Tornado Alley (PROG)

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Supreme Court preserves Obamacare coverage of preventive health care

"... Trump: ‘I Need the Kind of Generals That Hitler Had’
[...]In April 2020, Vanessa Guillén, a 20-year-old Army private, was bludgeoned to death by a fellow soldier at Fort Hood, in Texas. The killer, aided by his girlfriend, burned Guillén’s body. Guillén’s remains were discovered two months later, buried in a riverbank near the base, after a massive search.
[...]Trump became angry. “It doesn’t cost 60,000 bucks to bury a fucking Mexican!” He turned to his chief of staff, Mark Meadows, and issued an order: “Don’t pay it!” Later that day, he was still agitated. “Can you believe it?” he said, according to a witness. “Fucking people, trying to rip me off.”
[...]The personal qualities displayed by Trump in his reaction to the cost of the Guillén funeral—contempt, rage, parsimony, racism—hardly surprised his inner circle. Trump has frequently voiced his disdain for those who serve in the military and for their devotion to duty, honor, and sacrifice. Former generals who have worked for Trump say that the sole military virtue he prizes is obedience. As his presidency drew to a close, and in the years since, he has become more and more interested in the advantages of dictatorship, and the absolute control over the military that he believes it would deliver. “I need the kind of generals that Hitler had,” Trump said in a private conversation in the White House, according to two people who heard him say this. “People who were totally loyal to him, that follow orders.” (“This is absolutely false,” Pfeiffer wrote in an email. “President Trump never said this.”)
P - A desire to force U.S. military leaders to be obedient to him and not the Constitution is one of the constant themes of Trump’s military-related discourse. Former officials have also cited other recurring themes: his denigration of military service, his ignorance of the provisions of the Uniform Code of Military Justice, his admiration for brutality and anti-democratic norms of behavior, and his contempt for wounded veterans and for soldiers who fell in battle.
[...]Trump has responded incredulously when told that American military personnel swear an oath to the Constitution, not to the president. According to the New York Times reporter Michael S. Schmidt’s recent book, Donald Trump v. the United States, Trump asked Kelly, “Do you really believe you’re not loyal to me?” Kelly answered, “I’m certainly part of the administration, but my ultimate loyalty is to the rule of law.” Trump also publicly floated the idea of “termination of all rules, regulations, and articles, even those found in the Constitution,” as part of the effort to overturn the 2020 presidential election and keep himself in power.
[...]In my story, I reported that Milley said, “Mr. President, you have to understand that the SEALs are a tribe within a larger tribe, the Navy. And it’s up to them to figure out what to do with Gallagher. You don’t want to intervene. This is up to the tribe. They have their own rules that they follow.”
Trump called Gallagher a hero and said he didn’t understand why he was being punished.
“Because he slit the throat of a wounded prisoner,” Milley said.
“The guy was going to die anyway,” Trump said.
Milley answered, “Mr. President, we have military ethics and laws about what happens in battle. We can’t do that kind of thing. It’s a war crime.” Trump said he didn’t understand “the big deal.” He went on, “You guys”—meaning combat soldiers—“are all just killers. What’s the difference?”"

It’s the fourth time in the past 13 years that the high court has rejected major challenges to the 2010 health law.

By Alice Miranda Ollstein, Josh Gerstein and Lauren Gardner
06/27/2025, 10:52am ET

The Supreme Court has preserved the provision of the Affordable Care Act that requires insurance companies to cover preventive health services like colonoscopies and HIV prevention drugs at no cost to patients.

It’s the fourth time in the past 13 years that the high court has rejected major challenges to the 2010 health law. This time around, the vote was 6-3, with Justice Brett Kavanaugh writing the majority opinion for a cross-ideological majority. Three of the court’s conservatives dissented.

The case centered on a panel of experts known as the U.S. Preventive Services Task Force. The Affordable Care Act authorized the task force to specify health screenings and other preventive services that insurers must cover without charging patients copayments, deductibles or other cost-sharing. Tens of millions of Americans rely on those services, including cancer screenings, heart disease medications and the drug, known as PrEP, that prevents the transmission of HIV.

Opponents of the ACA who object to the HIV drug argued that the task force — which is chosen by the secretary of Health and Human Services — was unconstitutionally appointed. The task force members, the opponents argued, wield so much power that they amount to “principal officers” under the Constitution’s appointments clause and must be appointed by the president and confirmed by the Senate.

The Supreme Court rejected that argument, reasoning that the members are not principal officers because the health secretary can ignore their recommendations, fire them and replace them.

“Task Force members issue preventive-services recommendations of critical importance to patients, doctors, insurers, employers, healthcare organizations, and the American people more broadly. In doing so, however, the Task Force members remain subject to the Secretary of HHS’s supervision and direction, and the Secretary remains subject to the President’s supervision and direction,” Kavanaugh wrote for the majority. “The structure of the Task Force and the manner of appointing its officers preserve the chain of political accountability that was central to the Framers’ design of the Appointments Clause.”

Justices Clarence Thomas, Samuel Alito and Neil Gorsuch dissented.

The Trump administration surprised many when it revealed earlier this year that it would continue the Biden administration’s defense of the Obamacare provision. But it shifted the focus of the federal government’s legal argument. The Biden Justice Department had argued in lower courts that free preventive care was crucial for the health of millions of American patients. The Trump DOJ, on the other hand, focused during oral arguments before the Supreme Court in April on preserving executive power and fending off judicial and legislative encroachments.

Health policy experts and patient advocates who expressed relief that the Trump administration opted to defend Obamacare remain concerned that HHS Secretary Robert F. Kennedy Jr. and other officials will now deploy that power to reshape what services must be covered by insurance without copays.

“They really pointed out how much authority they think their Secretary wields, which is kind of foreboding given who the Secretary is and his ideas about science and health,” said Andrew Twinamatsiko, the director of the Health Policy and the Law Initiative at Georgetown University’s O’Neill Institute. “Somebody could be fairly concerned that there could be weaponization of the task force.”

And, while this case focused solely on the U.S. Preventive Services Task Force, the decision could also empower Kennedy to overhaul other advisory panels at HHS.

https://www.politico.com/live-updates/2025/06/27/supreme-court-rulings-decisions-today-news-analysis/obamacare-preventive-health-coverage-00427992