.
A majority of the justices seemed inclined to side with the government. Kavanaugh said he didn’t see indications in the law that the board was designed to have the kind of independent power that would require Senate approval, and Barrett questioned the plaintiff’s apparently “maximalist” interpretation of the board’s role.
“We don’t just go around creating independent agencies. More often, we destroy independent agencies,” said Justice Elena Kagan said about the court’s prior opinions.
Justices Samuel Alito and Clarence Thomas seemed likely to side with the plaintiffs. And some suggested they could send the case back to the conservative US 5th Circuit Court of Appeals. That would likely leave unanswered questions about which medications and services remain covered.
A ruling is expected by the end of June.
The case came before the Supreme Court after the appeals court struck down some preventive care coverage requirements. It sided with Christian employers and Texas residents who argued they can’t be forced to provide full insurance coverage for things like medication to prevent HIV and some cancer screenings.
They were represented by well-known conservative attorney Jonathan Mitchell, who represented Trump before the high court in a dispute about whether he could appear on the 2024 ballot.
Not all preventive care was threatened by the ruling. A 2023 analysis prepared by the nonprofit KFF found that some screenings, including mammography and cervical cancer screening, would still be covered without out-of-pocket costs.
The appeals court found that coverage requirements were unconstitutional because they came from a body — the United States Preventive Services Task Force — whose members were not nominated by the president and confirmed by the Senate.

SAN SALVADOR: A delegation of Democratic lawmakers arrived in El Salvador on Monday in a new push to secure the release of a wrongly deported US resident at the center of a mounting political row.
Kilmar Abrego Garcia was sent back to his country and remains imprisoned despite the Supreme Court ordering the administration of President Donald Trump to facilitate the man’s return to the United States.
“I’m in El Salvador to shine a light on Kilmar’s story and keep the pressure on Donald Trump to secure his safe return home,” congresswoman Yassamin Ansari of Arizona said on social media.
“We want to make sure that Kilmar is still alive. We want to make sure that he has access to counsel,” added Ansari, who was accompanied by fellow US House Democrats Robert Garcia, Maxwell Frost and Maxine Dexter.
“Trump is illegally arresting, jailing, and deporting people with no due process,” Frost wrote on X.
“We must hold the Administration accountable for these illegal acts and demand Kilmar’s release. Today it’s him, tomorrow it could be anyone else,” the Florida representative added.
The visit comes days after Democratic Senator Chris Van Hollen managed to meet with Abrego Garcia, though only after a considerable effort.
Van Hollen, who represents Maryland where Abrego Garcia and his family have lived for years, accused the Central American nation of staging a photo of him supposedly sipping margaritas with Abrego Garcia.
Trump’s administration has paid El Salvador President Nayib Bukele millions of dollars to lock up nearly 300 migrants it says are criminals and gang members — including Abrego Garcia.
The 29-year-old was detained in Maryland last month and expelled to El Salvador along with 238 Venezuelans and 22 fellow Salvadorans who were deported shortly after Trump invoked a rarely used wartime authority.
The Trump administration admitted that Abrego Garcia was deported due to an “administrative error,” and the Supreme Court ruled that the government must “facilitate” his return.
But Trump has since doubled down, insisting Abrego Garcia is in fact a gang member.
Bukele, who was hosted at the White House last week, said he did not have the power to return Abrego Garcia.
The migrant’s supporters note he had protected legal status and no criminal conviction in the United States.
“My parents fled an authoritarian regime in Iran where people were ‘disappeared’ — I refuse to sit back and watch it happen here,” Ansari said in a statement.
“What happened to Kilmar Abrego Garcia is not just one family’s nightmare — it is a constitutional crisis that should outrage every single one of us,” said Dexter, a congresswoman from Oregon.
Abrego Garcia told Van Hollen that he was initially imprisoned at the Terrorism Confinement Center, a mega-prison for gang members, but was later transferred to a jail in the western department of Santa Ana.